The Most Effective Way to Approach Process Reform

Amid new legislation, technological innovations, and shifting paradigms, businesses and healthcare practices have two options- maintain the status quo, or develop a strategy to keep pace with new developments. Process reform may seem like a daunting endeavor, but it doesn't have to be.  Providers and industry leaders can assess their current situation and map out a course of action, breaking it down into manageable steps, to accomplish long-term goals.

First Things First:  Get Your Staff Involved

 It can't be emphasized enough how important it is not to overlook the human side of process reform.  This is especially the case when introducing large-scale IT innovations, but holds true wherever significant change is implemented.  Everyone who will be impacted by the changes needs to be involved from the beginning.  Employees want to understand how reform will be implemented and how it will affect them.  As a leader, you'll be better able to accomplish your objectives if your team is on board.

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The Model for Improvement

Providers should always be aware of elements that impact, or have the potential to impact, their practice.  A multitude of factors can have a profound affect on processes and budgets.  Providers should also identify policies or procedures that need to be modified.

The Institute for Healthcare Improvement and many other health-related organizations use the Model for Improvement, a framework for implementing change in the healthcare industry.  The model doesn't have to replace strategies your practice is currently using.   It is merely intended to accelerate the changes you're hoping to bring about.

The Model for Improvement consists of two components.  The first suggests three questions to consider (in any order) with the team you're collaborating with.

• What are we trying to accomplish?
• How will we know that a change is an improvement?
• What change can we make that will result in improvement? 

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The second component, the Plan-Do-Study-Act (PDSA) cycle, which enables you to test changes in realistic settings, guides you as you evaluate change to determine whether it's an improvement.

• Include the right people.  Consider who will work best on your team.
• Set aims that are time-specific and measurable.  Be sure that they define the patient population or system that will be impacted.
• Determine quantitative measures to help you decide whether a particular change leads to an improvement.
• Select changes to implement.  You can get ideas from people in your practice or from those who have already implemented process reform successfully.  
• Test changes using the PDSA cycle.  Attempt change on a small scale, perhaps within a small group or department.  Observe the results.  If it's successful, try it in a larger area.  PDSA is essentially applying the scientific method within the context of work environments for action-oriented learning.
• Implement the change.  As you test change within a small area, you can "tweak" it as needed.  Repeat PDSA cycles as you fine-tune your modification.  Then, test it in a broader environment, such as an entire department or unit. 
• Spread the change.  After your "pilot test" you can move on to other departments in your practice or other organizations within your network.  

Although it may seem overwhelming, implementing process reform can be extremely rewarding.  Increased revenue, faster ROI, investment in staff expertise, and better organizational communication are just a few of the many benefits you can expect when you see your improvement plan through to completion.  Additionally, you'll be better equipped to anticipate and manage subsequent reform initiatives.