Latest / Becker’s Healthcare - Clinical Leadership Podcast / Proving the ROI of Quality: Building a Stronger Healthcare Workforce

Transcript

Proving the ROI of Quality: Building a Stronger Healthcare Workforce · Becker’s Healthcare - Clinical Leadership Podcast

• 0:00
  Hi, everyone. This is Lucas Voss with Beggars
• 0:01
  Healthcare. Thanks so much for being here today.
• 0:03
  It's great to have you. Today, we're going
• 0:06
  to talk about elevating quality workforce and innovation
• 0:10
  in health care. And I'm very excited to
• 0:13
  be joined by Stephanie Mercado, CEO at the
• 0:15
  National Association for Health Care Quality. Stephanie, thanks
• 0:18
  for being here today. It's great to have
• 0:20
  you. Thank you. I'm delighted to spend a
• 0:22
  little bit of time with you this morning.
• 0:24
  Absolutely.
• 0:25
  If you could introduce yourself to our audience
• 0:27
  and just share a little bit about your
• 0:28
  work in health care.
• 0:30
  Sure.
• 0:31
  As you have already mentioned, I'm the CEO
• 0:32
  of NACU, the National Association for Health Care
• 0:35
  Quality. And I've spent, the better part of
• 0:38
  twenty five years advancing my passion
• 0:41
  and a really important agenda in health care.
• 0:44
  My early career began with supporting,
• 0:47
  physician organizations and really sort of sinking my
• 0:50
  teeth in and understanding
• 0:52
  the issues that are present in what I
• 0:55
  would like to define as the front of
• 0:57
  the house of health care.
• 0:58
  And,
• 0:59
  since working with NAICU, I've had the opportunity
• 1:02
  to really dig into quality and safety and
• 1:04
  finance and all of the administrative
• 1:07
  complexities
• 1:08
  of how the business of health care
• 1:10
  is run. And, that's given me a really
• 1:12
  great perspective
• 1:14
  on what, I would call the back of
• 1:16
  the house of health care.
• 1:17
  So,
• 1:18
  together,
• 1:19
  both having experience in the front of the
• 1:21
  house, in the back of the house, and
• 1:23
  really just being super passionate
• 1:25
  about advancing
• 1:27
  quality and safety
• 1:28
  and lowering health care costs
• 1:30
  has been the the focus of my work.
• 1:34
  I'm a a builder. I'm an innovator. I'm,
• 1:37
  an approver,
• 1:38
  and I think we can do better in
• 1:40
  health care. I think we must do better.
• 1:44
  And I also think that when we talk
• 1:46
  about ways to do better,
• 1:48
  we can really weave workforce into the mix.
• 1:51
  And that's a very passionate focus here, not
• 1:53
  only in my role, but at NAICU as
• 1:55
  an organization.
• 1:56
  Because as you well know,
• 1:58
  the workforce is the biggest investment that we
• 2:01
  make in health care. And I think that
• 2:04
  people, our workforce,
• 2:06
  can
• 2:07
  really represent
• 2:08
  the biggest impact
• 2:10
  that health care can achieve as well.
• 2:12
  Yeah. Absolutely. And I love that combination that
• 2:14
  you just mentioned. Again, you get so much
• 2:16
  experience. It's fantastic to have you on. I
• 2:18
  wanna touch on the ROIQ
• 2:21
  report, which, by the way, I recommend everybody
• 2:23
  take a look at. Lots of incredible information
• 2:25
  there. So the ROIQ report reveals
• 2:28
  a really a powerful financial return from investments
• 2:31
  in quality and safety, which is incredibly important.
• 2:35
  Looking at that report, were there any findings
• 2:37
  that stood out to you, and how's the
• 2:40
  conversation around quality and safety shifting right now?
• 2:43
  What are you seeing?
• 2:45
  Yeah. In terms of,
• 2:46
  findings that stood out, I'm I'm gonna give
• 2:49
  a blanket statement, and I'm not trying to
• 2:50
  take the easy way out, on this question.
• 2:53
  But, honestly, it's it's the truth. What findings
• 2:56
  surprised me?
