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By Tommy J. Smith
President and CEO
Baptist Healthcare System, Inc.
Louisville, Ky.
Turning Data into Actionable Intelligence
Like other healthcare organizations across the nation, Baptist Healthcare System (BHS) collected and stored vast amounts of clinical and financial data. And like them, we faced the question of how all this information could be leveraged, not only for quality reporting, but also to improve patient care.
We found the answer in using performance analytics to build a culture of transparency that made data broadly available to administrators, clinicians and even the public in near real-time. By providing directors, managers and caregivers with timely access to actionable performance data, we achieved remarkable improvements in patient care, clinical efficiency and financial performance.
Developing Best Practices
To help drive clinical best practices, BHS used Appropriate Care Measures (ACM) as the primary performance gauge. Developed in conjunction with the Centers for Medicare & Medicaid Services (CMS), these indicators reveal whether patients receive all clinically appropriate care during their hospital stay.
By adopting these benchmarks, Baptist set a high standard for patient care in specific areas. In addition to tracking the compliance rates for more than 20 individual indicators, we created a single composite measure to give us an overall snapshot of how we were doing.
As a result, our improvements in ACM scores included:
 87% overall increase
Tripling of pneumonia scores from 29% in 2004 to 89% in 2007
Improved heart failure scores from 65% to 82%
Increased surgical care scores from 43% to 83%
When we began our initiative, our team realized that even quality measures required by regulatory agencies were not readily available to providers who wanted to improve outcomes. Typically hospitals share publicly reported indicators only after data has been scrubbed. By then, the data is months old and not very useful in making and measuring process change improvements.
Creating a Culture of Transparency
At BHS, we wanted to foster a culture of transparency, engagement and accountability. Managers believed they could achieve significant increases in performance by disseminating information broadly and in near real-time. We also wanted to ensure that clinicians at all five of our hospitals worked in collaboration to develop and share best practices.
We already had an extensive IT infrastructure based on a variety of clinical and financial solutions provided by McKesson. To more fully leverage the power of these applications, our team, led by our Director of Decision Support Bernie Porter, turned to McKesson Performance Analytics™. Using this solution, we were able to develop a single data set to support multiple metrics tailored to specific stakeholder groups.
Performance Trends — Near real-time, online scorecards give users documented performance trends by indicator, facility, physician, specialty, nursing unit and nurse.
Timely Data for Process Improvement — Clinical data is distributed on a timely basis to a wide range of groups, including physicians, quality managers and other individual stakeholders. We provide it in an interactive format that enables them to investigate trends and make improvements.
Evaluation, Education and Best Practices — The reports are used to evaluate the impact of process improvements and to educate caregivers. They also provide data for developing and implementing best practices that improve patient care and outcomes.
Pay-for-Performance Metrics — Clinicians use the scorecards to document and research key aspects of patient care related to pay-for-performance metrics.
The quality reports are available daily, enabling clinicians to evaluate the care process while specific patient encounters are still fresh in each clinician's mind. This near real-time reporting is essential to facilitating continuous process improvement. Accountability for clinical performance is improved because individual caregivers are assigned specific responsibility based on their role in the process.
Winning the Competitive Game
Our commitment to transparency helps distinguish BHS in a .highly competitive healthcare marketplace. We believe that our quality measures demonstrate that our hospitals offer the best care for patients.
For example, even as CMS tightened its benchmarks, BHS scores have continued to improve since 2004. In more than half of the publicly reported indicators, we are meeting or exceeding the scores of the top 10% of hospitals. Baptist also meets or exceeds its competitors' scores 75% of the time in its three major markets. Posting our performance indicators on the BHS Web Site enables the public and our patients to follow our process improvements.
All five Baptist hospitals have fully met CMS quality-of-care reporting standards to win the full CMS Annual Payment Update — representing more than $40 million for the organization.
In today's healthcare environment, information is the key to success. Through the use of analytics, BHS has been able to create not only a path to improved patient safety and superior outcomes, but a means for meeting the challenges of competition and government reporting standards.
Baptist Healthcare System is a winner of McKesson's 2009 VIP Award. Each year McKesson recognizes customers that demonstrate vision and innovation in the use of information technology to enhance healthcare performance.
Tommy Smith has served as President and CEO of BHS and BHA (Baptist Healthcare Association) since March 1995. His career in hospital administration spans more than 30 years with BHS. In 2000, he was awarded the Senior-Level Healthcare Executive Award from the Regent of Kentucky. He is a Fellow of the American College of Healthcare Executives and is a member of the American Hospital Association. He was appointed a section delegate of the American Hospital Association House of Delegates and Regional Policy Boards from 2001 to 2003. In addition, he is an adjunct professor in the Department of Health Services Administration at the University of Alabama at Birmingham.
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