Evidence-based guidelines from the Starbucks perspective
November 08, 2019
By Howard Willson
Consistency matters. Regardless of whether we are consciously aware of this, it is universally true. Consider, for example, Starbucks. When you visit Starbucks coffeehouse — whether in your home town, another city, or another country — you can trust that the flavor of a caramel latte, along with the entire buying experience, will be consistent. Think about that for a moment. Consistency across a buying purchase that is probably in the neighborhood of four dollars.
Now consider the medical care you or a loved one receive. Can you trust that you’ll receive the same level and consistency of care and expertise at your local health system as compared with the care received if you were on vacation and being treated at a facility in Miami, Winnipeg, or Honolulu? Considering the complexity of many healthcare visits, shouldn’t consistency be expected?
In 2018, health system acquisitions and mergers jumped 14.4 percent over the previous year, a trend that is expected to continue as organizations seek to preserve market share and revenue. As health systems work to integrate new facilities, leaders cannot overlook the importance of establishing an environment that supports consistent patient care, regardless of the facility or physician.
One way that health system leaders can ensure that patients will be cared for in the same manner, regardless of who treats the patient or where the care is provided, is by supporting the use of evidence-based practices. By integrating evidence-based guidelines into clinician workflows, physicians are prompted to make point-of-care decisions that are supported by the latest reference (or “gold”) standard for high-quality care.
Adhering to evidence-based guidelines can aid health systems in producing a Starbucks-like level of consistency in care delivery and quality, which may boost brand loyalty, drive more consistent revenues, and minimize risks associated with the introduction of new facilities.
Why orient care around evidence-based standards?
A growing amount of evidence has shown that greater standardization of medical care improves clinical outcomes, patient safety, and, possibly, costs. Among the most effective ways health systems can boost standardization is to promote the use of evidence-based order sets and care plans. Evidence-based order sets and care plans guide providers to follow interventions that have been proven to drive the best outcomes and reduce unwarranted care variations that may compromise patient safety, waste staff time, and increase costs.
Evidence-based physician order sets are standardized sets of evidence-based treatment guidelines for particular conditions, such as heart failure or chronic obstructive pulmonary disorder. These standardized lists include items such as recommended prescription drug options, diagnostics, lab tests, and follow-up care for each condition.
Properly designed order sets have been shown to improve the quality of patient care and increase the delivery of important care processes by helping hospitals avoid under- and over-utilization. For example, if clinical staff forget to order an electrocardiogram for a heart-failure patient prior to discharge, the order set would instruct them to invite the patient for a return visit to undergo the test. In this scenario, the hospital has avoided a situation in which patient care is compromised.
Conversely, the existence of a standardized order set can help prevent the ordering of tests and procedures that are not supported by evidence. This avoidance of overutilization enables the hospital to provide high-quality care without wasting resources.
Evidence pinpoints the most impactful interventions
Health systems can also embrace standardized “gold-key interventions,” which are the evidence-based clinical interventions with the highest likelihood of achieving a significant, desired outcome for a certain condition. These interventions are tied to corresponding quality-improvement goals, such as reductions in readmissions, mortality, and length of stay.
Perhaps the most valuable attribute of gold-key interventions is the focus they bring to clinical organizations. By identifying a few of the most impactful interventions for a certain condition, organizations can appropriately allocate their resources, time, and efforts on initiatives that are most likely to produce the desired outcomes.
Identifying the interventions with the greatest impact on desired outcomes can be challenging for organizations and requires research and analysis to pinpoint the greatest quality- and outcomes-improvement opportunities. The identification process requires organizations to leverage their internal data, plus incorporate the best-available clinical evidence from peer-reviewed journals, clinical guidelines, and studies.
The benefits of identifying gold-key interventions can be significant. One health system that sought to improve quality measures and outcomes for pneumonia patients researched its internal practices and identified 20 commonly used interventions. Next, they identified six gold-key interventions – including corticosteroids and professional oral care. By refocusing its resources to drive greater utilization of the most important interventions, the health system successfully improved quality measures and outcomes for all their pneumonia patients.
Consistency plus quality equals confidence
As previously illustrated by the extraordinary success of Starbucks, today’s customers prize consistency, predictability, and quality. Patients are no different. They want the confidence of knowing that regardless of the attending clinician or the location of the facility, the care received will be consistent and standards will be high. By embracing evidence-based care standards, health systems can drive a Starbucks-like consistency and quality, while enhancing brand loyalty and achieving more predictable revenue streams.
