by Julie Cerese
RN, MSN, Group Senior Vice President, Performance Management and National Networks


For more than a decade at Vizient, we have been studying top performers in cost, quality and outcomes. My colleagues and I spend a lot of time talking with hospital executives and ambulatory care professionals across the country about the strategies, tactics and behaviors that help them truly accomplish the goals they want to achieve. And perhaps more importantly, the factors that differentiate top performers. Surprisingly, factors such as the number of staff, if state-of-the-art technologies are in place or even the age of a facility are not foundational to top performing organizations.

We have conducted several studies since 2005 and of course, a few things have changed in 10 years but overall we see the same factors are critical to success. We know that data is foundational; you have to know where you are to know where you want to go. But there are other things in play, such as:

  • Shared sense of purpose. This is how hospital leaders articulate their views of the mission of the organization, centering it on patient care and the people the organization serves. Quality, safety, patient centeredness and equitable care are viewed by everyone in the organization with as much importance as the financial health of the organization. The senior leaders must communicate their aspirations around the patient experience. Patient engagement and experience metrics/measures and feedback play a vital role in understanding how patients view their experience in the organization. Sharing that information broadly and transparently helps engage physicians and staff to drive changes at the individual, department and organizational level.
  • Authentic, hands-on leadership style. The CEO should be clear in defining and aligning others around the shared purpose, and in bringing to life the mission of the organization through their words and actions. We found that the most successful leaders were passionate about quality and safety, and displayed an authentic, hands-on style. They used everyday events to connect to the larger purpose through stories and rituals, and the governance structure supported the organizational objectives and minimized conflict. The culture formed by specific leadership behaviors allows the top-performing organizations to define new levels of excellence in service, quality and safety.
  • Accountability mechanisms and a focus on results. Clinical leaders accept responsibility for service, quality and safety. They are willing to be measured against external standards. And good is not good enough. Top performers strive to be the best. It’s all about taking action on what you know today, getting as much information out of that data set, defining your opportunities, and then moving forward. Beyond this, accountability must be structured to understand who is responsible for the results, driving these results into the organization, and collaborating to come up with new solutions.
  • Collaboration. Mutual respect, deference to expertise, professionalism, multidisciplinary teams and alignment between senior leaders and staff demonstrate the collaborative climate seen in the top-performing organizations. Can everybody in your organization understand the goals and objectives and how you problem-solve? Do colleagues support each other so that they can be the best together? It’s really what you are doing today — the practice of your organization, how you are faring relative to the goals you want to achieve, and whether those are national performance measures or internal goals.

The essential role of clinicians

In a recent webinar, my co-presenter and I discussed how to use data to improve clinical performance. Physicians, pharmacists, nurses and other clinicians are important audiences in any health care organization. That is why having a conversation about where you are today, and where you want to be, based on a reliable and respected data source is critical for success. Clinicians need to be able to understand the factors that get built into that database so they can make meaningful comparisons internally and with peers.

Clinicians often like to compare themselves to organizations where their colleagues are working, where they might have trained and where they might have practiced before. Therefore, having the ability to select those individual organizations from a transparent data set is critical.

Performance improvement is a team sport that many people across health care organizations must understand to discover the greatest areas of opportunity. At the end of the day, executives and clinicians working together define the performance of the organization and the patient experience. These are key because they tell us the patient care story. Combined with data, health care organizations can evaluate themselves against other like organizations and evolve their care offering in the most impactful ways possible.

To download the white paper, “The Hospital’s Clear Path to Improving Care Delivery,” or to listen to recent webinar recordings from our Improve Care Delivery series, click here.

About the author. In her role at Vizient, Cerese has oversight of performance improvement products and advisory services, encompassing collaboratives that serve members’ clinical, operational and supply chain needs, nursing programs, patient safety programs and accreditation services. Prior to this position, Cerese led the University HealthSystem Consortium extensive performance improvement products and services. Her substantial knowledge of clinical quality improvement was supplemented by her service as director of quality and infection control at Chicago’s Northwestern Memorial Hospital. Earlier she served as senior director of University HealthSystem Consortium’s clinical process improvement area. She is the author of numerous journal articles on quality, performance improvement and other clinical topics.

Published: November 15, 2017