The shift from volume-to-value: An opportunity to drive clinical workforce improvement

It is highly unlikely any healthcare professional is unaware of the ongoing shift from volume- to value-based care delivery models. However, what might be less apparent are the primary factors driving that change, and the stakeholders that will be impacted by it in critical ways.

In an April 26 Cornerstone OnDemand webinar, Debra Mathias and Shanti Wilson, healthcare management consultants with Freed Associates, detailed how to anticipate the effects the volume-to-value shift will have on the clinical workforce, and which "must-have" strategies will help smooth the transition.

The market forces driving the transition from volume- to value-based care can be primarily attributed to aging demographics and increasing costs. The demographics that utilize healthcare services the most are growing everyday, and living longer, which is increasingly making the fee-for-service model unsustainable and resulting in increased waste.

Understanding the impact of a changing healthcare delivery model on the clinical workforce, and therefore organizations overall, is an even more complex issue. Cornerstone OnDemand for Healthcare provides a comprehensive suite of talent management solutions for the successful recruitment, development and engagement of staff throughout healthcare organizations — and helps prepare clinical teams for the impacts of the volume to-value shift.

Opportunities for positive impacts on the workforce

"Many commercial insurers have stated intentions to have at least 75 percent of their business linked to quality by 2020," Mrs. Wilson says. "Regardless of where your workforce sits, they will be impacted by this shift."

But the effects don't have to be negative. The shift to value also provides a number of opportunities, such as the possibility of moving to a more team-base care model, in which all care providers are working to support patients at the top of their license — thereby increasing efficiency while also delivering a better overall patient experience.

Coordinating care across the continuum is critical to meet value-based goals, and the implementation of such a model gives the hospital workforce the opportunity to better support patients as they transition beyond the hospital walls to various post-acute care providers. Technology also comes into play to support the expanding care continuum, as hospitals are increasingly adopting strategies that reflect the realization that health happens outside of hospitals. Access to healthcare is a major talking point for hospitals and health systems, and a value-based model dovetails neatly with offering patients better, more flexible options for care, from in-person to virtual visits facilitated by telehealth. Additionally, these digital tools enable the clinical staff to assess the social determinants of a patient's health to better inform the care plan. 

Assessing the clinical workforce you have

Many clinical leaders focus on assessing outcomes against benchmarks included in upcoming quality programs, such as the merit-based incentive program, but preparing the workforce is equally, if not more important.

Cornerstone OnDemand's Observation Checklist allows for increased transparency around employee activity and helps organizations standardize competencies that are tied to quality. Thoroughly evaluating clinical staff skills at bedside and throughout the organization makes it much easier to know where changes need to be made. Tools like the Observation Checklist have helped organizations such as Carilion Clinic in Roanoke, Va., Penn State Hershey Medical Center and Orlando (Fla.) Health not only brace for the volume-to-value shift, but to capitalize on it as a driver of positive change within the organization.

The information derived from assessments like the Obersvation Checklist helps leaders answer questions like: Has the organization reduced duplicative processes that result in waste? Do we have the soft skills necessary among our workforce to collaborate with other clinical team in the care continuum? Or, do we need a different staffing model?

Preparing the clinical workforce for what's to come

To effectively adapt to these new care delivery models, it is important to adequately prepare the clinical staff for the changes to come, and to give them the support needed to excel. 

Having leadership support at the top and a strong governance structure to address barriers as they arise is key to a successful transition.

Another critical success factor is engagement and support among clinicians. Systemwide changes designed to support value-based care will likely create marked change, both in the clinical workflow and culture. To foster engagement, identify a physician champion who can act as an evangelist throughout the organization and garner buy-in from the workforce. The same goes for patient buy-in; make all of the workflow changes supportive of an improved patient experience in some way.

To properly measure the impact of value-based programs, organizations need quality technical infrastructure. Developing actionable internal analytics will help identify opportunities for improvement, from meeting costs to improving the patient experience.

"Most importantly, try to have fun," Ms. Wilson says. "This shift is a change, and change is always hard. But celebrate this milestone that your organization has achieved, which presents a lot of opportunities to learn about your own workforce and set it up for success."

To download the webinar, click here.

To view the webinar on YouTube, click here.

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