About the author: Howard Willson, M.D., MBA, is the senior vice president of customer success at Zynx Health, where he is focused on connecting clients with clinical solutions that deliver an exemplary customer experience and leading customer satisfaction initiatives.
Consistency matters. Regardless of whether we are consciously aware of this, it is universally true. Consider, for example, Starbucks. When you visit Starbucks coffeehouse — whether in your home town, another city, or another country — you can trust that the flavor of a caramel latte, along with the entire buying experience, will be consistent. Think about that for a moment. Consistency across a buying purchase that is probably in the neighborhood of four dollars.
Now consider the medical care you or a loved one receive. Can you trust that you’ll receive the same level and consistency of care and expertise at your local health system as compared with the care received if you were on vacation and being treated at a facility in Miami, Winnipeg, or Honolulu? Considering the complexity of many healthcare visits, shouldn’t consistency be expected?
In 2018, health system acquisitions and mergers jumped 14.4 percent over the previous year, a trend that is expected to continue as organizations seek to preserve market share and revenue. As health systems work to integrate new facilities, leaders cannot overlook the importance of establishing an environment that supports consistent patient care, regardless of the facility or physician.
One way that health system leaders can ensure that patients will be cared for in the same manner, regardless of who treats the patient or where the care is provided, is by supporting the use of evidence-based practices. By integrating evidence-based guidelines into clinician workflows, physicians are prompted to make point-of-care decisions that are supported by the latest reference (or “gold”) standard for high-quality care.
Adhering to evidence-based guidelines can aid health systems in producing a Starbucks-like level of consistency in care delivery and quality, which may boost brand loyalty, drive more consistent revenues, and minimize risks associated with the introduction of new facilities.
Why orient care around evidence-based standards?
A growing amount of evidence has shown that greater standardization of medical care improves clinical outcomes, patient safety, and, possibly, costs. Among the most effective ways health systems can boost standardization is to promote the use of evidence-based order sets and care plans. Evidence-based order sets and care plans guide providers to follow interventions that have been proven to drive the best outcomes and reduce unwarranted care variations that may compromise patient safety, waste staff time, and increase costs.
Evidence-based physician order sets are standardized sets of evidence-based treatment guidelines for particular conditions, such as heart failure or chronic obstructive pulmonary disorder. These standardized lists include items such as recommended prescription drug options, diagnostics, lab tests, and follow-up care for each condition.
Properly designed order sets have been shown to improve the quality of patient care and increase the delivery of important care processes by helping hospitals avoid under- and over-utilization. For example, if clinical staff forget to order an electrocardiogram for a heart-failure patient prior to discharge, the order set would instruct them to invite the patient for a return visit to undergo the test. In this scenario, the hospital has avoided a situation in which patient care is compromised.
Conversely, the existence of a standardized order set can help prevent the ordering of tests and procedures that are not supported by evidence. This avoidance of overutilization enables the hospital to provide high-quality care without wasting resources.
Evidence pinpoints the most impactful interventions
Health systems can also embrace standardized “gold-key interventions,” which are the evidence-based clinical interventions with the highest likelihood of achieving a significant, desired outcome for a certain condition. These interventions are tied to corresponding quality-improvement goals, such as reductions in readmissions, mortality, and length of stay.
Perhaps the most valuable attribute of gold-key interventions is the focus they bring to clinical organizations. By identifying a few of the most impactful interventions for a certain condition, organizations can appropriately allocate their resources, time, and efforts on initiatives that are most likely to produce the desired outcomes.
Identifying the interventions with the greatest impact on desired outcomes can be challenging for organizations and requires research and analysis to pinpoint the greatest quality- and outcomes-improvement opportunities. The identification process requires organizations to leverage their internal data, plus incorporate the best-available clinical evidence from peer-reviewed journals, clinical guidelines, and studies.
The benefits of identifying gold-key interventions can be significant. One health system that sought to improve quality measures and outcomes for pneumonia patients researched its internal practices and identified 20 commonly used interventions. Next, they identified six gold-key interventions – including corticosteroids and professional oral care. By refocusing its resources to drive greater utilization of the most important interventions, the health system successfully improved quality measures and outcomes for all their pneumonia patients.
Consistency plus quality equals confidence
As previously illustrated by the extraordinary success of Starbucks, today’s customers prize consistency, predictability, and quality. Patients are no different. They want the confidence of knowing that regardless of the attending clinician or the location of the facility, the care received will be consistent and standards will be high. By embracing evidence-based care standards, health systems can drive a Starbucks-like consistency and quality, while enhancing brand loyalty and achieving more predictable revenue streams.
Howard Willson