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At Tacoma’s MultiCare, Leaders Pursue Core Patient Safety Improvement

March 14, 2016
by Heather Landi
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MultiCare’s data-driven, multidisciplinary project to standardize best practices has led to system-wide clinical outcome improvements and financial benefits.
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Note: MultiCare Health System’s Clinical Collaboratives project was named a semifinalist in the 2016 Healthcare Informatics Innovator Awards Program. Short descriptions of the projects of all of the semifinalists in this year’s program can be seen here.


At Tacoma, Wash.-based MultiCare Health System, a six-hospital integrated healthcare delivery system, physician-led, multidisciplinary teams, called Clinical Collaboratives, are developing and deploying system-wide improvement strategies that have resulted in some stunning clinical outcome improvements and measureable financial benefits. Even more impressive is the fact that MultiCare has successfully implemented a sustainable approach for standardizing best-practice, value-based care across not just a health system, but also across its commercial accountable care organization (ACO), called MultiCare Connected Care, and its clinically integrated network.

In 2011, MultiCare created the two initial Collaboratives focused on improving outcomes for sepsis and heart failure. The significant outcomes from this initiative – a 65 percent reduction in sepsis mortality rate – prompted the health system leadership to accelerate its investment in the Collaboratives and there are now seven Collaboratives across the system focused on critical care, medicine, surgery, primary care, emergency services, women’s services and pediatrics.

Healthcare Informatics’ Assistant Editor Heather Landi spoke with MultiCare leadership involved in the Clinical Collaboratives project to discuss the genesis of the project, the challenges of implementing it and the lessons learned. The second part of the interview will dive more deeply into the project’s impact on improving clinical outcomes and the project’s next steps. Taking part in the interview were: Florence Chang, executive vice president and chief operating officer, MultiCare Health System; Christopher Kodama, M.D., president, MultiCare Connected Care; Albert Marinez, director of information intelligence at MultiCare Health System; Christi McCarren, R.N., senior vice president, retail health and service lines, MultiCare Health System and Kate Mundell, program manager, Clinical Collaboratives, MultiCare Connected Care. Below are excerpts from that interview:

Tell me about the genesis of the Clinical Collaboratives project?

Christopher Kodama, M.D.: There were a couple of things that contributed to the original genesis of this effort. One was a broad recognition among senior leadership, at that time, particularly Florence [Chang], that we needed to transform data into actionable information to eliminate variation and improve clinical care and patient outcomes. Florence’s original work at MultiCare Health System was as a consultant to help with implementation of our electronic health records (EHRs) platform. We’ve been on Epic for over 15 years now, starting with ambulatory, and Florence came on board to help us with the implementation in the acute care environment, and then she ultimately stayed on as chief information officer. What was always interesting to me is that Florence is quite visionary. She is currently VP and COO for MultiCare Health System, but even during the period of time when we were implementing the EHRs, it was really a means to a bigger end. The EHR was the way to start gathering discreet data in a standard sort of way. So we were beginning of examining what’s next and where do we need to go with this so that we are actually harnessing the power of all this data that we spent all this time, energy and investment in creating platforms to support. And so that’s where Florence had initiated conversations with Health Catalyst  to look at, okay, how do we create our own enterprise data warehousing function to start a process of harnessing that data into actionable information that is going to accelerate improvement?

Christopher Kodama, M.D

Subsequently, we broke this into three buckets of work—one was the technical infrastructure around the enterprise data warehouse (EDW) and the data mart creation; the second was around the recognition that we needed some sort of singular governance and direction around analytics and knowledge management for the enterprise; and then the third had to do more with the logistics and standards around security and data definitions.

Now concurrent with that, Christi [McCarren] was already working, initially and primarily from an acute or hospital-based point of view, on cost improvement in the way that we delivery care. So Christi was already working with members of our finance team and our operations teams to start invoking a discipline around how to prioritize and identify the greatest opportunities that would have the greatest impact around cost without compromising quality.

So, if you fast forward a couple of years, the intersection of those two sensibilities—the analytics and transformation of data into actionable information and knowledge coupled with this discipline around prioritization and cost discipline and improvement—is where we landed. Those were the key components of the recipe for success. It began with a recognition that we needed to accelerate our performance in terms of quality, service and cost, and we had a lot of tools that were needed to put this together and we needed to add an operational sensibility into that discipline.

What were the first steps to get this project started?