Trevor Strome is process improvement lead in the Emergency Program at the Winnipeg Regional Health Authority in Winnipeg, Manitoba, Canada, as well as an assistant professor in the Department of Emergency Medicine, College of Medicine, Faculty of Health Sciences, a the University of Manitoba.
This spring, Strome published a new book, Healthcare Analytics for Quality and Performance Improvement, published by Wiley, and available on Amazon. He also blogs regularly on a variety of healthcare topics.
Strome is one of the conference chairs for the Health IT Summit in Seattle, to be held August 19-20 at the Seattle Waterfront Marriott, and sponsored by the Institute for Health Technology Transformation, or iHT2. Since December 2013, iHT2 has been in partnership with Healthcare Informatics through HCI’s parent company, the Vendome Group LLC. Strome spoke recently with HCI Editor-in-Chief Mark Hagland regarding the publication of his book, and his perspectives on healthcare IT, quality improvement, and executive management in patient care organizations. Below are excerpts from that interview.
Congratulations on the publication of your book. What made you decide to write it?
I’ve been working in the field for a long time, and the work I do crosses over from technology into management and leadership, and quality improvement. I work a lot with these different teams; and in my experience, technology, management, and IQ were always tightly linked in their activities, but acted as though they were living on different planets, right? So the QI guys would have all these requirements for data, but didn’t know how to connect to IT. And the people in IT didn’t know the first thing that these Six Sigma black belts needed. And the management and leadership teams sort of saw these groups as being in different worlds, and didn’t know how to bring them together.
So when I was leading QI teams, I was always frustrated that there wasn’t as much connectedness as needed. So when I was given the opportunity to write the book, I wanted to help connect the dots between and among those three groups.
Making all this work successful requires bringing everyone together at the same time, all the stakeholders, and speaking the same language, to get good initial data inquiries/queries, then, correct?
Every analytical question starts out best with a good, well-formed question, right? So what are we trying to do? Decrease sepsis? Decrease lengths of stay? Improve patient satisfaction? So there’s got to be a good question about that. And then once we know what we’re tackling—the projects that work the best start with a good perspective. So say we’re doing a lean rapid improvement event, or a Six Sigma DMAIC project [define, measure, analyze, improve, and control]—we start out with integrated teams. I’ll make sure we have strong clinical representation from medicine and nursing, strong management representation, and obviously strong QI representation; and then the IT folks and the analytics folks—and sometimes, they’re the same people and sometimes not.
And then the QI people start to formulate a way to better understand the problem; the IT and analytics guys can work with them to sort of better work out how to proceed, and they become familiar with concepts like run charts and other ways to present data—improving their familiarity with QI concepts. So then what we’ve seen is an incredible amount of brainstorming and synergy happening, where the data guys and the IT guys are able to deliver information that’s useful, and are able to come up with information that’s more useful, and more useful vehicles. So we’ve been able to generate dashboards, monitoring, real-time alerts, etc.
How do you see the role of IT managers and leaders in these performance improvement projects?
The way I think IT managers need to be is they need to be enablers. And they need to understand that our best work projects happen when the people with the creative ideas are unencumbered. Ideas will percolate naturally out of QI brainstorming. And if we keep QI and IT separate, they’re working in their own separate worlds, so the QI people don’t know what’s possible, and the IT people don’t know what the QI people need. So we get into this traditional cycle of QI people having to track down the data or ask for a data dump or whatever; but now, when our teams work together, all this innovation can happen. And the QI and IT people are talking from the beginning, and can build things better. So it all has to start at the very beginning, because if the QI and IT people come together too late on a project, a lot is lost.
How do clinical informaticists—physician, nurse, and pharmacist informaticists—fit into all of this?