A quest for standardization — How strategic partnerships can help hospitals achieve systemness

The inability for hospitals and health systems to operate as a cohesive unit can cost organizations valuable resources and may ultimately jeopardize patient care.

This content is sponsored by Medline

During a roundtable discussion at Becker's Hospital Review 8th Annual Meeting on April 18 in Chicago, Sue MacInnes, Medline's chief market solutions officer, defined systemness as the ability to provide a consistent experience for patients across the continuum regardless of the care setting. Ms. MacInnes delved into why systemness is crucial in the rapidly evolving healthcare landscape and why strategic partnerships can help hospitals succeed.

Are hospitals achieving systemness?
Throughout the nation, hospitals and health systems of varying sizes in different markets may fall across the board in terms of achieving systemness. However, the roundtable attendees concurred providing a consistent patient experience will be of paramount importance moving forward.

"To me, systemness means working with one another to provide standardization while promoting diversity and coming up with great solutions," said the CEO of a nonprofit, Midwestern community-owned hospital. The executive said her hospital was "very far" in achieving systemness. The hospital created physician-run consensus groups that collaborated on standardizing processes and protocols with technological tools.

While some hospital executives expressed similar trajectories regarding their progress, others fell more in the middle. The president of a Midwestern 254-bed tertiary care facility said the center is midway through the process and is making headway through its Epic HIT platform.

"This has been foundational for us to drive our clinical agenda," she noted. "The platform has been beneficial to have integration with the ultimate goal to furnish resources for population health initiatives."

Forming strategic partnerships
Medline conducted a survey of healthcare executives to uncover drivers behind organizations' decisions to achieve systemness.

•    54 percent of those polled ranked achieving systemness as a top priority with 84 percent citing reducing costs as their primary reason for seeking systemness.
•    73 percent wanted to gain better insights to manage population health and 67 percent aimed to improve patient satisfaction.
•    32 percent of executives said aligning incentives within an organization would expedite their systemness journey.

The survey results helped Medline assess how it could become a better strategic partner and provide resources that coincided with leaders' goals.

Ms. MacInnes highlighted two of Medline's strategic partnerships and the progress the parties made in achieving their goals.  

Riverside Healthcare
Medline teamed up with Kankakee, Ill.-based Riverside Medical Center to learn how the organizations could combine their skill-sets to reach a common goal. After conducting several meetings, an executive with Riverside Healthcare said the health system could lower costs and improve care if they created standardization in protocols, products and education to staff members on wound and skin care treatment throughout their continuum. An analysis found the health system was using 113 different products yet only 10 products were being used consistently throughout their continuum

"We made the assumption that there was standardization and clinical integration," the executive said. "It was eye opening to see the variation in product, education and training. Looking at it from a patient perspective, I can't imagine how confusing it must have been."

After the initial assessment, Riverside standardized its wound and skin care products. The health system polled their employees and found staff and physicians wanted more educational tools to achieve standardization.

"Nurses throughout our organizations are hearing about standardization and asking for those products in their unit," the executive added.

Riverside is now seeing the benefits of this project with both improved quality metrics and financial performance.

Dignity Health
Phoenix-based Dignity Health and Medline partnered on an entire surgical site infection-reduction initiative that was rolled out by every one of Dignity Health's surgical units.  Focusing on surgical site infections represented a significant opportunity for Dignity Health to demonstrate the financial and clinical impacts of systemness as well as the impact to the patient experience.

"We found there was so much variation. The hospitals have very culturally diverse populations, varying resources and geographic differences" Ms. MacInnes said. "We aimed to change the hospitals' protocols to the same practice and measure their progress."

Medline and Dignity developed products for pre- and post-surgery patients from the participating hospitals to reduce clinical variation. These products included information about SSIs, a step-by-step guide on how to prepare for surgery and symptoms of SSIs. Educating patient and designing the solution to represent the health system's brand promise is key to systemness as healthcare trends toward consumerism and the patient becomes the primary advocate for their care.
Next steps for achieving systemness: Risk-sharing contracts
In a strategic partnership, all parties should work in tandem to provide the consistent patient experience. Moving forward into value-based care, a strategic partnership may likely entail suppliers taking on a larger portion of risk. Medline is forming risk-sharing contracts with its clients to ensure they are both committed to the same goals.

A risk-based contract focuses on improving one metric such as reducing a provider's central line-associated bloodstream infections occurrences. The supplier and health system would work together to meet or exceed a certain benchmark. The supplier would pay the provider if that goal was not achieved, aligning incentives of both the provider and the supplier.

"The idea is that if you do X or Y, we can agree to reduce the number of CLABSIs or another metric by a set percent," Ms. MacInnes said. "We would pay a provider based on the agreed upon amount because we both have skin in the game. Our overall focus is to have innovative technologies and solutions that reduce variation and promote best practices."

As healthcare segues into a value-based reimbursement model, strategic alignment will become more important for leaders spanning the field. Suppliers and hospitals alike should prioritize patient outcomes and devise solutions to combat issues that may impede optimal care.

"We see value in suppliers wanting to know clinically what is important to us and aligning ongoing business support in that way," said an executive director of strategic sourcing at a Midwestern 805-bed academic medical institution. "If you are supporting us to reduce whichever metric, we feel you are committed to helping us and it is a positive thing."

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