The Role of the Clinical Team in Healthcare Quality Improvements

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While millions of people in the United States have access to high-quality healthcare every day, the sad truth is that many others do not. The disparity of quality plays out in a number of different ways, including use, under-use and misuse of services. As the Affordable Care Act sees more and more people — all told, 32 million Americans, according to the Association of American Medical Colleges (AAMC) — with health insurance for the first time in their lives, the healthcare system is expected to face unprecedented challenges. Clinical Implementation Teams (CITs) will play an essential role in steering hospitals and other healthcare settings toward quality improvements in healthcare.

To be very clear, just because an organization wants improvements to their quality output doesn’t mean that it will happen. There are many aspects to quality improvements that start with the data being collected, how that data is stored, the analytics tools used, and ultimately the interpretation of the data. The data that is necessary to indicate problematic areas is being collected every day. This probably isn’t the biggest issue that organization face. However, many run into problems with the way in which their information is stored because too often it is siloed and inaccessible by different departments. When you aren’t able to get the full picture, there are possibilities that resulting information isn’t completely accurate.

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The analytic tools necessary to dig through the data and uncover patterns, whether positive or negative, comes at this stage of the process. Not all analytics tools are the same, and there are many determining factors that you must address to know which company can provide the best product for your organization.

As you move forward with the data, and after it has been analyzed, this isn’t the end of the story. Again, not all software is equal, and the analysis will lead to action. The action you make will be determined from the information presented in analysis. If the analysis isn’t correct, the action plan will not lead to improvements in healthcare, but off on a different path. Your software must understand the nuances, especially within the complexities that exist for healthcare organizations, and produce data-driven and fact-driven information that translates directly into improvements not only for those in the organization, but those who utilize the organization’s services.

“I have a great respect for incremental improvement, and I’ve done that sort of thing in my life, but I’ve always been attracted to the more revolutionary changes. I don’t know why. Because they’re harder. They’re much more stressful emotionally. And you usually go through a period where everybody tells you that you’ve completely failed.”

Steve Jobs

The 411 on Clinical Implementation Teams

Once your organization has identified areas in need of improvement, you’ll need the right people in place to guide the implementation process. Enter the CIT. Typically, CITs are spearheaded by three key players: a doctor, a nurse, and an operations manager. These three work together in a unique way to increase effectiveness and efficiency across the entire care team — as opposed to for just one group. This group also comprises a delegate from each stakeholder in the care process.

Consider it this way: physicians, nurses and administrators often bring very different perspectives to the same issue. Working together to solve a problem or area of weakness instills a very important sense of collaboration and teamwork. Additional members of the CIT represent their peer workers. It is their job to communicate ideas, suggestions and concerns between the CIT and their fellow staff members. This helps promote open lines of communication, keeping staff members informed and engaged.

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A subset of the CIT, the Clinical Workgroup consists of the three CIT leaders, along with key analytical experts. Members of this group are tasked with collecting and analyzing data and determining actionable insights to be shared with the CIT. Because the Clinical Workgroup’s role is largely a fact-finding one, access not just to the right information, but also to the best tools is critical for optimal results. A wealth of data may be at our fingertips, but it’s worthless without meaning.

Based on the findings of the Clinical Workgroup, the CIT may determine a specific course of action or best practice. While the primary goal is to improve the workflow, this dynamic serves a secondary purpose: to establish the common objective of quality improvements in healthcare between these interconnected entities.

An even smaller subset of the CIT is the Guidance Team. These senior-level hospital leaders set the tone during times of transition. They also offer valuable direction and change management strategies, while working to remove any barriers in the way of progress. Support from the Guidance Team plays an important role in driving the work of the CIT, while reinforcing the importance of those efforts throughout your organization.

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Beyond Implementation

Unfortunately, making change isn’t always the hardest part of the implementation process: sustaining it is.

Once you’ve established your CIT, it’s here to stay. While other kinds of hospital groups and committees may rotate, CITs are permanent. Why? Because their role is not just to implement, but also to see the transition through — first through change management and later in a monitoring and maintenance capacity. This ongoing accountability helps keeps things on track.

Ultimately, the best healthcare systems are ones ready to constantly adapt to maintain what works and improve what doesn’t. And because no hospital or other healthcare setting will deliver its very best care without the buy-in of each and every employee, a rich, top-down culture prioritizing the need for ongoing healthcare excellence has the power to instill an organization-wide sense commitment to your mission and to the achievement of your goals.