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Chris Kerby, Diana Poulimenos

As payment models continue to evolve towards value-based care, healthcare organizations are using quality metrics to not only monitor outcomes but to create a better consumer experience and drive growth. Today, we know that consumers’ perception of the quality of their visit is impacted by ease of scheduling, meaningful communication with the physician/provider, facility cleanliness, and timeliness of follow-up activities. Similarly, consumers’ perception of the quality of hospital services offered is impacted by reported safety measures, including risk of hospital-acquired conditions (HACs), readmissions rates, and mortality rates. Defining, measuring, and improving quality is no easy task for healthcare organizations and something that cannot be achieved by administrators alone.

Central to the quality journey, which requires balancing reimbursement pressure with delivering care more efficiently and for less cost, is physician engagement.”

Central to the quality journey, which requires balancing reimbursement pressure with delivering care more efficiently and for less cost, is physician engagement. By developing strong partnerships with physicians on the journey to higher quality, leaders can gain physicians’ expertise on what will truly lead to higher quality care while creating alignment through a shared understanding of the organization’s vision and the need for change. In doing so, these partnerships also enable physicians to become catalysts for improvement.

Motivate Physicians to Engage in the Quality Discussion

Incentives such as bonus compensation and motivational messages are rarely effective drivers of change amongst physicians. Instead, leaders need to look at what truly matters to their physicians and align incentives for improving quality to physicians’ broader goals and purpose. For instance, as quality outcomes improve, reimbursement surpluses can fund priorities that physicians see as valuable, such as new technology to enable better consumer care or to streamline processes.

While physicians need to understand the organization’s “why,” they’re experts in what they do and should be key stakeholders through quality metric development, execution, and evaluation. This creates opportunity for physicians and operational leaders to partner and drive change by architecting new processes that will deliver results. It also provides physicians with the chance to be directly involved in the changes that need to occur by bringing forth innovative ideas and guiding them through implementation. In the end, the incentives physicians receive will be tied to the goals they set forth, supported by processes they developed, and results that can be achieved within their operational control.

Let Physicians Guide Goal Development

In an evaluation of 86 performance metrics related to internal medicine practice, just 37 percent were deemed valid by the American College of Physicians. There are also more than 2,500 different performance measure for physicians in the United States. To break through the noise of data and clutter, only focus on metrics that are valid and backed by credible data and equate to value (monetary or quality). In doing so, physicians will have a better understanding of the impact the organization is seeking to achieve through quality related initiatives.

Physician involvement also ensures goal development takes into consideration the care setting being measured. For instance, physicians who practice in an outpatient preventive care setting will be able to impact quality in ways that are different from physicians caring for complex hospitalized patients. With the input of physicians, you can better address the challenges around quality in different care settings during goal development and ensure the metrics you set forth are both relevant and impacting care.

Partners for Change

Defining quality metrics is only one step on the journey to improving quality. Engaging physicians early in the process sets the stage for the establishment of a governance model with a focus on quality and safety. This level of physician engagement and physician leadership supports:

• Cascading of goals that have been set forth throughout the organization
• Promoting a culture that emphasizes safety and reliability
• Training of team members on appropriate behaviors and skills to support quality initiatives and providing them with technology and equipment to make achieving quality goals attainable

Establishing transparent and real-time quality metric reporting across the organization. Goals are a critical piece of the quality puzzle and necessary for assessing the effectiveness of improvements and engagement. Additionally, goals reinforced by physician leaders can support positive changes to an organizations culture, which when supported by a robust process-driven improvement engine, can lead to improved clinical outcomes, higher reimbursement, lower cost, and increased consumer satisfaction.

In today’s changing healthcare landscape, quality has the potential to have a direct impact on increasing revenue and improving margins. Engaging physicians in the journey to move the needle on quality is key to generating future profits from risk-based contracts, building brand recognition in the market, and delivering high-quality care that attracts and retains healthcare consumers.