Topics: Healthcare quality, ACA, documentation, payment reform, change management, innovation

On the bright side, the ACA is driving American healthcare forward into a new era of active quality management. Unfortunately, the ACA’s data-hungry charter is forcing ground-level practitioners like nurses and doctors into the awkward dual role of practitioner and accountant, often manually capturing detailed time intervals and checking box after box in the EMR. One would struggle to find any coach who’d want their players to be capturing their own performance stats in the field, yet clinicians find themselves in this unenviable position. For clinicians, who are often working long hours in the hospital, documentation commands fully 25-50% of the average clinician’s workday.

Now, with ACA-related reimbursement adjustments amounting to hundreds of thousands of dollars for the average under-performing hospital, there is a burning platform. Hospitals are changing, with varying degrees of success. Thankfully, it’s becoming clear that there are some trends that can help free-up the clinical athletes to do their jobs without becoming too ‘meta’ themselves.

Proven methods for empowering clinician-athletes…

CLEAR FOCUS: Communicating a C-level priority on quality enables…
  1. Nurse and physician empowerment as critical owners of front-line quality
  2. Budget allocation when well-vetted investment opportunities are identified
CONSTRUCTIVE ENVIRONMENT: Blame-free accountability enables…
  1. Freer communication and greater stakeholder engagement due to lower-fear environment
  2. Increased focus on improved actions, instead of actors, driving improved behaviors.
PRACTICAL, TACTICAL LEADERSHIP: Active nurse champions enable…
  1. Practical translation of high-level priorities and metrics into concrete actions
  2. Better nurse input into ID’ing new opportunities and facilitating team discussions
  3. Connecting quality to nurses’ key motivators (i.e. patient-centric stories vs. financial metrics)
TARGETED INNOVATIONS: New technology enables…
  1. Front-line staff focus on providing medical care (vs. data capture)
  2. Capture of new data types to support process monitoring, post-analysis and eventually real-time staff performance support.

In the new world order, where hospital payment is determined by the bell-curve, there are few who would be well-advised to ignore the need for change. There are many points of reference, with some of the thought leading organizations and forums below:

More expert resources


Tico Blumenthal

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