Use Healthcare Process Improvement to Enhance Leadership Decision Making

Healthcare operations leaders make tough decisions every day and guide teams in their wake of choices:

  • Will automating this process accelerate patient care yet avoid depersonalization of care delivery?
  • Are we following the best path to deliver on outcomes while not burning out our staff?
  • Have we properly vetted this capital equipment purchase to ensure we are maximizing spend?

Decisions related to processes and procedures affect every facet of healthcare operations—from workforce morale and patient safety to provider referrals and even the future of the organization itself. 

Here’s how process improvement guides administrators and medical staff leaders in making the best choices for their patients, staff, and communities.

What is healthcare process improvement?

Healthcare process improvement uses data to determine the effectiveness of existing processes and, if necessary, implement new workflows and procedures to improve outcomes. These could be related to care quality, like patient outcomes, or other measures such as provider satisfaction and retention. As the healthcare landscape evolves, fostering an environment of continuous improvement can help your healthcare organization stay abreast of changes and position itself well for the future.

Effective decision-making skills are a must-have for healthcare leaders, and using healthcare process improvement strategies can hone and elevate those skills. 

How does process improvement impact leadership decision making?

Process improvement is the impetus for change and it guides decision making to achieve that desired change. Administrators focus efforts  on the financials of the healthcare business to reduce costs and maximize revenues, but also partner with medical staff leaders on clinical leadership decisions. 

Healthcare operations leaders can't afford to focus solely on costs and revenues, a premise made clear following events and advancements like the following:

  • The Institute for Healthcare Improvement’s (IHI) Triple Aim initiative
  • A push for healthcare reform and payment reform
  • The COVID-19 pandemic

Leadership decision-making must take into consideration improving overall value—and process improvement can help do that.

Better quality means better value…

The decisions healthcare operations leaders make directly impact how patients perceive the value of their care from an organization. By focusing process improvement efforts in areas where patient satisfaction is lower than expected, leaders can help boost scores. These quality improvements yield a better patient experience, which in turn boosts patients’ opinions on the value of the care they are receiving for their money.

Further, a “shopper’s mentality” is the new norm in healthcare. Patients want to be sure they get the highest-quality care at the lowest cost. And they’re shopping for it online until they find it. One example of how health systems are meeting patients’ expectations with regard to digital provider search and scheduling is Care Finder Direct—symplr’s partnership with WebMD.

…and better value means more revenue

Patients aren’t the only ones interested in getting the most value for their money—payers are too. Healthcare organizations that focus on process improvement demonstrate to insurers that they are committed to improving patient outcomes. From a payer’s standpoint, better clinical outcomes means a lower likelihood of repeat visits or cascading medical issues, which in turn means less money they have to spend on each policyholder. That, of course, means increased revenues for the insurer and a more harmonious relationship between payer and payee organizations.

How can good decision-making improve healthcare processes?

Above all else, good decision making is about foresight and planning. Healthcare operations leaders can sometimes get too focused on quick wins. Some improvements that have an immediate positive impact but aren’t the best decisions (or even the right ones) long term. This shortsighted thinking, unfortunately, can come at a cost to the patient experience.

Using principles of continuous process improvement, healthcare operations leaders are more likely to make the right decisions for the long term efficacy of the organization. The right decisions will boost revenue, make staff and providers happier and, crucially, improve patient safety and clinical outcomes.

4 healthcare process improvement strategies

Implementing effective process improvement strategies can be a lengthy process. But no matter what method healthcare operations leaders eventually employ, the first step should be to create a cause-and-effect diagram, also known as an Ishikawa or “fishbone” diagram. Identifying areas where process improvements must be made is not unlike diagnosing an illness: The goal is not to address the symptoms, but to identify and address the underlying issue that’s causing them. A fishbone diagram is a valuable tool in leadership decision-making: it helps healthcare leaders organize the effects of a systemic issue so they can drill down more effectively and find the root cause.

Once the root cause has been identified, the next step is for healthcare operations leaders to make the necessary adjustments to existing processes or workflows (or create new ones) to address it. To do that, leaders can employ a variety of different strategies. These four strategies are among the most popular—and most effective—methods.

