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Best Practices Stretching dollars without compromising care


Two industry veterans lay out a pathway to physician-directed, best-practice improvements through comparative effectiveness research.


T


By William C. Mohlenbrock, M.D., and Thomas M. Kish he economic challenges of the past decade


have placed hospitals under unrelenting pressures to reduce costs while maintaining quality. With most of the stray dollars already


found, any further cost-cutting initiatives will likely bring with them the danger of compromised quality of care.


endeavors. Timely, accurate and accessible data brings with it an immense power for clinical process improve- ments and enhanced effi ciencies. By allowing physicians to direct process improvements, the hospital can reduce the misuse and/or overuse of hospital resources, obviate costly errors and control variations in care delivery that compromise medical outcomes. But to do this, physi-


the misus costly err comprom


As history has proven, advancements in the healthcare fi eld rarely come from outside the profession. It’s up to providers to be proactive in addressing their well- publicized quality and cost problems.


How do healthcare organizations successfully re- spond to these challenges? They need new tools and new thinking; they need new ways to increase clinical quality and effi ciencies. More than ever before, physi- cians are the key. The next stage of improvement must be a collaborative effort among physicians, clinical staff members and execu- tives, working together to develop innovative ways to improve patient care. This imperative for phy- sician and hospital col-


William C. Mohlenbrock, M.D., is chairman and chief medical offi cer of Verras. Thomas M. Kish is president of Verras. For more information on Verras solutions: www.rsleads.com/001ht-207


laboration is felt most acutely in those hospitals where medical staff members are coming to the administration and requesting to become hospital employees. The burden of offi ce overhead, personnel management and loss of ancillary services is driving physicians to become employees. But this actually presents an opportunity for innovative hospitals. To take full advantage of physicians’ integration within the hospital, the enterprise must become as data driven in its clinical arenas as it is in its fi nancial


28 January 2011


cians need more specifi c clinical information. On the organizational side, aggregated information can be analyzed and compared to industry norms. Using comparative data, clinicians can facilitate incremental, continual and ultimately transformative reforms in re- source utilization and clinical outcomes. What’s more, measurements exist that can quantify the fi nancial benefi ts of clinical improvements, creating a system that actually pays for itself.


In the clinical environment, comprehensive informa- tion gathering begins with the physician. In order for a new era of quality improvement to be successful, new solutions must be implemented that are faster, easier for clinicians to use and more easily integrated than paper charts. Thankfully, technology is proving to be a terrifi c partner in this regard. New and increasingly affordable electronic charting alternatives exist that can not only be implemented in hours or days (instead of weeks or months), but also interface with enterprise- class data systems for analysis.


Such clinical systems have been shown to lower costs and raise quality of care through bi-directional information sharing. Knowing what tests have been


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