Clinical process analysis.

Abstract

157 Background: MD Anderson has been working with Harvard on a pilot project for Time Driven Activity Based Costing: a component is Clinical Process Analysis, which brings value on its own. It provides a visualization that “speaks” to those delivering the service. This brings great awareness of frontline reality for staff and leaders alike and the many “ah-ha” moments creates a urgency for improvement. As Berwick shared in his keynote speech at IHI 2011, "the quality movement will rise or fall on its success in reducing the cost of health care.” In order to make the right changes, who best to reduce the cost, than those delivering the service? According to Don Berwick and Dr. Brent James, the burden of changing the face of healthcare lies with us. Methods: When frequencies, probabilities and salaries are incorporated into processes of patient care, the cost of direct labor can be determined and opportunities for improvement visualized. Based on lessons learned, tools (data driven road maps, blueprints) and successful strategies (standardized process flow maps templates) have been developed to efficiently and effectively disseminate Clinical Process Analysis throughout clinical areas. Results: Data analysis and front-line reality are synchronized. Allows a “broader” view of the patient’s journey outside of one’s own discipline. Builds bridge between financial and clinical worlds by engaging clinicians through a patient-centered care perspective rather than a perspective of budget, variance and financial cost reduction. Identifies opportunities for improvement. Provides opportunities to build “psychological safety” in order for frontline staff to share with clinical area leadership the process realities of patient care. Based on feedback from physicians, managers, staff and financial experts, the process flow charts are useful to track patient flow, resource utilization, customer satisfaction, patient education, and on-boarding of new staff. Conclusions: Clinical Process Analysis provides an engaging first step to drive improvement in clinical quality and financial performance.