The Top Four Examples of Quality Improvement in Healthcare

To thrive in an increasingly challenging healthcare environment, undertaking quality improvement projects is more important than ever for healthcare systems to stay competitive and survive. To do that health systems need to be able to identify initiatives that will deliver the maximum impact for their organization.

Quality improvement initiatives can focus on clinical, financial, and operational and can have a significant impact on total costs of care, clinical outcomes, care variation, decision support, length of stay, and more.

Hospital systems across the country face many pressing problems: clinical variation, preventable medical errors, hospital acquired infections, delays in patient discharge, and dwindling cash flow.

Ensuring Quality Improvement Projects Deliver Return on Investment

Quality improvement is defined by the Centers for Medicare and Medicaid Services as “the framework used to systematically improve care.” Health systems that have access to data and analytics across their organization can quickly identify and prioritize quality improvement projects that will not only deliver a strong return on investment but also quantifiably improve care. Here are some excellent examples of effective, high-value quality improvement efforts.

Pharmacist-led Medication Therapy Management Reduces Total Cost of Care

Allina Health hypothesized that expanding the involvement of pharmacist-led medication therapy management (MTM) to a group of Medicaid patients covered by a shared-risk contract had the potential to improve patient outcomes and reduce costs. The organization leveraged its analytics system to demonstrate the impact of this initiative.

The analysis showed the following results:

• $2,085 mean total cost of care reduction per patient in the six months after the first pharmacist MTM encounter; over $590,000 extrapolated out over 283 MTM patients.
• 12 percent reduction in hospital admissions per 1,000 members and a 10 percent reduction in emergency department visits per 1,000 members.
• Statistically significant decreases in average medication count.

The analysis demonstrated the unique, positive impact of the pharmacist medication therapy management program on patient outcomes in a six-month period following the pharmacist MTM. This program is effectively reducing the total cost of care.

Optimizing Sepsis Care Improves Early Recognition and Outcomes

Sepsis is a major driver of mortality in the U.S.–it’s estimated that up to half of all hospital deaths are linked to the infection. Identifying sepsis early can be challenging, as the patient’s physical response presents a syndrome of non-specific symptoms which delay recognition, diagnosis, and treatment, resulting in increased mortality rates.

To combat this problem, Mission Health, North Carolina’s sixth-largest health system, implemented a comprehensive data-driven approach to facilitate early sepsis identification and standardize the treatment of sepsis. With that approach combined with evidence-based alerts, Mission Health gained insights into sepsis performance to drive improvements, including:

• 1 percent relative reduction in mortality for patients with severe sepsis and septic shock.
• 9 percent relative difference in mortality for patients who received the evidence-based protocols compared to those who did not.
• 4 percent relative reduction in emergency department (ED) length of stay (LOS) for patients with severe sepsis and septic shock.

This proven plan to improve sepsis outcomes and enhance care for patients with sepsis has laid the groundwork to move the early identification screening tools to the outpatient setting, including urgent care centers and physician offices.

Boosting Readiness and Change Competencies Key to Successfully Reducing Clinical Variation 

UnityPoint Health, a healthcare system serving Iowa, western Illinois, and southern Wisconsin, recognized the importance of reducing clinical variation and the need for strong physician champions and robust analytics to support improvement efforts effectively.

By consistently integrating information from a readiness assessment, an opportunity analysis, and expert resources, the health system was able to establish a prioritization and implementation approach to outcomes improvement that produced the following results:

• Variable costs were reduced by more than $1.75 million based on the deployment of interventions in sepsis alerts, order sets, and other clinical decision support tools.
• Reductions in LOS have allowed patients to return home earlier and spend more than 1,000 additional nights in their homes.
• 36 percent increase in sepsis screenings completed in the emergency department (ED).
• Sepsis order set utilization in the ED has increased by more than 185 percent.

The health system plans to continue identifying significant improvement opportunities aligned with its strategic planning cycle and the priorities identified by clinical and operational leadership.

Systematic, Data-Driven Approach Lowers Length of Stay and Improves Care Coordination

At Memorial Hospital at Gulfport, the hospital was faced with declining revenue due to changes in Medicare and Medicaid reimbursements. By reducing LOS, hospital leaders knew they could also improve financial, operational, and clinical outcomes by decreasing the costs of care for a patient, while also minimizing the risk of hospital-acquired conditions.

By adopting a systematic, data-driven, and multi-pronged approach, Memorial has achieved significant results in one year, including:

• $2 million in cost savings, the result of decreased LOS and decreased utilization of supplies and medications.
• Three percent increase in the number of discharges occurring on the weekend.

The Quality Improvement Journey

Healthcare systems working to improve care, reduce expenses, and improve the patient experience face many challenges, including the need to align changes across many levels of an organization. But the process of identifying, prioritizing, and implementing these changes can be improved with the right tools, process, and people. Once these things are in alignment, health systems can tackle clinical, financial, and operational quality improvement projects and make incredible strides in the clinical, financial, and operational health of the organization.

Health systems can deliver better outcomes, improve patient experience, and save lives through quality improvement projects that reduce clinical variation, preventable medical errors, hospital acquired infections, delays in patient discharge, and improve the bottom line.

Need help getting started? Contact Health Catalyst today!

Additional Reading

Would you like to learn more about this topic? Here are some articles we suggest:

1. Six Steps Towards Meaningful, Ongoing Healthcare Performance Improvement
2. Becoming A Change Agent in Healthcare: The Key to Meaningful Improvement
3. Data-Informed MIPS Improvement Efforts Drive Improved Quality Scores and Increased Revenue
4. How to Accelerate Clinical Improvement Using Four Domains of Clinical Analytics