by Kate Lizzi and Susan Hogan
Clinical Advisory Solutions
08/05/20

This blog post is one of a five-part series on clinical-supply integration, a process for informed business decisions that engage clinicians, preserve quality and safety and lead to greater patient satisfaction.

How does an organization with a traditional value analysis process (VA) maximize engagement and alignment to create a successful clinical-supply integration (CSI) culture? The focus in VA is typically limited to cost and contract optimization. In contrast, CSI utilizes a more integrated approach focusing on quality, safety and outcomes while still managing cost and contracts.

While CSI is the more sophisticated version of VA, both strategies require oversight. CSI necessitates additional attributes in order to be successful, such as a triad governance, accurate data insights, peer reviews, and a sustainable process that drives continuous improvement. Before developing these, the first step is to build a foundation of engagement and alignment.

Engagement and alignment are often used interchangeably, but they are unique and each meets different needs.

Engagement refers to individuals giving their best effort/work. Alignment indicates a group of individuals working together toward a common goal and/or strategy. Alignment also means moving individual viewpoints toward a common vision. Both engagement and alignment are essential to the success and sustainability of your CSI program.

The engagement and alignment necessary for a CSI culture goes far beyond the committee. CSI engages and aligns physicians creating leaders that are in sync with the needs of the organization and the patients. That physician alignment breaks down silos that physicians are typically accustomed to working in and forces the physician-supplier relationship to be more organization-centric. 

CSI requires a fresh approach to engagement and alignment

In order to advance your organization from VA to CSI, the following adjustments to engagement and alignment are necessary:

Governance. Establish a solid governance model by moving from a dyad leadership model (supply chain and clinical leader) to a triad leadership model (physician, clinical leader and administrative lead).  Supply chain provides data to support the model. Committee members are committed to meeting attendance and prepare appropriate materials, such as dashboards.

Goals. Develop goals for the committees to move beyond supply cost savings to a focus on quality, outcomes and reimbursement. Committee members are challenged to manage operational efficiency, profitability and patient outcomes.

Strategies. Align strategies with market needs rather than simply cost savings and contract optimization.

Decision-making. Peer-to-peer discussions and review of evidence and best practice drives decision-making. Replace decision by consensus with an objective, unbiased voting process.

Physician accountability and executive support drive change

Transitioning your organization’s engagement and alignment from VA to CSI requires two main drivers: physician accountability and executive support. 

Physician accountability. It is important for physicians to lead the charge of your committees because they will ultimately lead your cultural change and assist with breaking down silos, some of which may be their own.  In order for physicians to lead, they require organizational support. That support comes in the form of providing physicians with tools for success by:

  • Establishing relationships to better understand physician needs
  • Providing reliable data
  • Interpretation of reports
  • Assigning clerical support where needed
  • Using automation for a more efficient workflow
  • Interpretation of supply chain concepts
  • Providing clarity on organizational and market needs 

Organizations that aspire to a CSI model must also be prepared to answer the physician’s question of “What’s in it for me?” This is often accomplished through various physician incentive models, including gainsharing, reinvestment into the organization or into the community.

Executive support.  Executive support plays just as vital a role in CSI as physician accountability. Engaged executives assist in mitigating and removing barriers, driving necessary internal cultural change, and providing necessary resources to support the program. Executive support also helps committees to maintain focus and alignment with organizational strategies by continually monitoring progress and accomplishments.

Physician onboarding introduces organizational culture from the start

In addition to physician accountability and executive support, another driver for success is a robust physician onboarding program. An onboarding program will help you to engage and align physicians before they begin their tenure. A CSI physician onboarding program can make the addition of a new provider more seamless by facilitating cultural immersion into the organization, peer networking and social support, and mentoring. It can also lower physician turnover and maximize revenue at your organization. To do this, your organization should have processes outlined for the pre-boarding period, during the physicians first two weeks and then ongoing for sustainability. This effort on the front end will ensure that your new physician’s first day or first procedure goes smoothly and provides resources to reduce anxiety and frustration.

A CSI culture reaches all areas of the organization, but it begins with physician accountability and executive support. With a strong foundation of engagement and alignment, the other functional attributes of CSI will thrive. 

Clinical-supply integration is an ongoing, interdisciplinary strategy encompassing four performance domains — engagement, insights, process and knowledge — to inform decision making about products and services in order to eliminate harm, improve outcomes and lower costs. Read about the domains in the related articles below or learn more about clinical-supply integration.

About the authors. As senior consulting director, Kate Lizzi brings almost 20 years’ experience in healthcare delivery and health insurance. LIzzi has spent the past seven years creating and implementing physician engagement strategies and cost reduction strategies, exceling in physician integration and culture change as well as strategy and implementation.

Consulting director Susan Hogan brings over 40 years of experience in the health care industry, including 31 years in various clinical and leadership roles beginning as an operating room nurse. Susan’s professional skills include OR business management, project management and value analysis program development; aligning the value analysis decision-making process normally led by supply chain with a system-wide clinical appropriateness focus to improve cost, quality and outcomes.