• 2:57
  All of them. And the biggest one being
• 3:00
  that we could prove finally and sort of
• 3:03
  once and for all Mhmm. That precisely
• 3:06
  planned roles,
• 3:08
  precisely
• 3:09
  planned
• 3:10
  functions in health care quality and safety,
• 3:13
  and that a precision
• 3:15
  targeted learning approach, a skilling approach, a coaching
• 3:18
  approach
• 3:19
  can demonstrably
• 3:21
  impact quality outcomes
• 3:23
  and improve the performance. And I'll tell you
• 3:25
  what, nobody thought that this was possible.
• 3:28
  And, to our knowledge, nobody's ever tried to
• 3:31
  do this on the scale that we did
• 3:33
  it,
• 3:34
  which was really
• 3:36
  about connecting workforce
• 3:38
  to quality,
• 3:40
  to safety,
• 3:41
  and to finance. And I and I it
• 3:43
  was amazing.
• 3:45
  It's absolutely amazing.
• 3:46
  And if I can, can I tell you
• 3:48
  why this has been so elusive? Sure. Because
• 3:50
  I've spent the better part of a decade
• 3:52
  trying to figure out why we haven't figured
• 3:54
  this out already.
• 3:56
  I mean, I'm quite serious, but
• 3:58
  but I but I think we, we we've
• 4:01
  crossed the threshold, and we have, figured it
• 4:03
  out, which is
• 4:04
  so so quality has been really, really elusive
• 4:08
  over the years and,
• 4:10
  really seen as a compliance or a mandate.
• 4:13
  And I don't think I think people sort
• 4:15
  of conceptually thought you know, always thought it
• 4:18
  was a good idea and conceptually thought a
• 4:19
  lot of good things would come of it.
• 4:22
  But there has been very little attention to
• 4:25
  two things. One,
• 4:27
  focusing on quality and safety on scale.
• 4:29
  So
• 4:31
  before we did this project, this program, this
• 4:34
  workforce accelerator methodology that we created,
• 4:37
  most organizations
• 4:38
  were approaching quality and safety
• 4:40
  on a project basis.
• 4:42
  And I know you know this. Like, they
• 4:44
  would go in and and focus on improving
• 4:46
  sepsis,
• 4:48
  reducing
• 4:48
  falls, and many other things, and we absolutely
• 4:51
  need to do that. But the the big
• 4:53
  thing that no other
• 4:55
  organization has kind of, like, developed methodology for
• 4:58
  and that that few organizations have really achieved
• 5:01
  outside of those who, you know, have worked
• 5:03
  with us as early adopters of our workforce
• 5:05
  accelerator program was to prove that we could
• 5:08
  actually improve quality, safety, and finance
• 5:12
  programmatically.
• 5:13
  Like, we could we could do that across
• 5:15
  the board for the entire
• 5:17
  system.
• 5:18
  So, yes, our projects involved in that, do
• 5:21
  we wanna continue to improve,
• 5:23
  on an item by item, initiative by initiative
• 5:26
  basis?
• 5:27
  Of course, we do. But we also now
• 5:29
  know that it is absolutely possible and and
• 5:32
  I think critical
• 5:33
  that we do that on a system level
• 5:36
  and program level improvement, and that's that's really
• 5:39
  the basis of the ROIQ report, and what
• 5:42
  we proved out is,
• 5:43
  this is achievable, and there is a way
• 5:46
  to do this effectively.
• 5:48
  Yeah. You've mentioned sort of the elusiveness in
• 5:50
  the beginning and trying to trying to find
• 5:52
  it. What's been the industry response to this
• 5:54
  report so far now that you've made that
• 5:56
  connection?
• 5:58
  The overwhelming response from the industry has been,
• 6:02
  thank you, make you.
• 6:04
  We are getting calls from
• 6:07
  the public sector. We are getting calls from
• 6:09
  the private sector,
• 6:11
  and all of them are asking,
• 6:13
  how did you do this?
• 6:14
  What is the methodology
• 6:16
  that you used
• 6:17
  to improve quality and safety and finance on
• 6:21
  this scale?
• 6:22
  They're saying things like, we don't wanna play
• 6:25
  whack a mole anymore. And we can we're
• 6:28
  we have an untold amount of quality and
• 6:30
  safety projects going on. I mean, I was
• 6:33
  at a system the other day, and they
• 6:34
  had a 150 quality projects going on.
