Elements of Excellence
Clinical operations excellence includes elements of traditional healthcare performance improvement efforts, but it goes beyond them because of the emphasis it places on improving value to the patient, care delivery, health information technology, analytics and business intelligence as well as nonclinical operations. It uses a variety of business process reengineering, change management concepts and a value management approach to increase operational efficiency and reduce clinical variability; the ultimate objective is to drive down the total cost of care while maintaining patient safety or improving care quality.
Clinical Operations Excellence
Clinical operations excellence enables Healthcare Delivery Organizations (HDO) to achieve value-based transformation objectives by placing the emphasis on outcomes for providers based on specific patient conditions. This synergistic combination of people, process and technology approach is different from the conventional change management programs because it puts value at the heart of the change effort. By doing so, HDOs can make transformative changes that improve costs, processes, quality and satisfaction simultaneously, and ensure those changes are sustained over the long-term as the HDO moves from a fee-for-service model to a value-based model. The new emphasis on healthcare leadership by value and outcomes is crucial for the HDO to transform into a high performing network capable of accomplishing the Triple Aim.
Components
The five key components of clinical operations include:
Information Management: As healthcare has intense and complex needs for information management. Health IT, knowledge-based content, and methods are various facets of information management. Information management supports the processes of transactional healthcare delivery, collects data about those processes, and supports analysis and management of healthcare management. These tools are critical to value management, process improvement, and change management.
Business Process Reengineering: Provides the in-depth analysis and redesign of workflows within and between HDO stakeholders in order to optimize end-to-end processes and automate non-value-added tasks. The re-designs of core processes shall deliver quantifiable improvements in critical performance measures such as cost, quality, services and speed.
Analytics and Business Intelligence: Provides timely, reliable analytic and business intelligence data and products to support and improve clinical and operational programs at all levels of the health care delivery systems. Analytics and Business Intelligence support the goal of any HDO be a data driven organization, addressing organizational needs related to data acquisition, storage, analytics, and reporting.
Learning and Knowledge Systems: Leads the research and development hub for a new trans-disciplinary science of learning systems. It addresses how these systems can routinely learn and improve through continuous self-study and self-surveillance, application of analytical methods converting data to knowledge, and subsequent application of that knowledge to drive positive change.
Value Management: Serves as a center of excellence to determine evidence-based outcome measurements, which facilitates the creation of value-based care models, and supports IT governance by evaluating business case investments and projected benefits to link people, processes and technology. The Value Realization Framework © provides the methodology to align mission, vision and values with concrete strategies that can be measured and monitored to determine if the organization is achieving desired outcomes. This ensures that decisions regarding Health Information Technology Platforms, which aim to enhance clinical activity management and decision support to lead better evidence-based outcomes for patients, are supported with operational data to improve service delivery, product delivery, information security and fiscal management.
Conclusion
Collaboration between the five components creates an efficient clinical operation that supports patient-centered care by facilitating the deployment of innovative, secure health data systems and collecting, analyzing and disseminating the highest quality health information for patients, providers, and administrative staff for decision-making. This value-based approach drives standards, learning and growth, and science-based information technology resources, systems, and solutions for the benefit of patient health, their families and those who care for them.