Sherri Standridge, RN | Assistant Director, Operations
OVERVIEW
In an ever-evolving healthcare landscape, leaders must utilize strategies that enhance teamwork and engagement while improving patient outcomes. In a study of healthcare workforce turnover, researchers found that low engagement was a high predictor of turnover for clinicians (Willard-Grace et al., 2019) and led to lower rates of preventative care and patient satisfaction (Plomondon et al., 2007). Additionally, patients whose primary care physician left the workforce or changed practice locations sought less primary care and more specialty care, urgent care, and emergency department care services (Sabety et al., 2021). Leaders in the healthcare industry must employ innovative and strategic measures to ensure staff is engaged in order to ensure continuity of care and ongoing positive outcomes for patients.
BACKGROUND
Valor Healthcare, Inc. is a national leader delivering primary and behavioral healthcare services to more than 160,000 veterans in over 50 clinics across 16 states each year. As the largest contractor to the U.S. Department of Veterans Affairs (VA), Valor is responsible for continuous quality improvement and ensuring that America’s heroes continue to receive the world-class healthcare services they deserve. As an industry leader, Valor invests in quality. In addition to a robust data-driven quality plan, Valor invests in our single greatest asset for quality improvement – our leaders.
Recognizing the changing needs of our leaders across the country, Valor engaged with FranklinCovey, a respected advisor in leadership and business execution, and its online learning module, “The 4 Essential Roles of Leadership.” We made this content available to all national and regional leaders. Leveraging the training provided through FranklinCovey, Valor leadership found early success in implementing the “Wildly Important Goal” (WIG) strategy to engage our colleagues and improve patient outcomes.
SOLUTION DETAILS:
As outlined in the leadership program, Valor’s Area Director of Operations (ADO) executed the process outlined below to engage the team in one of our Tennessee clinics in developing a weekly WIG. The clinic has two Patient Aligned Care Teams (PACT), each caring for a defined panel of patients. The teams worked in a friendly competition to improve outcomes in two crucial preventive clinical measures – blood pressure control in non-diabetic patients and influenza vaccination rates for patients 65 and older.
Standard Operating Procedure
- ADO uses VA’s Electronic Quality Measures (eQM) database to pull outcome measures for the clinic at the beginning of the week.
- PACT Teams review the data and choose one measure to be the WIG for that week, including the targeted improvement amount for that week.
- PACT Teams work together to develop and implement the improved/redesigned process or workflow changes they believe will impact the WIG the most.
- ADO pulls the eQM data again the following week to measure progress, after which staff choose a new WIG for the following week.
OUTCOME
Valor measures its success on all quality measures against the VA national average and the average scores for the parent VA Medical Center to which the clinic belongs – in this case, VA Tennessee Valley Healthcare System (VATVHS).
The first two weeks of this process resulted in resounding success for both clinic staff, and the veterans served. In the first week, the clinic PACT Teams chose to focus on Non-Diabetes Mellitus Blood Pressure control, or “Non-DM Blood Pressure” and set a goal for 2.5% improvement from baseline. After one week of increased focus and friendly competition, PACT Team 1 achieved a 6.2% increase and PACT Team 2 achieved a 6.4% increase.
The second week, the teams chose to focus on flu vaccine utilization for veterans aged 65 and over and set a goal of a 5% increase from baseline. After one week of focus on this goal, PACT Team 1 achieved a 15% increase and PACT Team 2 achieved a 15.6% increase. The trend graphs below demonstrate the improvement achieved by each PACT Team.