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The Art and Science of a Successful Clinical Quality Value Analysis Program

05/01/19

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Nancy Masaschi, Associate Principal, Clinical Advisory Solutions

As health care continues to evolve with new technologies and continued pressure to lower costs, health systems must also evolve to decrease variation in care and eliminate waste – all of this without affecting patient outcomes. It’s a seemingly tall order, but one within reach of fulfilling.

Through the right clinical quality value analysis (CQVA) program, hospitals can put their supply chain and medical staffs on the same path toward success. What cannot be overemphasized is that a successful program requires more than just the science of data – it requires the art of engagement and collaboration with those who participate in the analysis. Both are essential to decreasing supply chain variation, eliminating waste and improving quality in the delivery of patient care.

In my work with hospitals across the country, I’ve identified three elements that are vital to ensuring a successful CQVA program: a strong, influential leader; clinically aligned supply chain processes; and a collaborative, physician-led governance model.

Wanted: a collaborative leader capable of driving change

One of the biggest gaps in many CQVA programs is underestimating the importance of identifying the right individual to lead the charge for change. A strong, influential leader possesses a natural curiosity and the ability to align the strategic goals of the program with the organization’s mission.

This change agent is capable of building and facilitating relationships with senior executives, physicians and clinicians. He or she has the ability to demonstrate proven results and can articulate how a comprehensive clinical and financial data-driven approach impacts the delivery of care. This leader also has the ability to influence teams of physicians and clinicians by consistently communicating how and why the need to reduce variations in practice is critical to a program’s success. 

Being a strong, influential leader includes an ability to first understand and then to resolve problems effectively and efficiently. This requires listening and understanding the issue at hand, who and what it impacts, and being able to determine appropriate escalation when necessary. Critical thinking, good judgment and informed decision-making are paramount to rectifying any concerns or issues. A demonstrated ability to fully assess situations and take appropriate action builds credibility with executives, physicians and other stakeholders.

A need for standardized, clinically driven methodology

Health care organizations that are transitioning toward a clinically integrated supply chain undergo a culture shift. To successfully address cost, quality and outcomes requires aligning clinicians with the supply chain. Hospitals can then collect and use actionable data to reduce variation in clinical practice, thereby improving patient outcomes while also addressing waste reduction and cost control.

A rigorous methodology is crucial to a successful program. It incorporates clearly defined processes and timelines that drive projects and delivers opportunities to succeed. It’s important to manage the methodology through a standardized process that’s data driven and comes with a plan at both the individual project level and at the programmatic level. This includes establishing data sources and dashboards that support the clinical, financial and operational impact, and the ability to make informed decisions. It’s imperative to establish clear roles, responsibilities and accountability for the process across all levels of the organization. 

Build a physician-led governance model

Health care organizations transitioning to a clinically integrated supply chain are bringing executives and physicians together into a collaborative leadership governance model. This physician-led model drives key strategic initiatives around quality, patient safety and outcomes that impact the fiscal goals of the organization and hold peers accountable to their commitment for change.

It also gives physicians a seat at the table in the dialogue about care and its relationship to cost management. Moreover, it escalates the level of discussion and accountability in establishing the goals and priorities for the areas of focus and performance improvement.

Organizations further along on this journey have a physician leader in supply chain leading the charge. A physician brings clinical expertise and has credibility when interacting with other physicians and when addressing variation in clinical practice and its impact on patient care.

Mastering the art (and the science) of a successful CQVA program in today’s health care environment can be a challenge, but these elements are vital to the success and ongoing sustainment of a program. They set the context for the approach that organizations need to take in order to tackle the issues that impact how they deliver high-quality, cost-effective care. 

About the author. With more than 20 years of experience in the health care industry, Nancy Masaschi leads and delivers clinical advisory services to leading health care organizations, enabling them to create a highly effective and efficient platform to improve clinical quality and financial performance. She has demonstrated success in developing, implementing, and managing multiple clinical practice and product utilization initiatives across service lines and has facilitated the development of physician alignment and engagement around clinical variation in practice and clinical outcomes. She is certified in Lean and Six Sigma and has been a contributing author for Healthcare Purchasing News since 2010.

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