Figure 3 shows our improvement over the past three years. We’ve shown steady growth in all our “quality spotlight” measures we identified as the most impactful to track and improve. Figure 2 shows a 6.82% to 20.84% improvement in the key outcome questions we were targeting. Our patient experience strategy was divided into three phases. Resilient teams: Implemented quarterly leadership development “boot camps” and devised multi-tiered internal communication platforms.Better value: Implemented eConsults in 13 specialties (and growing) to help PCPs manage common conditions and prevent patients from expensive unnecessary specialty appointments.Better health: Developed standard “top of license” nursing protocols, created a quality dashboard, hired quality nurse specialists and developed team quality competitions to drive improved clinical quality outcomes.Established a formal set of practice-wide ambulatory access standards and a set of appointment access/utilization dashboards developed to target opportunities for improved template management to facilitate better patient access. Exceptional experience: Developed a “secret shopper” program, employee customer service training and staff incentive plan to help drive improvement in patient experience. ![]() From there, we achieved organization buy-in with our support teams, practice plan board of directors, outpatient medical directors and nursing leaders. From that exercise, we set SMART (specific, measurable, attainable, relevant, timely) goals and listed them under each area of the Quadruple Aim we were focused on. We brainstormed tactics we felt we needed to take that year, grouped them into buckets of high value/high resource, high value/low resource, low value/high resource and low value/low resource. Annually, we participated in a strategic planning session that helped prioritize tactics to achieve strategic outcomes through a four-quadrant analysis. Working collaboratively within all operational aspects of our organization (clinical, nursing, administrative and revenue cycle), we were able to make organizational changes, set standard policies, change a culture that enabled bottom-up decision-making and set a strategic vision.Īs we developed a strategic vision, we based all decisions on our core purpose, core values and envisioned future (see Figure 1), which helped advance us in our QUEST toward achieving the Quadruple Aim. We could continue to cut costs and potentially go out of business or make key investments that would enable the organization to focus on a group mindset with improved operational efficiencies leading to improved revenue opportunities. MethodsĪ sense of urgency came after a significant financial downturn. This team was empowered to set strategic goals and drive system-level improvement efforts around the Quadruple Aim. Together with an on-staff chief nurse, they formed the clinical management team. We chose to hire a chief operations executive, a director of clinical financial services and an associate medical director. Prior to creating these positions, key operational decisions were primarily handled within each department. In July 2015, our physician practice, made up of 11 clinical departments, created three key positions to help our practice focus on a group mindset. Form a strategic vision and initiatives.Leading changeĮCU Physicians relied on John Kotter’s eight-step process for leading change2 in the QUEST project: Creating a shared vision, using data to drive improvement and harnessing the power of the EHR can serve as a framework to drive improvement within each arm of the Quadruple Aim. Setting the strategic frameworkĪchieving the tenets of the Quadruple Aim requires a strong strategic foundation that serves as a basis for all quality/process improvement work within the organization. At East Carolina University’s ECU Physicians, we have further defined QUEST to reflect our act of pursuit through improved quality, utilization, efficiency, satisfaction and teamwork.ĭuring a four-year period, the physician practice strategically created a framework for infrastructure investments, change management strategy and organization structure changes. ![]() It’s a never-ending pursuit with a clear purpose toward achieving a systematic cure to our healthcare system. Our quest for the Quadruple Aim - enhancing patient experience, improving population health, reducing costs and improving the work life of healthcare providers, including clinicians and staff1 - can be analogous to the search for the Holy Grail. LaGesse, MSM, CMPE, FACHE, chief operations executive, ECU Physicians/Brody School of Medicine, East Carolina University. Hopkins, PhD, teaching associate professor, director, Speech Communication Center, East Carolina University and Robert J. By Jason Foltz, DO, chief medical officer, ECU Physicians/Brody School of Medicine, East Carolina University Pamela D.
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