Elizabeth A. Delahoussaye (elizabeth.delahoussaye@cioxhealth.com) is Corporate Compliance andChief Privacy Officer for Ciox Health, located in Alpharetta, GA.
Patient medical records are rich with information, the transfer of which requires unparalleled security, timeliness, and accuracy. Until there is total automation in data exchange, healthcare decision-makers face the stark reality of resultant human error. Every organization’s leadership must decide the quality and risk rates that are acceptable for that organization, facing this threshold with a balance of pragmatism and high expectations.
Transparency, compliance, and privacy are key, particularly in the release of quality patient information. That patient record—every patient record—represents a real person. And it’s vital that every person involved in the exchange of records understands this human side of a very digital world. Release of information is a nuanced and innately human process, one in which stakeholders require a deep understanding of quality challenges, trends, and a depth of the commitment to compliance. Through a three-tiered approach including executive awareness, departmental reorganization, and technology enablement, we were able to achieve this understanding and reduce our quality errors by 48%. Here are the takeaways from our quality journey, and how we integrated all levels of staff and technologies to promote and measure quality improvement with minimal capital investment.
Top-down approach: Communication and messaging
Every month, our CEO engages the entire organization in monthly town hall meetings. While we hadn’t been experiencing a surge in quality errors, he makes it a priority to talk about the overall importance of quality to both our organization and to the providers and patients served. He consistently goes out of his way to emphasize the human side of quality by citing specific patient examples: There was a request for information and the patient needed to get her operative report to her provider in a timely fashion due to an emergency surgery. Assuming it wasn’t shared in time, what outcomes could have resulted? These types of questions and associated scenarios conveyed by our CEO highlight the significant responsibility of timely and accurate information transfer.
In addition to the monthly all-hands town halls, the presidents of all our divisions invite representatives from the compliance department to their regular meetings. We attend the calls and talk to their direct reports about the importance of quality, share patient anecdotes, and report their current quality grades. We perform data analysis ahead of those calls to present exactly how quality performance is trending so the teams can get an accurate understanding of quality and errors. In these calls, compliance and privacy representatives address the root cause of challenges using the Five Whys method, a strategy that enables us to have an impactful voice regarding quality. Further, we attend meetings with the general managers’ direct reports, repeating the same messaging about quality, improvement, and root causes of errors. We also added a “Coffee with Compliance” virtual meeting for all supervisors up to general managers where we review quality numbers and important areas to focus, opening the chat function to allow participants to ask questions. This dialogue among various levels of staff supported a foundation of transparency and trust regarding quality processes.
The entire executive team—from the top on down—demonstrated a redirection of focus on quality in these candid conversations with very minimal investment. In addition to the verbal framework, we included written components to our quality communications strategy. Each week, compliance and privacy staff members compile a compliance newsletter entitled “Think About It Thursdays,” in which we emphasize compliance items, new regulations that have been released, analysis of quality data, and other quality-related content. This newsletter is distributed to the entire organization across all levels of staff, even those who aren’t personally processing protected health information. Our organization has also recently begun highlighting top performers in this newsletter, noting greatest quality improvement, longest streaks, and similar accolades.
We publish the minutes from our “Coffee with Compliance” meetings on our intranet so all staff can access the discussions. On this secure site, we reviewed and revamped our compliance and privacy content, updating the organizational chart with staff photos, professional bios, and detailed descriptions of roles and responsibilities in the department. This provides a clear, concise “get to know us” resource highlighting our experience and interests in ensuring quality throughout the organization. These written communications have also bolstered our commitment to quality and consistent messaging across the organization. The executive awareness and refocusing campaign reduced quality errors by 19%.
