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Clinical Quality Improvement: Five Keys to Success


When you’re sick, hurt or need care for those you love, quality in healthcare is crucial. The topic of “clinical quality improvement” ranges from improved metrics on hospital-wide measurement, to ensuring payment for value-based care, to public ratings used to inform patients of the best possible providers for their medical outcomes.

Regardless of the various components which make up clinical quality care, what's important is how today’s hospitals and health systems can succeed across all components – oftentimes when they’re equipped with limited resources.

What is clinical quality improvement?

By definition, “quality improvement is the framework used to systematically improve the way care is delivered to patients. Processes have characteristics that can be measured, analyzed, improved and controlled.”

This pragmatic approach to quality measurement and improvement speaks to the scientific methodology implemented within programming and in outcomes reporting. The importance of improvement goes far beyond the slope of a patient’s charted progress; it extends to the value of population health and delivery of patient care to the communities served by healthcare organizations.

Today’s successful Quality team needs a comprehensive solution to ensure clinical quality improvement in their hospital. When applying the concept of comprehensive clinical quality improvement, trusted points of view driven by a breadth of data will empower teams to identify the path to meet the goals important to their organization’s specific mission.

When evaluating quality improvement solutions, here are five core capabilities to look for.

1. Trusted, Timely Data

The foundation of successful clinical quality improvement is informing all programming with a single source for the full range of data that’s needed to complete regulatory reporting, track quality ratings programs, improve outcomes and manage clinician performance.

Hospital quality has long been presented with the need to identify performance gaps based on historical or nationally benchmarked data but needs more to produce the understanding of true comparators and improve the factors affecting patient outcomes.

It takes data and collaboration to make real and timely change. For example, PINC AI’s QUEST® collaborative program proves that when trusted data is used and healthcare organizations come together to share best practices, outcomes improve. Premier collaborative members perform 6 percent better in the Centers for Medicare & Medicaid Services (CMS) Hospital Quality Star Ratings (based on February 2019 CMS Star Ratings hospital performance index).

Data that is critical to performance improvement is often siloed across organizations. INsights provides a high-performance environment that analysts can integrate clinical, operational, financial, and outcomes data for more comprehensive analysis. The typical analytics team spends approximately 80 percent of their time gathering and preparing data, leaving only 20 percent for the most critical task: data analysis.

With the right technology and data, healthcare organizations can better manage operational costs, identify real-time solutions, and improve patient experience.

2. Benchmarking Analytics

Actionable, risk-adjusted quality analytics are imperative to benchmark hospital performance against top-performing peers. A successful Quality team understands improvement paths in risk-adjusted clinical outcomes, cost of care, patient safety and resource utilization.

When data flows from a single source and is approached from a multifocal standpoint it can be more powerful and create stronger benchmarks for improvement. For example, by risk adjusting mortality, readmissions, complications, cost and length of stay relative to 40 percent of U.S. inpatient discharges, and then creating top performer benchmarks by outcome and service lines, Premier members see where they need to focus and achieve better outcomes quickly.

Benchmarks that are based on current timeframes are far superior to those that are based on older data. As a facility gets better with a measure, most other facilities are as well. Meaning, if a hospital’s observed data shows improvement but is based on a static benchmark that isn’t changing with performance, it will look like the hospital is performing better, which gives a false security.

Strong analytics capabilities enable service lines to impact standards of care, and risk-adjusted data provided by methodologies like PINC AI’s CareScience™ analytics allow those teams to discover opportunities, create data-driven discussion, and measure and monitor initiatives and metrics strategic to an efficient operation that delivers highly reliable patient experiences.

INsights provides organizations the ability to access a library of measures that combine clinical and outcomes data with peer benchmarks. This answers questions such as, “What was the hemoglobin value at the time of the blood order and for those values how do we compare against our peers?”

3. Interactive Dashboards

It’s clear there’s an overwhelming amount of disparate data in healthcare, but all this data is not optimized until it’s delivered in a way that can be used for real critical thinking and answer questions developed specifically by a Quality team.

A dashboard should be powered by comprehensive data driving actionable results to meet the goals important to the team’s mission. When in the process of transforming into a quality-centric organization, standard reports may be nice, but they’re often not enough.

Premier has a history of enabling like-minded health systems to work together to improve care. With INsights we are ‘crowdsourcing’ analytics and building a community where organizations can share best practices, information, measures, queries and results. This makes it possible to get to accelerate analytics content development. Have a dashboard that is a game changer in your organization? Share it with your peers in the community.

4. Chart Abstracted Measures Reporting

Automation and algorithms dominate conversation within the topic of quality measurement, but refinement is still required for the management of many modern reporting requirements.

Flexibility is important to allow for the population of eligible patients from system data and manual abstraction to satisfy the complex governance within compliance-driven initiatives. For the needs of this specific measurement, it's important to be able to identify those eligible patients and populate system data to ensure compliance.

5. Ratings Tracking

A high priority for any healthcare organization is to ensure that the true value of care is illustrated to outsiders – whether the media, payers or patients. To ensure true visibility into the high quality of care provided, Quality teams must utilize targeted measures to track improvements for major public reporting (e.g., value-based purchasing, CMS Star Ratings, Leapfrog and US News & World Report).

Transparent projections will correctly identify risk and opportunity so Quality teams can take appropriate action to achieve better performance in practice and ratings.

The evolving nature of quality improvement.

Quality improvement isn’t a new concept; it changes daily as the endless stream of data continues to flow through often disparate systems. Actionable analytics are key to informed decision making but are difficult to come by with the carousel of applications and vendors that may be pieced together creating obstacles or inconsistencies.

Today’s hospitals and health systems are making crucial decisions affecting the outcomes and futures of their patients and need comprehensive and trustworthy data to ensure the foundation of the decision-making process.

The mission of clinical teams and the oaths taken may vary slightly but they harmonize consistently to do good by their patients. To accomplish that goal at the scale needed requires more than good intentions.

To connect data with actionable insights, there must be a call for comprehensive knowledge. By selecting the appropriate tools fueled by sound data and analytics, the complication and burdens of quality improvement should dissolve and bridge the gaps to informed decision making.

Ready to take your hospital’s or health system’s quality improvement program to the next level? Check out our Quality Enterprise comprehensive suite of solutions, part of our new PINC AI™ technology and services platform.

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