Streamlining OPPE and Improving Outliers

Two doctors speaking in hospital hallway

A recent article identified The Joint Commission’s Ongoing Professional Practice Evaluation (OPPE) process as “costly, ineffective, and potentially harmful”. While The Joint Commission issued a statement countering this contention, conversations we’ve had with other healthcare systems indicate they agree. With the right technology, your hospital or health system can both streamline the OPPE process and improve the process of identifying outliers and driving performance improvement.  

If your OPPE process fails to identify outliers and provide a tool for performance improvement, your process may have one or more of three problems: 

  1. Putting the information into a useful format is time-consuming
  2. The review process is cumbersome
  3. The data is stale, out of date, and doesn’t provide an apples-to-apples comparison of performance expectations

We have found that a quality improvement application that connects the OPPE process to real-time data, patient level risk adjustment, and provider scorecards with alerts can improve these shortcomings and make the OPPE process more effective.  

Statit, part of the symplr Quality Suite, delivers: 

  • Customizable dashboards that present reviewers with criteria needed for OPPE 
  • Data analytics using statistical process control (SPC) to identify process changes that worked or didn’t at a glance 
  • Measurable indicators from a variety of data sources that you already have 

Reducing the time used for OPPE reviews 

Using Statit review workflows, chiefs and chairs performing OPPE reviews save time by batch reviewing acceptable performance providers. The time savings can be used to dig into individual reviews of outliers and develop process improvement plans.  

The provider review process begins with a few simple steps: 

  • Rapid batch review of providers with acceptable performance on a single screen with minimal clicks 
  • Easy identification of outliers for chiefs and chairs, leaving more time for individual counseling and focused training 
  • Automated workflows to enter physician reviews and export reports from the software  
  • Real-time data analysis with the ability to drill down to patient details for transparency and to instill trust in the data 

Statit provides tools for health systems to set targets and alarms on the quality indicators they are measuring, and then assists them in setting batch review qualifications, so that the poor performing outliers are easily identified in the review process.  

Outliers are determined by SPC. When an outcome indicator trends negatively over time, the SPC alert indicates this is a provider scorecard that should be reviewed in depth. When an alert occurs, Statit highlights specific providers that need review.  

Example of outlier review 

Reviewers can drill into a particular outlier scorecard for a closer look. For example, a reviewer gets an SPC alert and sees that one doctor has an average length of stay of 6.11 days, compared with his peer group average of 5.28 days. This doctor breached the alarm value 15% of the time while his peers breached it only 4% of the time. Additional scrutiny by the reviewer reveals that he failed to meet the target for 22% of patients while his peers failed to meet the target for only 5%.  

Looking beyond the formal review period, the reviewer sees that there is continued degradation in performance. In the most recent period, he missed the target 23% of the time while his peers are at 9%. 

Regardless of the ongoing debate about the benefits and improvements needed in OPPE programs, healthcare providers will need to continue to measure performance. This will allow them to continuously improve, reinforce great performance, and support payment programs that depend on performance. While the debate goes on, and likely for many decades afterwards, Statit performance scorecards will continue to make it easier to deliver a timely, trusted, and transparent OPPE program. 

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