In this blog post, IHI Vice President Kathy Luther, RN, MPM, shares tips for building strong working relationships within condition-focused teams. Ms. Luther leads IHI's work on Quality, Cost, and Value, which included the Joint Replacement Learning Community to improve value for hip and knee replacement surgery and reduce costs by 5 percent.
IHI Vice President Kathy Luther describes the experience of a financial analyst who shadowed his clinical colleagues in this video.
Powerful solutions come from clinicians, physicians, and financial analysts work closely together, aligned in their focus on improving care and reducing costs. The challenge is developing teams willing to break down silos in the best interest of their patients.
In her article, “Discussing Cost with Clinicians,” in the March 2015 issue of HFM Magazine, Betty A. Marton articulates precisely what IHI has discovered about increasing value. “Gone are the days,” she writes, “when financial and clinical staff can stick with what they know best, stay on their own turf and maintain silos of responsibility separate from one another.”
We couldn’t have said it better ourselves. During the Joint Replacement Learning Community, IHI worked with 32 organizations for a year to reduce cost while maintaining or improving quality for their hip or knee replacement procedures. Teams of financial analysts and clinicians worked side by side to determine the cost of each step of the care process and identify cost-reduction techniques. High-value changes included revamped pre-operative preparation, cement and implant standardization, and scripted discharge with shortened inpatient stays. Nearly all of the teams achieved a reduction in total cost while maintaining or improving quality; over half of the teams saved at least 5% or more.
While the cost savings are impressive, the real learning was the new way of working participants discovered. For many teams, this project forever changed the way clinical and financial staff relate to each other. This change is not easy, but it is worth the effort.
Here are some tips for building strong working relationships within condition-focused teams:
1. Ask clinicians and financial analysts to create process maps from their respective perspectives. Compare the maps side by side and look for differences. These differences can illuminate differences in language, opinion, and working styles that are important to address before working together.
2. Ask counter-intuitive questions, like these:
- “How could we make this procedure cost more?”
- “How could we really degrade quality?”
- “How could we ensure an HCAHPS score in the lowest quartile?”
By looking at cost and quality from a counterintuitive perspective, you can unlock the knowledge and influence of the disciplines represented on the team.
3. Craft an aim statement together – one that the entire team agrees on. This is an essential step to ensure buy-in and collaboration.
These simple steps can go a long way toward moving team members away from their comfort zones – and closer to unleashing the power of real collaboration and new levels of performance.