As Electronic Quality Reporting activities become more prevalent in health care settings, so are the staff assigned to operationalize their corresponding activities. Acmeware staff has observed a correlating shift – where the workload and administration of electronic reporting applications are being transferred from predominately information technology (IT) departments to clinical quality departments. Perhaps this is partly due to electronic methods of quality reporting are not so new anymore and we suspect that the technical challenges of installing them have been mastered. Combine this concept with the healthcare information technology boom, and it stands to reason that IT teams are seeing the need to transition these quality reporting projects to increase their bandwidth for other priorities. The logical handoff is to members of the quality department who are typically responsible for final quality reporting.
However, there can be challenges with this transition. We at Acmeware have witnessed these scenarios within our customer base and are optimistic that these challenges can be mitigated. Here is how and why we see an exciting potential ahead.
An excellent example was shared by Jonnie Berneking, RN, Quality Improvement Coordinator for Clinics at Salina Regional Health Center (SRHC) in Salina, Kansas where her facility experiences staffing constraints and challenges finding technical staff to focus on quality efforts. Jonnie continues “To help with this issue SRHC moved all the MIPs requirements, measure validation and CMS reporting to the Quality Department. IT still assists with coding and mapping, but the everyday maintenance is done in Quality.”
As a registered nurse specializing in clinical informatics, I am pleased to see this evolving trend. Acmeware believes that Quality department members are well primed for this transition as they already possess the essential ability to apply a clinical perspective to data capture and foundational working knowledge of their current reporting tools used for their facilities’ quality performance. Their skill set already includes keen attention to details and valuable innate ability to partner with clinicians to adjust data capture and workflows. Many may have obtained these skills via manual chart review processes of paper-based documentation and it is these same skills that most certainly cross apply to electronic quality reporting methods.
The reality is, IT teams have found it necessary to involve the quality teams for specific information regarding clinical data capture in the past and will rightfully continue to do so. But the actual set up and administrating of the electronic quality reporting tools and processes, appear to have been managed by IT (such as setting up application access, assigning roles, filling out dictionaries, nomenclature mapping, running reports, and setting alerts and subscriptions for output).
Acmeware client Jodi Frei, PT, MSMIIT, Director of Quality at Northwestern Medical Center in St. Albans, Vermont explains how her facility prepared for this transition: “We changed our direction intentionally, knowing that Quality now is not what Quality was 5 years ago, and that a deep understanding of the EMR is a must have not only for eCQM purposes, but for improving patient engagement and outcomes in general.”
The impact of this shift has a few considerable aspects: The clinical quality teams must now learn additional technical skills to administer these electronic reporting tools. Primed for success, they are already process oriented and well versed with the data they are reviewing. We do predict there will be some technical application tasks (such as upgrades, server maintenance and security/permissions) that will continue to be more appropriately managed by IT. So, the need for technical support still exists and hence a partnership between these 2 departments is critical, now more than ever. Collaboration will be key.
Jonnie from SRCH illustrates the power collaboration can have within quality related efforts: “IT and Quality should always work in tandem to achieve high performance for all quality measures and new upcoming programs. A perfect example of SRHC collaboration in our new Meditech Expanse Discharge Planning committee (Acute, clinic, IT, Pharmacy and leadership are all a part …). It was identified early on that a team of employees working together to make discharge documentation more meaningful for the patient and reflect accurate information would solve most issues. Not only was the entire hospital and clinics affected by poor discharge documentation but patient outcomes (poor medication management causing readmissions) has affected our readmission scores.”
Collaboration activities should also include cross-training and the transfer of knowledge for functionality and end user skills to quality team members. The IT staff need to ensure the quality team members will have adequate access to these tools, so they may efficiently conduct their work which now realistically encompasses a broadened scope.
Quality Team members can prepare for these incoming technical responsibilities by planning necessary orientation activities for new teams or team members. It is wise to include succession planning for when members transition to another role, to not leave gaps in program oversight or activities as duties are re-assigned (this scenario is inevitable in any organization across all projects, yet so often overlooked). Quality teams should become familiar with all the aspects of their electronic quality reporting programs – from the program regulations, to measure specifications and logic, to their site’s clinical workflows and validating the results for accuracy and completeness. They need to become proficient with their electronic quality reporting tools and should seek out help guides, user manuals and any training that can be made available to them.
The upside of this shift is quality teams are naturally closer to the actual clinical workflows and hence, their enhanced involvement can only facilitate the optimization of their data capture which is critical to achieving high performance in quality reporting. They are in the best position to analyze current clinical workflows and improve them if need be, ensuring the required data for quality reporting is accurate and complete. This will in turn result in better quality performance. Performance goals are based upon CMS’ guidance and expectation that when proven best practices for care delivery are applied, patient outcomes will improve. The 2 real-world scenarios shared here validate a positive impact quality reporting efforts can have on patient outcomes. After all, isn’t improving patient care our collective goal?
By Theresa Jasset at 14 Mar 2019, 16:13 PM