Improving Care, Cutting Costs Can Work Hand in Hand, Expert Says

Healthcare leaders can improve patient care and their organizations’ financial performance by borrowing methods from other industries, according to the leader of the Joint Commission.

Mark R. Chassin, MD, FACP, MPP, MPH, discussed ways to identify and implement process improvements during a talk Monday morning at the Healthcare Financial Management Association’s 2016 National Institute in Las Vegas. Chassin is president and CEO of the Joint Commission, which has been working with healthcare organizations to help them achieve “high reliability” by eliminating errors and failures that impact patient outcomes.

“The ultimate goal has to be zero harm,” he said. “That’s a high hurdle to get over.”

But Chassin said “zero harm” isn’t a futuristic dream; it’s a goal that’s achievable now.

To start with, Chassin urged healthcare leaders to make quality their top goal. He said in healthcare, just as in other fields, the organizations that focus on quality usually find that all of their other business objectives can be met along the way to achieving high quality.

The idea of focusing on quality isn’t new, but Chassin said healthcare organizations in general haven’t been very effective at self-improvement. To fix that problem, the Joint Commission advocates a method they call Robust Process Improvement (RPI).

A good starting point for RPI, Chassin said, is to utilize performance improvement methodologies like Lean and Six Sigma, which were born in other industries but have proven highly effective in transforming healthcare organizations.

“Together, Lean and Six Sigma are incredibly powerful—far more powerful than anything else we’ve ever tried in healthcare,” he said.

Chassin said healthcare organizations can often see quick and dramatic results from Lean and Six Sigma. But he said the long-term effectiveness of those methods is only as good as the organization’s success at implementing the solutions identified through the processes.

That’s where a method called “Change Management” fits in. Change Management principles help organizations ensure their solutions are fully implemented and sustained over the long term.

“Change Management is about how you start at the beginning of a process, engage everyone who’s relevant, and work through the change with them so that at the end of the day the technical solution and the change go together and you get a result,” he said.

Chassin said the great thing is that Robust Process Improvement comes with a beneficial side effect.

“On top of that it turns out that there is a compelling business case for adopting RPI in healthcare,” he said.

Chassin said a return on investment of four to one is easily achievable for most organizations that implement these methods; he said many have achieved even higher ROIs.

Part of improving processes is measuring performance. Chassin said healthcare organizations should publish their quality measures both internally and externally as a means to encourage improvement and create a stronger relationship with the public.

The Joint Commission has created a series of “Targeted Solutions Tools” (TSTs), which guide organizations through the processes of measuring performance, identifying solutions, and implementing and tracking those solutions. Four TSTs—focusing on preventing falls, hand hygiene, hand-off communications, and safe surgery—are available now on the Joint Commission’s website.