Tuesday, 09 June 2015 21:44

Hi, Do You Have a Minute? Can You Help Me Understand? How Are We Doing?

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c gormanThese seemingly innocuous questions cited in the headline seem to be being asked in hospitals everywhere these days. But in this ever-changing environment of healthcare reform and pay-for-performance the answer is rarely if ever simple! No corner of the building, no meeting or causal lunch in the hospital cafeteria is immune to being morphed into an impromptu educational session. Once reserved for the harried weeks leading up to accreditation surveys scheduled months in advance and with the dates widely known, this fervor to understand the rules of the game and what the score is has become a way of life. What is causing the stir? Value-based purchasing (VBP), of course!

While certainly not a new phenomenon to those in the worlds of quality, clinical documentation improvement (CDI), and health information management (HIM), interest is at a crescendo among stakeholders who in the past would have happily remained on the sidelines, allowing the "accreditation team" work its magic in coordinating successful surveys. Accreditation is one thing, but the bottom line is quite another story. And in addition, performance is publicly available!

As penalties continue to increase and pose a very real threat to hospitals' overall financial solvency and reputation, the expanded healthcare team wants and needs to understand the components of the initiatives – and most of all, how they, as an organization, are doing. An often unstated but frequently anticipated question is "how much better are we performing than 'them?'" Further complicating the equation is the ever-changing and evolving requirements and associated percentages. Truthfully, sometimes it feels like one must be a trigonometry professor to get it all straight!

We all know it is an issue, but shy of locking yourself in your office and never eating, what are the best answers to these questions?

Patients: First and foremost, pay-for-performance and its associated components are about the core of healthcare: the patients! Delivering safe, effective, cost-effective care for the best outcomes is a basic and grounding concept. Keep this uppermost in your mind and messaging, and the rest comes easy.

In a perfect world, the above would be enough to ebb the flow of questions. But since we know that isn't the case, here are some are some tips for success.

Patience: It is no secret that many of your current "students" are new to the intricacies, pitfalls, and pain of the "off-stage" regulatory process – but most are familiar with the "on-stage" performance when regulators are on site. Embracing each query as a teachable moment will make it easier for you to educate the team.

Preparation: You know the questions are going to come, so be prepared! Knowing that most adult learners don't retain all they are told, keep hallway conversations light and on point. Have a basic script that answers the basic questions for these chance encounters. But prepare documents, FAQs, and dashboards that can be emailed or presented at meetings.

Prudence: Be judicious in mailing out dashboards, benchmarking data, and distributing other documents that are dynamic and easily can be misunderstood and misconstrued. Keep in mind how easy it is to hit "forward" and redistribute these documents to others. No one wants to be in the middle of a virtual game of telephone, especially when the data is old. Better to send easily consumed documents and an offer to provide live education.

Practice: Practice your response for these unscheduled meetings. Keep it simple and consistent. Do not assume that the game of virtual telephone will not carry over to conversations. Practice until it is a well-known script. Provide the scripting to others on your team so the message is consistent.

Performance Analysis: Data speaks, and we all know and practice that already. But in this arena you need to think outside the box. Think of all the questions you have been asked and also of those you anticipate. Prepare metrics to address them, even if it is to demonstrate the non-applicability of the data.

Proactive Monitoring: Know what you will be measured upon tomorrow and monitor for this today. Monitor and report so there will be no surprises.

Plan: Plan remediation for tomorrow today! Include the performance improvement plans in all that you report. But remember, report and explain. Just hitting "send" is not the right option.

Public Relations: Don't be shy about including them in your education and scripting. These folks are word-smithing pros! They will make sure your message is clear, crisp, and very unlikely to be misconstrued.

Presentations: Once you have gotten your dashboards, FAQs, and scripting down pat, schedule live presentations. Go to as many meetings as you can, and do a road show. The more stakeholders who hear the message and planning firsthand, the less likely there will be for misunderstanding.

Parameters: As with any other initiative that can have serious public implications, work with leadership and public relations to establish what can and will be shared publicly before a situation arises. Hospital performance and all the components of VBP are prime fodder for media coverage. They will be armed with the publicly viable data, so you need to be armed with the facts and a well-prepared spokesperson.

Perseverance: Value-based purchasing and its associated components is a journey, not a destination. Performance is dynamic and not static. Just like most things in healthcare, there will be victories and there will be performance slippage. This is just a different initiative, not a new concept.

Patients: Coming full circle, remember, this is where the focus belongs. The patient is at the center of the healthcare universe. They expect and deserve the best care that can be offered. But are their expectations and perceptions always correct, or even fair?

Healthcare is dynamic, and this is a concept we all know well. Some things are out of our hands and cannot be controlled; they are the proverbial unknown variables. Is the patient's interpretation of their experiences the latest unknown variable?

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Cathy has over 30 years of experience in healthcare. In addition to a varied clinical background, she has extensive experience in project design, implementation, and management. As director of the Quality Service Line for Nuance's Quality Management Suite, she is responsible for product strategy for the Clintegrity 360|Quality Measures, Performance Analytics, and Narrative Search Solutions. This includes monitoring the regulatory horizon to ensure that current and future Clintegrity 360|Quality solutions are compliant with new and revised regulations, including but not limited to TJC; CMS; HIPAA; value-based purchasing; and the American Recovery and Reinvestment Act.

A frequent speaker, author, and blogger on quality and compliance activities, Cathy truly understands the challenges industry stakeholders face, and she uses her experience to help them meet the ever-increasing and changing regulatory and accreditation requirements. Prior to her role with Nuance, Cathy served as a corporate director of regulatory requirements, privacy, and data security for an integrated health system.

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Cathy, has over thirty years’ experience in healthcare. In addition to a varied clinical background, she has extensive experience in project design, implementation and management. As Director of the Quality Service Line for Nuance’s Quality Management Suite, she is responsible for product strategy for the Clintegrity 360 | Quality Measures, Performance Analytics and Narrative Search solutions This includes monitoring the regulatory horizon to ensure that current and future Clintegrity 360 | Quality solutions are compliant with new and revised regulations; including but not limited to TJC; CMS; HIPAA, value-based purchasing, the American Recovery and Reinvestment Act.

A frequent speaker, author and blogger on Quality and Compliance activities, Cathy truly understands the challenges industry stakeholders face, and uses her experience to help them meet the ever increasing and changing regulatory and accreditation requirements. Prior to her role with Nuance, Cathy served as a Corporate Director of Regulatory Requirements, Privacy and Data Security for an integrated health system.