The June 2012 e-bulletin highlights the Summer 2012 Leadership magazine, which showcases how hospitals and other providers are responding under increased transparency by working to improve quality and reduce costs.

Using Business Intelligence Intelligently  

Across the country, health systems are turning data into useful information in surprising new ways. By combining data from a myriad of sources, analyzing it to inform specific processes, and presenting it in easy-to-understand formats, they are improving efficiency, lowering costs, and saving lives.

For example, Denver Health is using business intelligence to identify patients who are likely to have a heart attack or other serious cardiac event. A programmed "workflow" continually scans the hospital's data warehouse in search of patients who are deteriorating. If certain factors-for example, oxygen levels or systolic pressure-hit predetermined thresholds, clinicians are notified so they can intervene.

The Push to Value-Oriented Payment  

Centura Health has insurance contracts that tie payment to its performance on everything from readmissions and quality improvement goals to patient satisfaction scores and timely notification of a member's hospitalization. In general, 1 percent to 2 percent of Centura's net revenue is tied to its performance. "One to 2 percent is an important number for Centura," says Bradley Olson, former director of payer relations and contracting for the 13-hospital system.

Major employers, however, are pushing for much more. Catalyst for Payment Reform, a not-for-profit organization that represents 22 of the nation's largest employers and other healthcare purchasers, wants 20 percent of aggregate net payments to providers to be value-oriented by 2020.

Device Alarms: Ensuring They Help, Not Harm  

During a 24-hour period at Boston Medical Center (BMC), patients and staff in a single unit heard 2,489 cardiac arrhythmia alarms. The vast majority-some 1,600-were clinically unimportant.

"It causes alarm fatigue," says Jim Piepenbrink, director of clinical engineering at BMC. "People get desensitized to alarms and they may overlook a crisis tone."

Alarm fatigue-along with other alarm safety issues-contributed to more than 500 patient deaths between 2005 and 2008, according to one report. Eliminating unnecessary noise may also influence hospital revenues. Through its value-based purchasing initiative, Medicare is evaluating each facility's scores on the HCAHPS patient satisfaction survey, which includes the question: "During this hospital stay, how often was the area around your room quiet at night?"

Fixing the problem of alarm safety involves both simple and complex solutions, say leaders at BMC and Johns Hopkins.

Transparency Leads to Better Quality at Two Health Systems  

The phone did not ring off the hook as expected. In September 2005, Alegent Health thought it was making a dramatic move by posting its quality scores on its website and in the local Omaha, Neb. paper. "We thought it was an enormous deal. We thought we'd get all kinds of questions and start discussions in the community," says president & CEO Richard A. Hachten II, FACHE. "But most of the questions came from our competitors who wondered why we were doing this," he added with a laugh.

However, one very important contingent-Alegent physicians and employees-took the publicly posted metrics very seriously. Unhappy with their performance on nationally recognized quality measures, they committed to meeting aggressive improvement targets. Within a year, Alegent's scores rose to 94 percent on average, from below 90 percent. Today, the health system scores 97 percent or better on 40 quality metrics.

Communicating Difficult Changes  

"The most important way of dealing with monumental change is to have frequent, timely, and transparent communications," says Richard J. Henley, FACHE, FHFMA, president & CEO, Healthcare Strategic Solutions, LLC.

Brought in as interim CEO, Henley transitioned the 85-bed New Milford Hospital through a merger with Danbury Hospital, a larger teaching hospital. The merger was anything but routine. "It was clear from the start that we needed to approach this with a strong sense of openness and transparency," says Henley.

More Inside Leadership  

The Summer 2012 Leadership magazine also contains profiles of three prominent healthcare leaders: Catalyst for Payment Reform executive Suzanne F. Delbanco, Unity Health System leader Joyce Zimowski, and telemedicine guru Curtis L. Lowery Jr., MD.

In addition, access columns from Leadership contributors, including Northwestern Memorial CIO Timothy R. Zoph; the Institute for Healthcare Improvement's Katharine Luther, RN; performance improvement expert James L. Reinertsen, MD; and HFMA's Todd Nelson.

Finally, healthcare leaders share the important management lessons they've learned from patients

Publication Date: Monday, June 25, 2012