Quality Metrics: Combining the Power of Social Media and Data Transparency to Drive Frontline Provider Engagement and Improve Outcomes.
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Abstract
The Affordable Care Act has increased accountability in health spending, in particular, a shift from the traditional fee-for-service model to an outcomes-based, metric driven model of reimbursement. In the US, Value Based Purchasing is established as the main pay-for-performance quality improvement mechanism. Historically, frontline care providers have not had access to "live" data on measures of quality and the practices that drive them. "Engagement" was limited to responding after the fact to top-down analysis and directives. Already burdened frontline care providers would inherit responsibility for data gathering systems and improvement programs that increased workload without necessarily increasing a sense of ownership, commitment or engagement.
Optimizing clinical value requires broadening conversations around clinical outcomes: creating institution wide awareness of metrics, deficits, and goals. A clinical quality system should allow bundling and tailoring both metrics and best practices in ways that are accessible, minimally burdensome, and both accurate and actionable in the data they gather and return. Dissemination of knowledge broadly, rapidly, and accurately is increasingly seen as a mandate for institutional transparency. Leveraging social media, a powerful resource common in everyday lives, for this transformation in communication expands the reach broadly, efficiently, and seamlessly.
In order to best coordinate care delivery, Mayo Clinic utilized the "Agile" design and development methodology to create a performance improvement platform that populates hospital, unit, and provider level quality metrics, fostering a culture of complete performance transparency. In addition to centralizing performance metrics, constructing a social element that allows for clinical conversations and best practice dissemination allowed for care team coordination between all members of the care team.
The frontline care providers requested the ability to easily disseminate Mayo Clinic best practices and to improve communication between multidisciplinary teams, independent of geographical location. Sharing best practices made isolated quality improvement projects more widely available; information about disparate efforts was centralized.
In addition, frontline care providers requested the ability to set and disseminate metric targets instantaneously, and to create quality improvement projects. They originated requests for pain management metrics, physician-level-cost and-length-of-stay data, and physician-level patient satisfaction scores. New ideas for performance improvement initiatives gained traction, and providers began to ask to compare their performance against other units within the hospital.
The ability to quickly and easily access hospital, unit, and physician level performance data, make real time evidence-based decisions, share best practices, and initiate quality improvement projects significantly improved front-line engagement. Once nurses, nurse practitioners, and physicians assistants understood that they could individually affect performance of quality measures, a widely expressed desire to improve developed. Staff was excited to collaborate around common improvement goals at the local, regional, and national level.
Optimizing clinical value requires broadening conversations around clinical outcomes: creating institution wide awareness of metrics, deficits, and goals. A clinical quality system should allow bundling and tailoring both metrics and best practices in ways that are accessible, minimally burdensome, and both accurate and actionable in the data they gather and return. Dissemination of knowledge broadly, rapidly, and accurately is increasingly seen as a mandate for institutional transparency. Leveraging social media, a powerful resource common in everyday lives, for this transformation in communication expands the reach broadly, efficiently, and seamlessly.
In order to best coordinate care delivery, Mayo Clinic utilized the "Agile" design and development methodology to create a performance improvement platform that populates hospital, unit, and provider level quality metrics, fostering a culture of complete performance transparency. In addition to centralizing performance metrics, constructing a social element that allows for clinical conversations and best practice dissemination allowed for care team coordination between all members of the care team.
The frontline care providers requested the ability to easily disseminate Mayo Clinic best practices and to improve communication between multidisciplinary teams, independent of geographical location. Sharing best practices made isolated quality improvement projects more widely available; information about disparate efforts was centralized.
In addition, frontline care providers requested the ability to set and disseminate metric targets instantaneously, and to create quality improvement projects. They originated requests for pain management metrics, physician-level-cost and-length-of-stay data, and physician-level patient satisfaction scores. New ideas for performance improvement initiatives gained traction, and providers began to ask to compare their performance against other units within the hospital.
The ability to quickly and easily access hospital, unit, and physician level performance data, make real time evidence-based decisions, share best practices, and initiate quality improvement projects significantly improved front-line engagement. Once nurses, nurse practitioners, and physicians assistants understood that they could individually affect performance of quality measures, a widely expressed desire to improve developed. Staff was excited to collaborate around common improvement goals at the local, regional, and national level.
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