It’s often been said that you can’t improve what you don’t measure. And when it comes to healthcare, there’s no shortage of things to measure. But uncovering the right data, the data that can identify trends in clinical variation and then allow hospitals to act on those trends, can be harder to come by. Gaining visibility into resource utilization at the provider level is necessary to pinpoint areas of opportunity and implement widespread change.
One of the biggest challenges is order set appropriateness and consistency, and the workflow that leads to ordering and clinical decision-making. Leveraging order data in the electronic health record: Here’s how one hospital redesigned its order sets to improve order set compliance from 73% to about 85% over one year.
A sepsis success story
While working on an unrelated initiative, the hospital identified ordering gaps that it believed if addressed, could lead to improvements in how it addresses sepsis. A multidisciplinary team that included clinical stakeholders, quality improvement and IT and informatics audited electronic health record actions that clinicians take, such as when orders are placed and what orders are placed. The clinical stakeholders also were able to provide insights into why clinicians might not be using the order set and ways to modify it.
From there, the hospital was able to optimize the order set to better align to clinical guidelines, while also reducing clicks for providers. The team also monitored for alerts that were a part of their sepsis pathway. The team achieved its goal of implementing an evidence-based bundle that would lead to consistent care across providers. Beyond the successful improvement of alert and order set metrics, the team ultimately was able to deliver an improvement to the average rate of timely antibiotic administration from 58% to 65% in a six-month period.
From insights to action
Having the ability to identify variation across the care continuum is the first step to reducing clinical variation. From there, hospitals need to drill down to identify things such as ordering patterns across service lines and specialties and which clinicians are (or are not) using the order sets that may ultimately be driving the variation.
Getting to that level of granularity and leveraging it at scale across a health system can be a challenge. Hospitals struggling with workforce challenges may not be able to pull frontline clinicians from the bedside to be able to offer their insights into possible behaviors related to the data. It also can take significant analytics resources to be able to understand the data and generate the visualizations needed to interpret the information.
Addressing barriers
Don’t let the challenges of uncovering the right data, keep your organization from maximizing opportunities to reduce clinical variation. If you need support, learn more about Vizient’s Clinician Decision Analytics solution, brought to you in partnership with Phrase Health, a data and analytics company that provides a platform for electronic health record configuration to gain deep insights into physician ordering practices and quality improvement interventions. Combined with our Clinical Data Base and quality consulting expertise, we can deliver the granular level of information which allows you to develop evidence-based order sets and alerts, monitor compliance and track ongoing performance.
To learn more, check out the three-part Modern Practice Podcast series (part 1, part 2, part 3), or email the Clinician Decision Analytics team today.