Optimizing clinical performance with meaningful data

In 2022, the Office of the U.S. Surgeon General issued an advisory on health care worker burnout and wellbeing, declaring the situation a threat to the nation’s health requiring action from health systems, insurers, government and other stakeholders. Today, the health care industry continues to experience significant clinician burnout and staffing shortages.

“Burnout is caused by administrative tasks like documentation and insurance claims that providers and clinicians aren’t taught in residency and medical school,” said Patrick Woods, physician advisor at RSM US LLP.  “Follow up queries, lengthy orders sets in electronic medical record systems and temporary staff without proper training all take significant time and energy away from patient care.”

The most common causes of clinician and provider burnout include:

• Data paralysis
• Documentation overload
• Lack of standard tools
• Inconsistent or poor communications
• Staffing shortages and temporary team members
• Varying and labor-intensive payor requirements
• Insurance denials and queries
• Patient outplacement issues

To drive operational change with busy clinicians and providers, it is critical to introduce new approaches to engage them with meaningful analytics and reporting, develop straightforward dashboards that summarize complex data, and implement consistent and sustainable data reporting.

Leveraging analytics to drive clinical performance

Developing a successful approach to engaging providers and clinicians with analytics will improve clinical documentation, more effectively use provider and clinician time, and ultimately lead to positive changes along the health care continuum.

Key steps to implementing change and encouraging the adoption of organizational transformation using analytics include:

• Identifying opportunities, creating SMART (specific, measurable, achievable, relevant and time-bound) goals, and leveraging data analytics
• Designing operational strategies to address gaps
• Developing a roadmap and standardized care paths to guide treatment choices
• Executing approaches to transform and sustain improvements

“We have more data than we've ever had, and it is a challenge for clinicians and providers to gain helpful insights from it,” said Jamie McGlothin, principal, health care analytics at RSM. “By analyzing which departments need process improvements and what types of insurance claims are being denied we have a real opportunity to make data-driven decisions that are beneficial for clinicians and patients alike.”

Clinicians and providers need insights provided in a simple, straightforward manner that is easy to understand, is relevant to them and points to executable process improvements. Providing data to streamline documentation for greater impact can help to curb clinician burnout and motivate them to identify opportunities for change.

In a recent analysis, RSM utilized data with a previous client to pinpoint which clinical conditions were being underreported compared to the expected code rate.  One example of this showed that there was a 9% difference between the actual and expected code rates for encephalopathy for a specific physician group. In response to the data, RSM worked to introduce training and education through the client’s electronic medical record system to better assist providers with reporting. After receiving the data, clinicians improved their code rates and individuals who did not adapt were quickly provided additional training.

In another recent analysis, RSM reviewed the length of stay index, which compares the expected patient length of stay to their actual time in the hospital.

Many factors lengthen hospital stays unnecessarily including:

• Extra diagnostic tests or imaging
• Duplicative or unnecessary consultations
• Delays in getting patients to be ambulatory
• Placement challenges upon discharge

“Studies show that good treatment is more profitable and that reducing the length of hospital stays lowers readmissions and mortality. The longer a patient stays in the hospital, if they don't need to, the more likely they are to get a hospital-acquired infection,” said McGlothlin. “The best treatment is the highest margin treatment, so clinicians have easy choices to make.”

Organizations that are successful when it comes to sustaining data improvements make adjustments based on data readouts, set and stick to scheduled reviews of data dashboards, and in parallel continue to move the overall business forward. When reviewing an organization’s performance improvement plan, leaders should consider several questions:

• Is the plan still relevant?
• Do we still need the same measurements and analyses?
• Are we regularly and transparently communicating data and lessons learned?
• Have new technologies become available that should be integrated into data readouts?

Get more information and insights on sustainable margin improvements in clinical settings.