• 6:37
  Not to say that we don't need to
• 6:39
  improve a 150,
• 6:40
  you know, things, but
• 6:43
  everybody is ready to scale. Right? They're ready
• 6:45
  to stop playing whack a mole and to
• 6:47
  come at this in an over the top,
• 6:51
  sort of way.
• 6:52
  And so the response has been absolutely overwhelming.
• 6:56
  And and and and and and to the
• 6:58
  point on the methodology, and they're asking, well,
• 7:00
  what what's the how did you do this?
• 7:03
  Like, tell us more. What's the one thing?
• 7:05
  Right? Because our our ROI queue report actually
• 7:08
  outlines five strategies.
• 7:10
  But, in speaking, you know, with leaders at
• 7:12
  CMS, they're like, but what's the one thing
• 7:14
  that you did? And I said, the one
• 7:17
  thing is is we developed
• 7:19
  a methodology
• 7:21
  to define what quality and safety is,
• 7:24
  how to get your workforce aligned to that,
• 7:27
  how to get them doing the right roles,
• 7:29
  the right functions with the right skills at
• 7:32
  the right time.
• 7:33
  And we figured out a way to then
• 7:35
  pull that through and measure it on quality
• 7:37
  and safety and finance outcomes. So so the
• 7:40
  the that methodology
• 7:42
  that we have through our workforce accelerator program
• 7:44
  is, like, the one thing. So the industry
• 7:46
  has been excited, and I could just tell
• 7:47
  you,
• 7:48
  NAICU's board is excited about this. Our headquarters
• 7:51
  staff is excited.
• 7:52
  This is this is big news for the
• 7:54
  industry, and we're so excited to be a
• 7:56
  part of it.
• 7:57
  Yeah. It's it's such an interesting report. Again,
• 7:59
  I recommend everybody take a look at it
• 8:01
  because it's it's fascinating to see that scalability
• 8:03
  and to see that connection, which is important.
• 8:05
  You've mentioned something, that is also very important,
• 8:07
  which is the fact that it starts with
• 8:09
  specializing folks, it starts with people, it starts
• 8:12
  with with training, etcetera. And, again, the workforce
• 8:15
  accelerator program emphasizes that up upscaling piece of
• 8:17
  of teams and reducing variability across the board.
• 8:20
  Can you touch a little bit on what
• 8:22
  that looks like in practice
• 8:24
  and how it then in turn really influences
• 8:26
  outcomes?
• 8:27
  Yeah. I sure can. And I I will
• 8:29
  tell you, a couple things. So I'll tell
• 8:31
  you broadly and then, or maybe, yeah, broadly,
• 8:34
  and then I'll go a little deeper. So,
• 8:36
  first of all, it is a somewhat complex
• 8:38
  methodology
• 8:39
  that we make simple. Right? Mhmm. So, there
• 8:43
  is a whole sort of, twelve month process
• 8:46
  that gets an organization
• 8:48
  ready,
• 8:50
  for this type of focus on quality and
• 8:53
  safety. And then also,
• 8:55
  prepares leaders to lead,
• 8:57
  this initiative within their organization so that you
• 9:00
  can come in and be an enabling force
• 9:02
  for them. And,
• 9:04
  also, that then guides them through our method,
• 9:06
  which includes assessments and trainings and development and
• 9:10
  coaching programs and communities of practice, like the
• 9:13
  guided by a NICU navigator, which is a
• 9:16
  a person who's who's sort of like, a
• 9:19
  a coach,
• 9:20
  for the systems to help get them set
• 9:22
  up and situated for success.
• 9:24
  But but what I will say,
• 9:27
  outside of that sort of broad representation that
• 9:29
  there is a program, it is robust, it
• 9:31
  is effective,
• 9:33
  I will tell you a couple things that
• 9:34
  this program does.
• 9:36
  So very practically,
• 9:38
  I know everybody who's listening to this podcast
• 9:40
  can relate to
• 9:42
  this statement, which is quality is everyone's job.
• 9:45
  Mhmm. And that is true. I believe that
• 9:49
  wholeheartedly.
• 9:51
  But before this workforce accelerator program was developed,
• 9:55
  the industry had did not define what that
• 9:57
  meant.
• 9:58
  And so we were left with the ambition
• 10:01
  to advance quality as everyone's role, but we
• 10:04
  didn't actually have a way to do that.
