In smaller cities and towns across the country, community hospitals are providing essential support in managing the care requirements for a given geographic area. Important leaders in the provision of quality, cost-effective care, these community hospitals are handling everything from delivering babies and stitching up cuts to cardiac arrest. Their staff must be agile, innovative, collaborative and resourceful as they deal with the range of patient issues that come through their doors every day.
While the scope of patient care presents a certain set of challenges, community hospitals must also respond to the changes associated with the transition from volume- to value-based care. If they don’t navigate these changes effectively, community hospitals may become financially at risk.
Analysis of the data related to patient care is critical to managing the changes. Until the merger with University HealthSystem Consortium, Vizient's Clinical Data Base (CDB) was only available to academic medical centers and their affiliated hospitals. Now this powerful tool is available to community hospitals that can leverage the insights the data offers to take a more targeted approach to improving performance.
“The CDB enables hospitals to make a wide range of data comparisons with peers which, in turn, makes it possible to identify strengths and weaknesses, focus resources and drive change,” said David Levine, MD, FACEP, senior vice president, advanced analytics and informatics for Vizient.
Analytics in action
By drilling into the robust metrics and measures contained in the CDB, a hospital gains insight into both areas of strength and areas that need improvement. “Hospitals can look at the entire scope of a patient’s visit, including inpatient, emergency department, clinic and observation visits,” said Levine.
Another benefit the CDB provides is quarterly and annual scorecards that give great insight into the entire hospital experience for all patients, regardless of payor status. The scorecards can serve as a predictor for CMS’ Overall Hospital Star Ratings. These balanced scorecards help identify potential actionable items to bring each domain score and the organization’s overall score higher.
A collective review of scorecards of all participating community hospitals in September showed members with positive star ratings were also strong performers in improving readmission rates, managing emergency department throughput and had solid performance with patient safety. The data also indicated the need for continued improvement in the areas of hospital-acquired infections, and certain core measure metrics such as stroke and venous thromboembolism. To stay competitive within their geographies in quality as well as cost improvement, the data pinpoints a pathway to success for each of these hospitals by focusing their resources on the most relevant initiatives.
“Most hospitals are currently using some form of clinical analytics tools. However, even hospitals well-seasoned in the use of those tools can experience a reduction in the ability to leverage insights if there are limitations in methodology and benchmarking capabilities,” said Diane Hanson, RN, BSN, MM, vice president, clinical and operational solutions for Vizient. “It’s like they hit a ceiling and can’t move beyond or sustain the improvements they had made initially by using the tools.”
Analytic tool capabilities such as evidence-based methodologies and transparent benchmark cohorts are now must-have features in the quest to accelerate performance. “It’s always important to know who you are benchmarking your organization against so you can raise the bar on your own performance expectations. CDB offers this capability,” noted Hanson.
Also critical to using the insights from data to accelerate performance is the ability to collaborate. Fortunately, community hospitals are natural collaborators, readily seeking out opportunities to learn from others.
“Analysis of data highlighted one community hospital’s ongoing issues with mortality. They were able to stop the cycle of looking at the same problem the same way and felt they could gain new insights by participating in a performance improvement collaborative on mortality offered by Vizient,” said Hanson. “The sharing in this forum provided an abundance of actionable steps this hospital could implement that they would not have initiated themselves.”
For many community hospitals, the final piece of the performance improvement puzzle is accessing the right resources. Due to their size of staff, community hospital team members oftentimes wear many hats, and hospitals are finding value in utilizing external advisors or consultants, such as Vizient, to supplement their internal team capacity. These external resources can bring subject matter expertise and outside-the-box thinking, as well as best-practice toolkits to assist hospital staff with opportunity identification, prioritization and change management. Augmenting internal expertise provides a market advantage by creating a learning environment for team skill development and accelerating the rate of improvement initiatives implementation.
While there are numerous challenges that every community hospital faces, leveraging their innate strengths and utilizing tools such as CDB, collaboratives and external resources when necessary can help organizations continue to deliver a high quality of care to the communities that need them.