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University of Utah HealthcareValue Management SystemBob Pendleton MD FACPChief Medical Quality Officer
UUHC: Becoming the Provider of Choice INPATIENT: Rate this Hospital 1-10 (% total patients choosing 9-10) UHC National %tile Rank UHC National %tile Rank
UUHC: Nationally Ranked Outcomes 1 *Ranking out of >98 National Academic Medical Centers 4 7 9 37 50 20082009 2010 2011 2012 2013 * UHC Quality & Accountability Annual Scorecard
Use of Color Payers of Healthcare & a sample of Value related Initiatives Government Insurers (e.g. Regence, etc.) Employers Public Medicare (CMS) Medicaid HEDIS Direct Contract Direct & Rankings ACO IPPS OPPS CMMI PQRI OQR MU IQR VBP HAC HRRP MU PQRS MU
Growth of National Value Metrics 700 Measures & counting… 614 measures 464 measures 402 measures 277 measures
Value Management System: System Management Resource Management Measure, Analyze, Improve Service Delivery Service Delivery Service Delivery Inputs Outputs
Clinical Services Safety Committee (QM.8) HCEC QMOC (QM7) Hospital Board Document Control Cmt Value Core (QM.7) Value Council (GB.1) Management Review: Audit results Corrective actions Measurement Analysis Governing Body: Operational oversight of clinical delivery system Value Creation Team Medical Board Support Services Basic Structure of our VMS
Clinical Services Chief Value Officers Rob Glasgow - Surgery Peter Yarbrough - Medicine Chris Pelt- Orthopedics Susan Baggaley - Neurology Meic Schmidt - Neurosurgery John Bohnsack -Pediatrics Jerry Hussong- Pathology Howard Sharp – OB GYN Bernadette Kiraly – Family Medicine Mark Eliason - Dermatology Jim Ashworth- Psychiatry Dave Gaffney- Rad Oncology Value Council (GB.1) GME Value Council
System alignment • System goals • System mgt.
Entitlement • Typical approach to system performance & improvement: • BUT- isn't every patient entitled to optimal performance? Poor value Average value Optimal value Standard value
Value Management System: Focus on Improving Processes • Focus on Results Problem Solving (Reaction) • Focus on Process Problem Prevention Fix Problem 1 Fix Problem 2 Fix Problem 3 Redesign Process to Prevent Problem 1 Redesign Process to Prevent Problem 2 Redesign Process to Prevent Problem 3 Build Standard Work & Forcing Functions Build Standard Work & Forcing Functions Build Standard Work & Forcing Functions Monitor Results Monitor Results Monitor Results Improve Process Further Improve Process Further Improve Process Further
How? Value Improvement Methodology: (re-)Define Problem & Goals Analyze & Investigate Design & Implement Impact 1 Improve Value 2 5 1 Improve Value 2 5 4 3 1 Improve Value 2 5 4 3 1 Improve Value 4 2 5 3 4 3
YOU (& your residents) voice & input is critical: • GMEC sponsored group to facilitate two-way input on UUHC value efforts • Coordination with the CVO in your Departments • Should CRIT (empowered CMRs) remain a vehicle? • System use of Value Summary • Core training from Value U • Safety event reporting & subsequent management