• 10:07
  And what I've observed too again, like I
• 10:09
  said, I spent a better part of a
• 10:11
  decade trying to figure out what we haven't
• 10:12
  figured out and figured out how to solve
• 10:14
  this problem yet. And and one of the
• 10:16
  things that I've realized is that
• 10:18
  health care as an industry has invested millions
• 10:21
  of dollars,
• 10:23
  probably
• 10:24
  billions and billions of dollars
• 10:26
  as an industry in training and development for
• 10:29
  quality.
• 10:30
  But
• 10:31
  here's the here's the the punchline.
• 10:34
  We've let learners
• 10:35
  choose their own adventure in learning.
• 10:38
  They choose how they're trained. They they decide
• 10:40
  what courses to go to on their own
• 10:42
  without any guidance, support,
• 10:44
  or precisely
• 10:46
  targeted
• 10:47
  learning.
• 10:48
  Or worse,
• 10:50
  they they maybe are trained by a predecessor
• 10:52
  who also also
• 10:54
  learned their job
• 10:55
  on
• 10:56
  the job. And and and also,
• 10:58
  we the as we've learned the the quality
• 11:01
  competencies and skills through training and and, you
• 11:03
  know, peer support,
• 11:05
  we have focused so much and rightfully so
• 11:07
  on quality and on safety.
• 11:10
  But what we haven't done well enough
• 11:13
  is communicate the financial return on investment,
• 11:16
  which is particularly important right now when efficiency
• 11:19
  is critical.
• 11:21
  Not only because that is a priority of
• 11:23
  the Trump administration,
• 11:24
  but because it's the pathway for sustainable health
• 11:27
  care. And so,
• 11:29
  you know, I think this defining the roles,
• 11:32
  targeting the learning, making sure that we connect
• 11:35
  it to an ROI so that people understand
• 11:37
  this is a worthy investment that pays
• 11:41
  untold dividends,
• 11:43
  for their organization,
• 11:45
  I think is
• 11:46
  really, really important,
• 11:47
  and that there and most important is there's
• 11:50
  a way to do it now. And and,
• 11:51
  it's it's it's effective.
• 11:54
  There's a pathway to it. I think that
• 11:55
  that's really the one of the big keys
• 11:57
  to it as well. And, again, the the
• 11:59
  ROI piece you mentioned is so important, especially
• 12:01
  from a leadership perspective, and you touched on
• 12:03
  sort of the the programs that you have
• 12:04
  in place for leaders to be able to
• 12:06
  to fully take advantage of this too. Can
• 12:09
  you touch a little bit more specifically on
• 12:11
  that too in terms of how the workforce
• 12:12
  accelerator
• 12:14
  really benefits c suite leaders and and some
• 12:16
  of the examples that you could share to
• 12:18
  that really show that value for executives?
• 12:21
  Yeah. Sure. And I'll, take us back as
• 12:23
  a quick reminder too.
• 12:25
  Quality is everyone's job. You know? That is
• 12:28
  something so c suite is responsible for leading
• 12:31
  the entire
• 12:32
  operation
• 12:34
  of health care where they work. And to
• 12:36
  say quality is everyone's job, before and and
• 12:39
  I think everyone everyone everyone believes that, But
• 12:42
  that has been, elusive.
• 12:44
  And now c suite have a concrete way
• 12:48
  to make that actionable. Right? That's what the
• 12:51
  workforce accelerator does. It takes the the guesswork
• 12:54
  out of figuring out how to get their
• 12:57
  teams ready
• 12:58
  to be more high functioning.
• 13:01
  Also,
• 13:02
  we have made a lot of gains with
• 13:04
  c suite, by helping them to understand how
• 13:06
  to organize their workforce,
• 13:08
  how to activate their workforce,
• 13:11
  in ways that were previously complex. Like, we
• 13:13
  have broken that down into a consistent,
• 13:17
  reliable method, and we have made something that
• 13:20
  is complex
• 13:21
  simple. And we've done that with the Veterans
• 13:23
  Health Administration. We've done that with Kaiser Permanente.
