Hospital systems, post-acute care providers and physicians are all participants in today’s world of value based healthcare. The Centers for Medicare and Medicaid Services (CMS) has established specific models to encourage all participants to work together to improve quality and coordination of care from the pre-surgery process through recovery1. In order to receive maximum bundled payment reimbursements, they must meet recognized patient outcomes.
Today's Challenge
Hip and knee replacements are the most common inpatient surgery for Medicare beneficiaries and can require lengthy recovery and rehabilitation periods1. It is crucial that the participants in their care establish strong oversight teams to navigate their way through the quality metrics and standards. It sounds easy, right? However, the challenge is that many participants don’t have the technology or the means to obtain the data to assess key success determinants or the process flow to standardize their process of care.
How Workflow Can Help
Hip and knee replacements are a great way to demonstrate how clinical pathways are complemented by workflow automation. The surgical process can be broken out into discrete processes. These processes can be easily converted into workflow which contains the necessary actions for oversight.
For example, patient appointments, scheduling, pre-optimization, patient progress tracking, discharge dispositions and patient follow-ups are all handled by multiple care takers at varying stages of the process. Each entity in this process needs to see different information to give the green light for the next action to take place. System generated rounding snapshots can help surgeons see exactly what they need to see if the patient is not walking timely post-surgery. The information in the rounding snapshot will show why and allow for changes to be made in real-time. In this case, an overuse of medication by a physician might be preventing proper mobility.
In addition to managing the patient flow, standardized workflow means ensuring all surgeons within a group or system are meeting the same best practices defined by the healthcare organization. Let’s say a patient is discharged without having the proper range of labs within discharge tolerances. When the process doesn’t follow best practices, the workflow will alert stakeholders and launch an exception path for review. This establishes visibility into not only physician performance but allows you to review patient’s clinical data in relation to length of stay and what might eventually be a readmission.
Raise the Bar
To take this innovation to the next level, organizations are creating positions like Nurse Navigators to provide coordination into the management of the patient pathway. With the right technology they can deliver surgeons actionable data to review a patient risk factors for maximum pre-surgery optimization. These critical actions and data points can be proactively managed by skilled nurse navigators accessing real time information from within workflow views, integrated with EMR data for critical clinical oversight and ease of decisioning.
Key risk determinants and process standards are embedded within the clinical pathways. Examples being mobility, ambulation, labs and comorbidities. The patient data becomes actionable as it is compared from one day to another in one quick view. This quick view provides a linear story of the patient’s progress without chart scouring and allowing physicians to make quick assessments. At the same time because of the interoperability and dynamic views, the nurses are no longer burdened with heavy patient data collection.
CLARIFIRE HEALTH®
Innovation requires a new way of thinking. CLARIFIRE HEALTH is the innovation you are looking for to take your clinical workflows to the next level. Our mobile technology standardizes and streamlines workflow associated with administering patient care. Enabling participants to have the information they need, when they need it. With successful measurement of processes and variations of care, the result is higher quality and better, more consistent outcomes. Go beyond standardizing surgical pathways, raise the bar for excellence of care.
1https://innovation.cms.gov/initiatives/cjr
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Lauren Walling
Lauren Walling is a graduate of Emory University with a degree in Industrial Psychology, as well as an MBA from the John Sykes School of Business from The University of Tampa. She currently sits on the Board of Fellows at the University of Tampa, and is a member of the Healthcare Business Women's Association, National Association of Professional Women, and the Morton Plant Skip Cline Society. Lauren works with large Healthcare Systems implementing Patient Experience Solutions that streamline processes, increase patient experience and improve quality and safety.
