The state of clinical process improvement: 6 report insights

Clinical process improvement is an essential tool for improving financial performance and patient outcomes, according to a new report from LogicStream Health.

The report, titled "The New Healthcare Imperative," captures a June 7 roundtable discussion, sponsored by LogicStream, in which seven healthcare executives discussed the definition, application and challenges of clinical process improvement.

"This report is important and relevant today because excessive variation in care delivery is an ongoing problem generating a tremendous amount of wasteful spending," said Brita Hansen, MD, CMO at LogicStream Health. "Provider organizations are facing unprecedented cost pressure while patients and payers are demanding greater value for their healthcare dollars. Continued focus on process improvement in the clinical space is the disruption healthcare needs."

Here are six insights from the report:

1. While different definitions of CPI exist, the report cites the following key characteristics of the discipline:

  • It is a process that produces outcomes, which drives value
  • It is a continuous process
  • It involves culture and technology
  • It is constantly evolving
  • It involves reducing variation

2. The healthcare executives used different terminologies for CPI based on how they apply the process at their own organizations. For example, Joanne Roberts, MD, chief value officer at Providence St. Joseph Health, said her team uses the term "clinical value improvement" to emphasize the focus on value. "Process implies there is an ending; this work remains ongoing," she said.

3. Leaders said they were using CPI in the following areas:

  • Value-based purchasing and regulatory initiatives
  • In-depth review of specific areas of outlying performance
  • Review of top 20 admitting patient conditions
  • Financial performance
  • Patient flow and capacity issues
  • Continuous learning initiatives
  • Foundational cultural changes
  • Patient and provider satisfaction

4. Executives highlighted several challenges of CPI, including market variability, changing delivery platforms, limited resources and financial constraints.

5. The leaders agreed CPI decisions require real-time actionable insights from EMR data.

"You can't do process improvement without data. You need data to find out where the areas of opportunity are," said Nicholas Desai, MD, chief medical information officer at Houston Methodist Hospital System. "Most of the time we are not even sure what to ask for — we don't even have a good reference of where to start."

6. A culture of constant improvement and staff awareness is a crucial component of CPI, according to the executives.

"We talk about performance improvement as a continuous effort. Our goal is to be a learning organization," said Beth Heinz, chief quality officer and vice president for quality and performance improvement at Minneapolis-based University of Minnesota Health.

Download the Key Insights from U.S. Healthcare's Leading Clinical Innovators

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