Value-Based Care: Quality Improvement in Organizations

COURSE 6 of 7. Fragmented healthcare has created the need for healthcare reform, changing how healthcare is delivered and managed by shifting the structure and culture of healthcare organizations across the U.S. In this course, you will explore ways that provider organizations can successfully move from volume to value through implementing Quality Improvement plans and Continuous Quality Improvement. Organizational improvement is a continuous process. To be successful means coming to grips with things you have to do, how they get done, and who needs to be involved. Paramount to the process is recognizing that every role—every team member—in the organization is important to a successful VBC strategy. You will also learn about adaptive leadership and how to advance vision and innovation through collaboration. Collaborative relationships between team members and leadership are critical to the transformation. You will explore strategies to gain buy-in, agreement, and understanding about the organization’s vision of value-based care and learn to engage team members in developing solutions to challenges. In the summative assignment, you will identify a measurable value-based care goal that would benefit from process improvement, describe how that goal will be communicated with the care team, and explain your role in leading the targeted improvements.

• Quality and Process Improvement to Evolve the Practice
• If you participated in earlier courses, you have learned that the journey from volume to value for any provider organization is one of continuous improvement and change. Successfully moving to a value-based care agreement with a health plan takes many steps and is not completed all at once. In Course 5, new competencies, new roles and responsibilities for staff, and new financial and other measures required for a successful transition to and ongoing maintenance of a value-based care organization were examined, in addition to some of the challenges in the transition and ongoing work. Throughout, it was clearly noted that a big part of success is adopting a Quality Improvement (QI) plan. Why? What does that even mean for you and your organization? In this module, we look more closely at continuous quality improvement, or CQI. In this course, you will again hear the theme, “This is not once and done.” Organizational improvement is a continuous process. To be successful means coming to grips with things you have to do, how they get done, and who needs to be involved. This statement is not intended to overwhelm, as often a small change can make a huge difference. However, paramount to the process is recognizing that every role—every team member—in the organization is important to a successful VBC strategy. Remember, as you read or hear terms or concepts that are new to you, have your digital (Word doc) or analog (paper) notepad handy to write them down. At any time, you can use your favorite search engine to learn more. Be a self-directed learner!
• Building a High-Performing Care Team
• Fragmented healthcare has created the need for healthcare reform. This requires changing how healthcare is delivered and managed by changing the structure and culture of healthcare organizations across the U.S. However, as you explored in previous courses or may know from experience, successful transformation of the current system of fragmented, high-cost, ineffective care to one that is built on coordinated, efficient, and effective care cannot be accomplished quickly. While decisions must be made to determine strategic directions and obstacles have to be resolved, the process is a steady, thoughtful, and reflective journey. And, the key to success is an adaptive leadership able to advance vision and innovation through collaboration. Collaborative relationships between team members and leadership are critical to the transformation. This is not the time to direct teams, but instead to gain buy-in, agreement, and understanding about the organization’s strategy for and vision of value-based care. Listen, understand, and engage team members in developing solutions to challenges, workflows, etc. that directly impact them. Empowering, inspiring, respecting, and valuing team members will lead to the best decisions, care, and outcomes for patients. Believing in team member abilities leads to everyone reaping the benefits—from staff to patients, family members, other customers, and vendors. As the organization transforms, a new culture emerges with the common goal of supporting and advancing how value-based healthcare is delivered. Remember, as you read or hear terms or concepts that are new to you, have your digital (Word doc) or analog (paper) notepad handy to write them down. At any time, you can use your favorite search engine to learn more. Be a self-directed learner!
• Course Project: Making This My Own