New CMO of Allegheny Health Network Sets Sights on High Performance

Bethany Casagranda brings experience of establishing centers of excellence at diagnostic imaging sites.

The new CMO of Allegheny Health Network is focused on delivering high quality and high-value care.

Bethany Casagranda, DO, MBA, became CMO of AHN and president of Allegheny Clinic effective Jan. 1. She had previously served as chair of AHN's Imaging Institute since 2017. Casagranda is succeeding Donald Whiting, MD, who is remaining at the health system as chair of AHN's Neuroscience Institute.

High quality and high-value care go hand in hand, according to Casagranda.

"If you elevate the quality in a health system, you elevate value," Casagranda says.

Casagranda pursued quality and value as chair of AHN's Imaging Institute, which grew significantly under her leadership. In 2017, when she became the chair of imaging, the institute covered three hospitals and had 30 radiologists. When she left that role on Dec. 31, the institute covered 14 hospitals and had 130 radiologists.

"In imaging, we thought the best way to improve value was standing up centers of excellence," Casagranda says. "It was a four-year journey to do that work, and we were able to establish every diagnostic imaging site as a center of excellence. It involved not only regulatory work but also decreasing radiation for our patients and increasing appropriate use of contrast. We were also able to decrease the cost of care, which benefits the patient tremendously."

Achieving high quality and high-value care requires having a just culture, Casagranda explains.

"We have processes and procedures in place to track quality metrics, but people need to be able to bring problems forward if they affect quality," Casagranda says.

At AHN, staff members are encouraged to report safety and quality issues through an online incident reporting program called RL6. The program allows for anyone in the health system to be able to put in something as simple as a needlestick during a procedure versus more complicated issues that happen in settings such as operating rooms.

"People can put in all of the issues that arise," Casagranda says. "There are dropdown menus so people can select different categories and put in information that elevates up to clinician leaders, nursing leaders, and regulatory staff."

All serious incidents are subject to a root-cause analysis.

"We get together and talk about every step of the process involved in an incident and how we can help to rectify an issue in the process or to provide a necessary resource," Casagranda says.

The keys to success in providing high quality and high-value care include the ability to build teams where everybody is focused on the mission of keeping people healthy, according to Casagranda.

"We often talk about the role of doctors on these teams," Casagranda says, "but other staff members such as our nursing colleagues, advanced practice providers such as physician assistants, and pharmacy colleagues all need to be part of a culture to keep people as healthy as possible."

Bethany Casagranda, DO, MBA, is CMO of Allegheny Health Network and president of Allegheny Clinic. Photo courtesy of Allegheny Health Network.

Boosting patient experience

Providing a positive patient experience has an easy component and a hard component, Casagranda explains.

"The easy way to provide a good patient experience is to follow-up diligently on the Press Ganey surveys that our patients submit," Casagranda says. "You need to celebrate wins whenever we provide a good patient experience and tackle the challenges that arise in these surveys."

The more difficult component is linking patient experience with provider experience, according to Casagranda.

"When the workforce is healthy and well supported, we are in a better position to provide a remarkable experience for our patients," Casagranda says. "I try to remind staff members that in our journey to provide the best experience for our patients, we cannot forget the puzzle piece of the clinician experience. This is harder to tackle than a survey, but it is worth the work."

Supporting the 'Living Health' clinical model

AHN and its parent organization, Highmark Health, have adopted a long-term strategy called the Living Health clinical model.

"It features our ability to provide programs and resources to Highmark Health customers and AHN patients that allow them to live their healthiest lives," Casagranda says. "Examples of these programs include Onduo for diabetes management, Spring Health for mental health and behavioral health, and opportunities to utilize apps on smart phones."

The goal of the Living Health clinical model is to focus on health rather than illness.

"Instead of being in the business of taking care of sick people, we would like to be in the business of taking care of healthy people as long as they can be healthy," Casagranda says. "We want to give people everything they need to stay healthy on their own."

As CMO, Casagranda is playing the role of communicator and facilitator to support the Living Health clinical model.

"I have an opportunity to connect all of the programming that Highmark Health is putting forth in the Living Health clinical model with our clinicians, who can then communicate about these programs with our patients," Casagranda says. "I want our patients to know these programs are available."

Casagranda communicates about Living Health clinical model programs in simple ways such as email and more complicated ways such as engaging the health system's clinical leadership teams.

"When we do rollouts, I communicate with all of the physician chairs and the hospital presidents, who are physicians," Casagranda says. "We talk about these opportunities, then they cascade the information down to frontline clinicians throughout the enterprise."