• 13:25
  We've done that with CHRISTUS. All sorts of
• 13:27
  organizations
• 13:29
  who,
• 13:30
  have followed the the workforce,
• 13:32
  accelerator
• 13:33
  methodology,
• 13:34
  and we've proven that it works. And so
• 13:36
  I think c suite right now, another thing
• 13:38
  is they're looking for solutions,
• 13:41
  and they they know that they need to,
• 13:44
  you know, kind of, break the mold, be
• 13:46
  creative,
• 13:47
  try new
• 13:48
  things. But the the challenge is is that
• 13:51
  there's not a lot of tolerance for, risk
• 13:53
  and failure. Right? Like, a lot of people
• 13:55
  don't wanna put their neck out on the
• 13:57
  line and say, you know, I have an
• 13:58
  idea,
• 14:00
  and then to not have it work out.
• 14:01
  Nobody,
• 14:02
  we don't have the time kind of,
• 14:05
  luxury of time and money, that maybe we
• 14:07
  thought we had before, to to, quote, unquote,
• 14:10
  you know, waste on something that that may
• 14:12
  or may not work. And so I think
• 14:13
  for c suite, not only is the program
• 14:17
  really focused on ROI, which brings a ton
• 14:19
  of value to them as individuals to be
• 14:21
  able to bring that forward to their organization,
• 14:24
  but we've eliminated the risk associated with trying
• 14:27
  a new program.
• 14:28
  The not only we have NAICU, but so
• 14:30
  did all the other leaders who implemented the
• 14:33
  program, VHA,
• 14:34
  Kaiser,
• 14:35
  CHRISTUS.
• 14:36
  All all sorts of organizations are listed in
• 14:39
  our ROIQ report, and on our website.
• 14:42
  They they've proven this out. They took the
• 14:44
  risk, and, they've proven that NICU as an
• 14:48
  enabling force with the workforce accelerator,
• 14:50
  it it works. And so I think that
• 14:52
  C suite can take comfort in knowing that,
• 14:55
  there is a safe solution out there, for
• 14:57
  workforce readiness and quality and safety.
• 15:00
  Yeah. I love that you mentioned, again, that
• 15:02
  risk factor. And and, again, like, time, we
• 15:04
  don't have we don't have time. Right? It's
• 15:06
  everything is about funding and ROI and and
• 15:09
  risk. Right? What risks are we taking? What
• 15:11
  risks are we not taking, etcetera? I think
• 15:13
  this becomes especially important when you're looking at
• 15:15
  organizations that might not have the resources. Right?
• 15:17
  They're becoming even more concerned about where are
• 15:19
  my investments going.
• 15:21
  Can you touch a little bit on on
• 15:23
  what programs or solutions are are particularly valuable
• 15:26
  for some of those organizations that might struggle
• 15:28
  with either smaller teams, right, smaller workforce, but
• 15:30
  then especially also
• 15:32
  limited resources?
• 15:34
  Yes. A 100%. So we work with organizations
• 15:38
  large and small, and I will tell you,
• 15:41
  with a 100% confidence,
• 15:43
  every single one of them, the biggest of
• 15:45
  the biggest, the smallest of the smallest, the
• 15:48
  the most immature organizations, and and the most
• 15:50
  mature organizations
• 15:52
  all struggle to some degree with,
• 15:55
  activating quality and safety and finance. And and
• 15:57
  it's real. You know? Each organization has a
• 16:00
  different amount of resources. So a couple thoughts.
• 16:03
  So one is, you know, we work with
• 16:05
  smaller organizations.
• 16:06
  We have worked with,
• 16:08
  King's Daughter. We have worked with
• 16:11
  El Paso Medical
• 16:13
  Center. We have worked with Columbus Regional. These
• 16:16
  are organizations on the smaller side,
• 16:19
  of of system size. Right? Some single sites.
• 16:23
  And,
• 16:24
  we've worked with organizations I mentioned as big
• 16:26
  as the Veterans Health Administration. So on this
• 16:28
  on the small side,
• 16:31
  the one huge thing that organizations could do
• 16:34
  would be to help their, teams become CPHQ
• 16:39
  certified.
• 16:40
  So the CPHQ is the only
• 16:43
  accredited certification in health care quality. It's NAICU's
• 16:46
  certification
• 16:47
  held by more than
• 16:48
  15,000
• 16:50
  individuals today and growing rapidly,
• 16:52
  not only in The US, but around the
• 16:54
  world.