1. Plan, Do, Study, Act strategy

The Plan, Do, Study, Act (PDSA) strategy is a tried-and-true approach to process improvement. Named for the four steps in the cycle, the focus of PDSA is to ensure that a proposed process improvement will in fact be an improvement over the existing process. 

  • In the Plan step, healthcare leaders generate ideas to address an existing problem: improving patient flow, enhancing patient safety, or a similar quality improvement. 
  • The Do step is about putting those ideas into action and collecting data along the way.
  • In the Study step, healthcare leaders review the data to determine whether the planned changes had the intended effect.
  • In the Act step, healthcare leaders act on the results of their study. If their changes worked as intended, they are ready to be implemented across the organization. If not, leaders return to the Plan step and tweak their ideas, keeping in mind the new information they gleaned from the previous Study step.

PDSA is an invaluable tool in improving leadership decision-making because it gives healthcare leaders clear feedback on the “real world” viability of their proposed process improvements. Leaders can learn a great deal about what will work for their organizations simply by watching an idea fail and using that knowledge to inform future decision making.

2. IHI Model for Improvement

The (IHI) Model for Improvement also uses the PDSA approach. It incorporates the use of rapid cycle improvement (RCI) to test changes on a smaller scale for a limited duration before rolling them out across an organization. The inclusion of RCI in the IHI model makes it particularly useful for leaders at large healthcare organizations. Implementing new processes can take a long time in a big organization, and a process that works for some of the facilities within an organization may not work for others.

A small-scale approach allows healthcare leaders to collect the data they need faster and more efficiently and hone their ideas along the way. That way, when the time comes to roll out a large-scale process improvement, healthcare leaders can do so with confidence that the decision will benefit staff, providers, and patients.

3. Lean methodology

Lean methodology is primarily focused on adding value to the customer—or, in the case of healthcare organizations, the patient. Its core aim is to provide optimal value to the patient with minimal wasted time, effort, or cost. Anything that does not add value is simply removed from the workflow.

Lean was designed for use in manufacturing and production, so naturally it requires some modification to be effective in a healthcare setting. For example, even if the patient doesn’t see the value in a second blood draw or urinalysis, they are still necessary parts of the diagnostic workflow, so they can’t simply be skipped. 

That said, however, Lean is an effective way to identify steps in the patient care process that are redundant or fail to add value to the overall patient experience. By knowing what those steps are, healthcare leaders can make better decisions when it comes to updating or implementing processes.

4. Deming principles

Dr. W. Edwards Deming is a legendary figure in the automotive industry, and many of his theories on efficiency and quality improvement have been applied in healthcare organizations.

To begin, Deming wrote that process improvement must be data-driven, evidenced in one of his most often quoted phrases, “In God we trust—all others must bring data.” It’s a useful way for healthcare operations leaders to think about process improvement. Why use resources to implement an improvement if there’s no quantifiable way to tell if it is, in fact, an improvement? 

Another of Deming’s principles was adapted specifically for the healthcare industry by Dr. Brent James. It states that management should involve managing the processes, rather than the people. So for healthcare leaders, managing care means managing the workflows and processes that go into patient care—not the individual providers who deliver that care. 

This strategy is often a part of a Just Culture program and other methods of shared accountability for healthcare quality improvement. They carve out a role for everyone in effecting positive change. It can be used to identify when equipment, processes, or policies fail/are not adhered to and may require revision. 

However, Deming also champions leveraging the insights and experience of the “smart cogs” in the machine. In healthcare these are patient-facing providers who are on the floor. The Deming approach requires getting providers involved in process improvement wherever possible. They have insights that can give healthcare leaders a clearer understanding of the issues. And this data, in turn, helps healthcare leaders make better decisions about how best to address and correct those issues.

Healthcare process improvement challenges the decision-making skills of healthcare operations leaders. Adopting tried-and-true approaches can enhance healthcare leadership decision making. Ultimately, better decisions lead to improved care quality, better value, a more positive patient and provider experience, and increased revenues for healthcare organizations.

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