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At Tacoma’s MultiCare, Leaders Pursue Data-Driven Improvement Strategies (Part 2)

March 22, 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, such as a 65 percent reduction in the sepsis mortality rate.
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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. There are now seven Collaboratives across the system focused on critical care, medicine, surgery, primary care, emergency services, women’s services and pediatrics. The Collaboratives were tasked with accomplishing the following—reduce clinical variation across the system and standardize care; improve and monitor clinical outcomes for high impact health conditions; reduce costs and improve documentation and collections.

Led by physicians, the Collaborative teams are multidisciplinary, including clinicians, operations, finance and data analyst. The Collaboratives are supported with dedicated resources—including clinical resources as well as technology and analytics experts who could work with frontline teams to interpret the data. Technology-enabled analytics were used to support the hardwiring of best practices, providing validated data to support decision-making and prioritization and near real-time feedback on performance transforming data into actionable information to drive results.

Healthcare Informatics’ Assistant Editor Heather Landi spoke with MultiCare leadership involved in the Clinical Collaboratives project. 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. Part one of the team’s interview with Landi from last week can be found here; part two excerpts can be seen below.

How did you set up the governance and structure for the Clinical Collaboratives and the adoption of best practices?

Kate Mundell: In the past 18 months, the biggest step forward, in addition to continuing to focus on matching the clinical quality work with the data analytics piece, has been packaging the Collaboratives as a more formal and methodology program. And we have put that program under the auspices of MultiCare Connected Care, which is MultiCare Health Systems’ relatively new ACO and clinically integrated network product. So, now we have the added alignment of not just the triple aim—experience, quality and the cost—but now you have the contract methodology and payment methodology from an ACO and a clinically integrated network perspective that we’ve aligned that same quality improvement with.

Kate Mundell

The other thing we’ve put into place and one of the other things that has propelled the work forward is that we have instituted a governance and a structure around the Collaborative that didn’t exist 18 months ago. So in addition to the formal staff and the informal staff that we have through the service line agreements, we also have leads on each of the seven Collaboratives and their subsequent work groups. So in addition to people’s day jobs, they provide anywhere from two to five hours a week, which for a provider or a nursing director is a substantial amount of time to invest, and that has helped to move the work forward.