"At the earliest stage at Advocate, we had about 25 metrics," Shields says. "After a decade, there are 140 going across all specialties."
He says the goal is not to drown physicians in measurement and rankings, but instead to get them to focus on changing processes that affect a few metrics negatively. Vasile credits "actionable user reports" that help physicians and other caregivers address individual problem areas.
"That's when we began not to talk about integrity of the data and instead about how we're actually going to move the scores," he says.
2. Teamwork and Culture
Shields calls clinician culture the critical component to success, defining it as the ability to work together across specialties in conjunction with the hospital to drive quality and patient safety.
"You're working with them to help paint the picture of a rapidly changing environment and the implications for physicians," he says. "That's a big communication issue because it's difficult for them to step back and think two to five years ahead."
Vasile remembers a lot of dinner meetings with physicians explaining the goals and objectives of the CIN. Measuring their buy-in was critical. The best way to do that at GRIPA, he says, is through its clinician portal, which monitors whether physicians are logging in to access the tools. At this point, compliance is close to 100%. Vasile also says an "outspoken" medical director visits their offices and seeks feedback on compliance or lack thereof.
At the primary care level, GRIPA makes quality scores transparent among physicians, and identifiable by name.
"When you have that engagement, physicians are eager to hold themselves accountable," says Vasile.
Shields remembers monitoring clinicians' use of registries and other elements in the portal as a key early indicator of participation.
Every quarter there was a report card on the specific metrics of the specialties and early interventions were arranged with "folks that were lagging," he says.
Philip Betbeze is the senior leadership editor at HealthLeaders.