Arch Collaborative Summit: Moving the Needle
It’s day two of the Arch Collaborative Summit, and I can’t listen fast enough. We started off the day with a Moving the Needle presentation from some of the Collaborative organizations that had seen the most impressive improvements over the last year. Here is a quick look into each of these case studies.
Rachel McEntee of University of Vermont Medical Center: Ambulatory Sprints
10 years ago, University of Vermont Medical Center went live on Epic. McEntee painted a picture of the provider burnout from that period at the medical center. The organization struggled to know how they could help their legacy users be motivated and satisfied in their work with the EMR.
“We had a hunch that most of our providers felt ill prepared to succeed with the EMR,” McEntee said. “Our Arch Collaborative measurements confirmed that hunch. We were at the 0th percentile for the question about how well our initial training had prepared our end users.”
Then the organization heard about the concept of sprints. They looked the University of Colorado Health’s model and made a few tweaks. This was new territory; University of Vermont Medical Center had never collaborated with another organization. But they found great value in finding someone who was doing great in a specific area and adapting their approach.
McEntee then described University of Vermont Medical Center’s timeline for the sprints, makeup of the sprint teams, and core competencies they expected the providers to gain by the end of the sprints. They also included hands-on training with content about cross-disciplinary workflows.
“We felt it was most important to listen to the providers’ questions,” she said. “Sometimes those questions took us way off track from our original ideas, but we created a positive culture. Our providers knew that the process was about helping them.”
The results speak for themselves: the two participating clinics’ net EHR Experience Scores jumped from 2 to 32 and 44 to 63, respectively.
Christine Machado of Compass Medical: Committee Governance
For those who were at the first Arch Collaborative Summit in 2018 may remember that Compass Medical had a case study; they had achieved the 98th percentile for trust in IT team. However, they weren’t happy with their overall training or personalization statistics.
“If you can’t measure it, you can’t improve it,” Machado noted. They decided to take a closer look. The result was a decision to focus on governance and create a set of committees to help.
The committees included an EMR advisory committee, a change control board committee, a clinical affairs committee, an EMR optimization committee, and an HIT committee. There is now an established process for requesting changes to the EMR.
Another hurdle that Compass Medical has worked through is spreading the word about changes to the providers. The providers hear news through superuser meetings, post-go-live engagement, and even newsletters. Machado credited their 83% open rate for those newsletters to silly, attention-grabbing lines and content.
The great news is that these improvements—including a Net Experience Score jump of 22.4 points—is didn’t involve any upgrades or code changes, and Compass Health didn’t even have to involve their EMR vendor. In addition, their organization is now at the 100th percentile for trust in the IT department.
H.C. Eschenroeder of OrthoVirginia: Provider Orientation
Eschenroeder started off by pointing out that discussions about EMR satisfaction stir very deep emotions and are critical to the market. “The Arch Collaborative is like studying physics,” he said. “We are trying to figure out the laws that make things work and share those laws with the industry.”
He then remembered a mountain climbing trip to Alaska and the guides telling the climbers, “If you get stuck, don’t plan to call 911. Your survival is your own responsibility.” Eschenroeder feels that that applies to the EMR. “I told my providers to not blame the EMR and that they could fix many things themselves.”
OrthoVirginia chose to create the Provider Support Specialist (PSS) program. One PSS is placed in each region so that a PSS could touch each person at least once every two weeks. OrthoVirginia has also worked to make each PSS as effective as possible.
“A teacher has to try to get into the heads of their students,” Eschenroeder said. “We used multiple ways to try to get into the consciousness of our doctors.”
Eschenroeder also stressed the importance of rounding, noting that physicians on the governance committee make regular visits to regional clinics. “You will not understand what’s going on unless you visit,” Eschenroeder tells them.
Between the PSS program and improved change management, OrthoVirginia’s Net Experience Score rose by 37 points.
Rob Schreiner WellStar Medical Group: Provider Engagement
Unlike the previous organizations, WellStar Medical Group is on the inpatient side. Their scores started in the Collaborative in the top 10% and have only improved, even though the organization has recently added several new hospitals. So what have they been doing?
“We invest a heck of a lot in engagement, which we define as the likelihood that a staff member will put forth discretionary effort on behalf of the patient,” Schreiner says. “We insist on hiring and promoting leaders that promote the ideas of improving the environment every day through rounding and listening. We push servant leadership.”
WellStar Medical Group also monitors the status quo through annual surveys and “pulse” surveys. “We treat those results as a vital sign.” They also didn’t stop at helping physicians. “It pays dividends across the spectrum of finance, quality, and patient care to take care of all of your people.”
Schreiner detailed a few positive results—including adding half of an FTE to each clinician—and reminded the Summit attendees why we were there. “The healthcare IT industry is notoriously bad at getting to work on best practices. How do you actually get working on them?” Then, motioning around the room, he finished: “We do this. We get together, share, and fight the good fight together.”
Greg Ator and Jennifer Wilson of University of Kansas Health System: Provider EMR Experience
University of Kansas Health System was another repeat attendee. “Listening to everyone here last year really helped us decide what to work on,” Greg noted. That work led to a jump in more than 7 percentage points.
In surveying their clinicians, University of Kansas Health System leaders learned that 80% were bothered by “pajama time,” or after-hours charting. The organization worked to provide trainers who were available three times per day to help providers make small but impactful changes.
Branding is also a big focus for University of Kansas Health System. They ask themselves, “What’s the message we’re telling our health system? How do we get the same messaging everywhere so that we can all row in the same direction?
One thing they did was launch their brand with a video, which the Summit attendees got to watch. The video was 90 seconds long and highlighted results of the Collaborative survey and what the organization was hoping to accomplish in the future.
“Our keys to success are branding and consistent messaging, data collection and analysis, and having multiple leaders talk about the provider EMR experience,” Wilson said.
Much More to Come
Ready to hear even more insights from Summit attendees? We’ll be publishing more insights into the breakout sessions in the coming weeks. Stay tuned!