According to the Institute of Healthcare Improvement (IHI), preventable harm in health care is a public health crisis, with estimates placing it as a leading cause of death in the United States. Let that settle in for a second. For healthcare administrators across the country, this crisis translates into an overwhelming amount of malpractice costs and erodes already razor-thin margins.
The National Patient Safety Foundation (NPSF), now formally a part of IHI, has introduced an evidence-based approach that, according to them, identifies effective, replicable interventions for effective propagation across the health care system.
Many healthcare systems have effectively implemented many of the components of this framework; primarily, they set goals, measure/monitor, and identify causes and interventions. However, where they fall short is in creating systemic interventions (with a focus beyond just the clinical elements) and making those interventions stick. At W3 Group, we have identified three main root-causes as to why this occurs:
Now, let’s explore how our evidence-based management system addresses these.
To understand how to address these root-causes, let’s use a specific and recent client example.
Managing Patients with Diabetes. More and more people are developing diabetes which presents a considerable challenge to healthcare systems. Primarily because patients with diabetes present a higher risk and, thus, must be better managed. For instance, in one healthcare study, wrong dosage or delayed/omitted dosage of Insulin accounted for 46% of harm to diabetic patients. At one of our current clients, we conducted a current state analysis of how healthcare organizations typically manage their diabetic patients. Here is what we found.
Current State of Diabetic Patient Care. Our client’s goal was to reduce incidents of harm and measure A1c levels in their diabetic patients. To accomplish this, they implemented a policy to administer Insulin within 30 minutes of a finger-stick to ensure the insulin dosage would be correct, and there would be no issue with omittance. In addition to this process, they coordinated patient meal delivery to ensure the patient would have a proper meal to eat per their individualized protocol.
In the agreed-upon future state, we addressed each one of these failure modes as follows:
Upon implementing this solution, the process adherence resulted in the percentage of Insulin delivered within 30 minutes of a finger stick to increase from an average of 40% to a high of 100%. Immediate improvements are exciting; however, long-term sustainable improvements are what we strive towards. In this particular example, we just hit 100% after a month and a half of iterations and incremental improvements. Over the last six weeks, we have tremendously improved, and within the next couple of weeks, we should be hitting our target of 85%.
Image: The following image depicts the improvements made to the process of completing the administration of Insulin to the patient within 30 minutes of a finger stick.
As you can see, here at W3, our evidence-based management systems go beyond surface level solutions. Our evidence-based management system involves a series of tools that comes together to create an evolved system that ensures delivery of care, decreased incidents of harm, and improved margins. Please give us a call if you would like to implement such systems that can extend beyond the management of patients with diabetes to any healthcare problem.