• 16:55
  And,
• 16:56
  it's a wonderful program. In fact, the CPHQ
• 16:59
  was endorsed
• 17:01
  by the joint commission just this past November.
• 17:03
  In fact, the joint commission has endorsed endorsed
• 17:06
  NAICU's entire competency framework and is wildly supportive
• 17:09
  of the ROIQ report and all of the
• 17:12
  efforts we're doing to drive quality and safety
• 17:14
  in health care.
• 17:16
  So CPHQ is a great opportunity.
• 17:18
  We also have a lot of other learning
• 17:20
  resources,
• 17:22
  available to people including,
• 17:24
  a huge, event that both sort of,
• 17:27
  rallies,
• 17:29
  the the health care quality workforce and and
• 17:31
  prepares them for what's next. It's called NAICU
• 17:34
  next. So
• 17:36
  that event is virtual. It's, very affordable, very
• 17:39
  accessible. A few $100 per person instead of
• 17:42
  hundreds or thousands for registration and travel and
• 17:44
  flights and all the things. So we get
• 17:46
  about 5,000 people a year to attend that
• 17:48
  event in September.
• 17:50
  And then, of course, you know, there's the
• 17:52
  workforce accelerator program, which is,
• 17:54
  you know, a a bigger commitment from an
• 17:57
  organization,
• 17:58
  but effective.
• 17:59
  And and I I would say one more
• 18:00
  thing, can I, which I I think this
• 18:02
  is I think it's super important and worth
• 18:04
  mentioning is, you know, we hear a lot,
• 18:07
  especially from people working in quality departments, that
• 18:11
  budgets were cut?
• 18:12
  We're not doing discretionary spending.
• 18:14
  Training is
• 18:16
  on hold sort of thing.
• 18:18
  And what I would say to that is
• 18:20
  two things.
• 18:21
  Number one, there's a ton of spending going
• 18:24
  on in health care. Millions and billions and
• 18:26
  trillions of dollars are being spent on health
• 18:28
  care. So while there are cost pressures
• 18:32
  that are absolutely real, and and I understand
• 18:35
  them and I appreciate them,
• 18:37
  People are choosing what to spend money on.
• 18:39
  And and I think that it's important that
• 18:41
  they choose to spend money on developing their
• 18:43
  workforce
• 18:44
  and having sustainable systems to not have this
• 18:46
  whack a mole situation,
• 18:49
  you know, going on in quality and safety
• 18:51
  and health care,
• 18:53
  for you know, as it is, oftentimes.
• 18:57
  And I would also say too,
• 18:59
  there is a return on this investment. So
• 19:01
  it used to be
• 19:03
  reasonable to sort of say, like, we don't
• 19:04
  have money to spend on things like this
• 19:06
  because, you know, there wasn't a an ROI
• 19:09
  established, but now there is. And now it's
• 19:11
  six and ten and twenty times the investment.
• 19:14
  So I think that what we need to
• 19:15
  get health care leaders to be doing and
• 19:17
  people working in quality
• 19:18
  is to get innovative and and brave and
• 19:22
  bold and say, yeah.
• 19:23
  Everything costs money in health care, but we
• 19:25
  should be spending on the things and investing
• 19:28
  on the things that are gonna return for
• 19:30
  this organization,
• 19:31
  return for our patients, and return for their
• 19:33
  families. So large and small,
• 19:36
  you know, mature and immature, there's all sorts
• 19:39
  of organizations needing support, and all of them,
• 19:42
  I think, you know, really need to commit,
• 19:44
  to their workforce and to the outcomes and
• 19:47
  to our patients. And this is a great
• 19:48
  way to demonstrate that commitment.
• 19:51
  Yeah. Absolutely. Again, proving the ROI, making that
• 19:54
  financial connection, I think, is a great starting
• 19:56
  point. Thank you so much for your time
• 19:58
  and insights today. This was a fantastic conversation.
• 20:00
  Thanks for being here.
• 20:02
  Of course. I loved it. Thanks for the
• 20:03
  opportunity. Yeah. It's great to have you. And
• 20:05
  we also want to thank our podcast sponsor,
• 20:07
  NAQ. You can tune in to more podcasts
• 20:09
  from Becker's Healthcare by visiting our podcast page
• 20:11
  at beckershospitalreview.com.