October 27, 2015
You know health information technology (HIT) is an important part of your business operations. You can’t survive in home health or hospice without your core EMR product. Most likely, you also have ancillary HIT solutions to support programs such as referral interfaces, telehealth or analytics and benchmarking products. But how easy is it to implement and maintain these solutions? Chances are there are challenges—and quite possibly significant challenges that can jeopardize the success of a project as well as the stability of the entire organization.
Of course you are not alone. Luckily, there are research studies and evidence-based practice resources that we can learn from. One such resource is the base of knowledge centered around something called “Clinical Transformation”.
My job title includes it but what is Clinical Transformation?
“Clinical transformation” is a term that came into widespread use after the 2001 publication of the Institute of Medicine’s (IOM) “Crossing the Quality Chasm” report. This important report revealed deficiencies in the safe and effective provision of care and challenged stakeholders to make changes to improve healthcare including the use of information technology to support clinical and administrative processes.
The Healthcare Information and Management Systems Society (HIMSS) defined clinical transformation in a 2011 survey:
“Clinical transformation involves assessing and continually improving the way patient care is delivered at all levels in a care delivery organization. It occurs when an organization rejects existing practice patterns that deliver inefficient or less effective results and embraces a common goal of patient safety, clinical outcomes and quality care through process redesign and IT implementation. By effectively blending people, processes and technology, clinical transformation occurs across facilities, departments and clinical fields of expertise.”
So what’s the translation?
Strategies can be used to incorporate clinical transformation principles into day-to-day practice at home health and hospice agencies. As the definition states, patient safety, outcomes and quality care is the focus. Getting to achieve success in these areas must involve blending people, process and technology in an organization-wide approach. This may not be easy, but if attention is not paid to it, negative outcomes can occur.
What are the results of poorly executed clinical transformation efforts?
Let’s try to put into context what happens organizationally when there is not good alignment with people, process and technology. With any EMR implementation, disruption is expected but trying to minimize that disruption is key in achieving success. Cultural resistance, lack of clear project goals, not seeking staff buy-in at the outset, and not understanding current workflow, process and practice are risks with any health IT project. Without addressing these risks, projects may get off the ground technically, with users trained effectively, and progress going seemingly well. But without true clinical transformation, the changes implemented will not permeate the organizational culture—leaving the project in jeopardy and the organization left at risk. There are ways to overcome this, using clinical transformation strategies.
What can you do to elevate clinical transformation strategies within your organization?
When kicking off a new project, always start with a readiness assessment that includes a plan to examine existing operational processes and all applicable workflows. Both existing and proposed processes should be well documented. A picture is worth a thousand words so get it in an easily digestible workflow diagram.
Once your processes are documented, kick of an implementation campaign. Focus on the goal and strategies of improving patient care. Make it fun! Enlist organizational cheerleaders who can garner up more support. Seek experienced leaders who can drive this effort to seek staff buy-in at all levels. This group can easily become your very early adopters which is crucial to clinical transformation.
Set reasonable expectations. Don’t over promise and under deliver. A project can easily be derailed with inflated expectations. Keep it reasonable and impactful with frequent smaller milestones to reach and celebrate.
Be willing to customize or tailor your approach. True clinical transformation will require frequent adjustments or shifting focus as the product, processes and outcomes evolve. What sounded like a good practice at the beginning of an implementation may wind up being not the best idea after all once you can evaluate the actual outcomes or impact. Be flexible but be sure to stay within the project goals and scope.
And lastly, remember that an implementation is never truly complete. Practice, policy and regulations always change in the HIT landscape. Because of this, clinical transformation never actually ends. Embrace it as an integral part of your ongoing best practice HIT efforts.