6 Tips to Improve Quality Measures

Reimbursement in the future will rely more heavily on quality measures than it does now, which means hospital administrators will have to rethink efficiencies and methodology for improving patient outcomes. This requires a culture change within the hospital, often including further collaborations with physicians and hospital staff. Here are six considerations for hospitals in transition.

1. Think of physicians as collaborators. Instead of considering physicians customers, hospital administrators should consider them business collaborators, says C.J. Bolster, national director of the healthcare practice at Hay Group. Physicians, especially those that are hospital employees, should be included in the discussions about administrative policy changes and goals for the future. "The processes to deliver the care are so complex that you need the engagement of the physicians to be highly successful," he says. Including the physicians in the decision-making process means the planning sessions could take longer. However, once the decisions are made, it will take less time to fully implement them because there is awareness and agreement on the measures.

2. Be transparent about hospital costs. If physicians are going to collaborate in leadership roles, hospital costs should be transparent to them, which mean providing physicians with monthly financial reports. Transparency is important to gain the physician's trust, but also to make sure the physicians have all the information they need as they begin to make more decisions, says Richard Bankowitz, MD, enterprise-wide chief medical officer for Premier healthcare alliance. "The clinicians know best how to go about setting up systems for consistently delivering evidence-based care and avoiding unnecessary readmissions," he says.

3. Provide physician assessments against other hospital physicians.
In addition to discussing the best methods for the standardized processes, the information technology system in the hospital should be able to provide statistical data on each physician, says Peter Szekrenyi, PhD, senior vice president of the healthcare industry at Business Intelligence. The anonymous reports tell physicians who is succeeding and who trails behind the others. Physicians who need to change their processes can activate pop-up screen reminders though the hospital's IT system.

"Each physician needs a profile to see how he or she is performing against the standards," says Mr. Szekrenyi. "It isn't that the outlier physician has bad outcomes, but the physician needs to be as good as his or her colleagues. When the government is looking at these reports, outliers might not get paid as well."

4. Provide incentives for better outcomes. Hospitals can reward top performing physicians through higher compensation, faster career advancement and allocating them additional resources, says Mr. Bolster. Hospital administrators can also incentivize hospital staff to perform along higher quality measures in the same way they incentivize physicians. Providing the entire team with an incentive to improve quality outcomes is another stepping stone in creating the environmental change necessary to succeed under pay-for-performance measures.

5. Use stories to motivate hospital staff for change. When introducing new quality measures, Peggy Naas, MD, vice president of physician strategies at VHA, suggests hospital administrators use stories about how the quality measures improve the patient's health and experience at the hospital. These stories will personalize the outcome changes and motivate the staff more than saying, "The federal government is forcing us to make this change."

Another method for personalizing the investment in quality measures is to begin by asking employees to imagine the type of care they would want delivered to their family and loved ones, says Hilton Raethel, who oversees the HMSA's provider services department, health services delivery division and Integrate Services, Inc.

6. Educate physicians and staff in intervals.
When hospitals are making transitions, like incorporating processes based more heavily on pay-for-performance or implementing electronic medical records, physicians will need additional education and training. Jane Metzger, principle of emerging practices at CSC Healthcare Group, suggests hospitals provide educational sessions in intervals as opposed to long education sessions. She says physicians do better when there is a little training and then personnel available to assist them when they start using the new systems. "It's too much change to be sure you're getting all the details right," says Ms. Metzger.

Read more coverage on pay-for-performance:

- 5 Ways to Make the Pay-for-Performance Transition Smoother

- Pay-for-Performance Improves Radiology Turnaround Times

- Study Finds Financial Incentives and Public Reporting Improve Quality of Care

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