Tag: process improvement

Enterprise Resource Management Drives Triple Aim Compliance: 5 Keys to Completing the Quest

Guest post by Kate Jester-Brod, vice president of client success, EoScene.

Kate Jester-Brod
Kate Jester-Brod

Since Hurricane Katrina, the healthcare industry has been pushing towards maintaining comprehensive EHRs. The concept of an EHR combined with the concepts of the health information exchange (HIE) creates a means for patients and providers to always have a 30,000-foot view of the patient’s health. Which then begs the question, ‘what about the actual healthcare facilities?’ What does their 30,000-foot view look like? Are facility and staff doing their part to support exceptional and safe patient care?

In the most basic of explanations, enterprise risk covers the overall opinion of others towards your organization. It can affect revenue, staff retention, grant funding, and much more. In the healthcare industry, the enterprise is at risk at many levels. Drug safety, staff and patient safety, clinical outcomes, facilities maintenance, public relations, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores are some but not all of the components of enterprise risk.

Moreover, reducing enterprise risk in any industry includes reducing not only overhead and operational costs but also consumer costs. In healthcare reducing costs for consumers can increase patient satisfaction, which is an obvious connection. More interesting, however, are recent news stories reporting on suits against major hospital systems for frauds and schemes—or applauding them for lowering healthcare costs.

While telemedicine and home health are increasingly major components of healthcare, much of healthcare operates in a facility like a hospital or clinic. Facilities, along with structural integrities and heating, ventilation, and air (HVA) systems, also include patient equipment and a state of cleanliness. All of these components comprise the environment of patient care and healing, and the enterprise. By taking control of these areas a hospital or healthcare facility becomes one step closer to protecting the enterprise.

The best way to protect it is to predict and manage risk before problems happen. This is even more critical as the healthcare industry works towards the Institute for Healthcare Improvement’s Triple Aim as a means to optimize care. The three components of the Triple Aim complement and overlap the need to reduce enterprise risk.

Fundamentally, the Triple Aim works towards creating system-level metrics to measure success. Enterprise risk is at the center of these metrics that ultimately drive decision making. Understanding the policies and procedures that make up facilities management, patient safety, accreditation, and the overall health of the system can significantly reduce enterprise risk while supporting more effective decision making.

Taking control of facilities management can directly impact the reduction of enterprise risk. Facilities Management holds many different responsibilities in a healthcare system, including emergency management, fire safety, patient and staff safety, infection prevention, environmental services, utilities and equipment, accreditation, and many others.

Improving patient-centered care with consideration for facility compliance results in tangible ways to improve the Triple Aim. The electronics health record is assumed to document all the components of the Triple Aim, but this clinically based monitoring system focuses on provider-patient experience and overlooks other components of the healthcare environment.

Utilizing facilities information technology plays a critical role in establishing the foundation necessary to achieve positive results in achieving the Triple Aim. Recent innovation in health facilities IT has resulted in quality improvement and measurement from the ground up and has the potential to address an often overlooked component of that we all strive for in Triple Aim.

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Can Healthcare Learn from Aerospace and Airlines About Process Improvement Technology?

Ironically the prevailing attitude among clinicians remains; “healthcare does not consider itself a process or system industry” therefore, it is not one which would significantly benefit from leveraging technology to improve its processes. As a data science community within the healthcare industry, we must all push the envelope to demonstrate that Healthcare has a lot to gain by becoming more efficient and effective via process improvement technologies as it clearly has done by embracing clinical improvement technologies.

Dale Schroyer, a certified data scientist, and ProModel’s leading healthcare simulation expert overheard these comments while attending an immersion workshop on RCA, or root cause analysis, at the NPSF Patient Safety Congress earlier this year.

This program looked at what hospitals do when an adverse event occurs. According to the workshop instructors, Dr. James P. Bagian and Mr. Joseph M. DeRosier, “Usually, such events occur because of system faults or failures, not necessarily human error. The challenge is determining what the faults in the system are, how they can be fixed and instituting actions to fix them and measure those fixes.”

Schroyer found it a fascinating topic because of the similarities to what is done in the aerospace industry in which he started his career. One of the instructors was also from the aerospace industry. Both instructors teach at the University of Michigan which is also Schroyer’s alma mater.

From listening and interacting with conference attendees, most of whom were nurses and doctors, Schroyer observed that healthcare does not consider itself a process industry. However, the mere fact that doctors and nurses were having the conversation is a considerable step in the right direction.

Many in attendance wanted to know what techniques would best serve them in convincing their coworkers back home that the system approach is a good and necessary one for the healthcare industry that can benefit patients, hospitals, nurses and physicians. Using a predictive/prescriptive analytic tool such as discrete event simulation (DES) is one possible approach.

Schroyer spoke with the instructors, as well as other attendees, about simulation as a tool to improve patient flow and other hospital system shortfalls. They mentioned that the barriers to simulation are many such as a long, cumbersome learning curve.

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