Integrating Clinical and Cultural Data: A New Frontier for Performance Improvement

Healthcare organizations have long used clinical data to help gauge patient safety, analyzing key information such as infection rates, mortality rates, and adverse event data.

When organizations look at the drivers behind these and other clinical outcomes, they tend to focus on processes, protocols, and resources. Do we follow infection prevention measures? Do we have processes to confirm the correct surgical site? Do we offer the appropriate training and have the right workforce in place? Although these factors can influence outcomes, a work setting’s culture can also play a significant role—and until recently, this has been largely overlooked.

In general, culture measurement is not well understood, and healthcare organizations often hold outdated views about its usefulness. However, with well-designed culture surveys, we can capture the perspectives of people providing care, gaining insights into their perceptions and experiences and how those might impact clinical and operational performance, as well as the patient experience. Sophisticated culture surveys explore how well teams communicate, how burned out they are, whether they feel safe speaking up about problems and how supported they feel by local leaders, as well as senior management. Granular data from these surveys allow us to see how different departments and job titles compare to one another. This detail ensures we have more than a general sense of an entity’s culture but a true appreciation of what’s happening at the individual, departmental, and organizational level.

Integrating Diverse Data Provides Even Greater Insights

Viewing clinical, cultural, and patient experience data separately is powerful, but when we integrate the data, we can uncover correlations between work environments and clinical outcomes and patient experiences in the same areas. This provides a more holistic picture of performance and can help focus improvement work on the most impactful interventions.

Consider hospital-acquired infections, for example. This is an area where there are robust, evidence-based protocols that can reduce infections when used consistently. However, if we look at the variation across a health system that uses these protocols, and we notice that certain units have significantly higher infection rates than others, we can use culture data to probe into why that’s happening. What are the levels of burnout? How are teams communicating? Do people feel safe raising concerns? By looking at correlations between cultural and clinical data, we can shift the conversation so that the organization considers cultural dynamics when designing interventions. They can weave in proven techniques that create effective huddles, leader rounding, and visual management to improve communication, reduce burnout, and build trust.

Why Doesn’t Everyone Use Integrated Data?

Integrating cultural and clinical data is a relatively new idea, and there are challenges with the work. Currently, the data is stored in separate systems, and it takes time and effort for analysts to pull data and map it appropriately to allow for clear analyses. In addition, there can be variability in the quality, organization, and comprehensiveness of the respective data sets, further hampering clean comparisons. It remains though limited without meaningful external benchmarking.

Also, correlations are not necessarily linear—a cultural issue doesn’t directly cause a clinical event. However, by connecting the dots between culture and performance, we gain new insights into the role culture plays. For example, there is a correlation between higher levels of team burnout and higher levels of patient mortality. Designing interventions to reduce burnout could help decrease mortality rates and build team resilience at the same time—something that could ultimately improve other clinical and patient experience metrics as well.

We’re Just Starting to Tap into the Potential

Integrating and interpreting clinical, operational, and cultural data involves understanding what the combined information is saying and drawing meaningful connections. It requires deep expertise in various types of data sets to validate patterns and correlations. Our recent acquisition of Safe & Reliable Healthcare accelerates our ability and priority to integrate our clinical, operational, and cultural data to understand the relationships between culture and outcomes. There are exciting and important opportunities ahead and we look forward to sharing these insights through the Vizient Safe and Reliable Healthcare solution. Going forward, we as an industry must continue to evolve our use of integrated insights to help leaders focus improvement work on those drivers that can make the biggest difference in improving safety, quality, and the patient experience.

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