A big part of quality improvement and patient safety work involves learning from past experience so we can do better next time. Here at IHI, we are also committed to sharing what we learn.
In that spirit of sharing, I can honestly say that one of the mistakes I made as a quality and safety officer for a large health system is that I did not consult with my colleagues in finance nearly as much as I should have. Even though I saw the CEO often and felt comfortable discussing safety and quality goals and practices, I seldom made the leap to the CFO to help outline what that work meant to the institution’s bottom line.
Today, those working to advance patient safety within a health care institution, large or small, would do well to connect with their liaisons in finance early and often when working on proposals. That’s an essential piece of advice in a new toolkit designed to help safety professionals develop and deliver a solid business case for work they seek to pursue. In particular, the guide focuses on three actions that drive a successful business case for patient safety:
Collaborate far and wide. Safety professionals know a lot about systems thinking and the importance of culture and transparency. Finance professionals know a lot about budget cycles and the financial intricacies of value-based payment models. While one side understands numbers and balance sheets, the other sees every day how preventable harm affects patients. Together, their shared knowledge can demonstrate how important patient safety initiatives are to the organization’s reputation and market share. Together, these subject matter experts need to develop a common language to help frame safety issues as important business concerns.
The new guide emphasizes the importance of a “Safety-Finance Team” that develops shared goals and perspectives for the business case they are preparing. But collaboration shouldn’t stop there. Insights and support from other colleagues, such as a clinical champion, information technology staff, biomedical engineering, purchasing, or any number of other potential subject matter experts, can help inform the proposal. Depending on the project being considered, partnering with members of your patient population and community or with industry representatives may add additional perspectives that help make a successful business case.
Align goals with the organization’s strategic goals and mission. The team assembled to prepare a business case needs to have a firm understanding of the organization’s goals, its current financial outlook, and how safety fits into the mission. The goals of the safety initiative you are proposing need to align with the organization’s goals in scope, timing, and focus.
Choose the right data to tell a compelling story. The right data, presented in the right way, are critical to the success of a business plan. Here again, collaboration is essential. While the finance lead can acquire, analyze, and synthesize relevant financial data, including the costs of implementing a program or project, it’s also important to gather key metrics and trends from clinical departments and to reference state or national data when available. Some financial outcomes, for example, reductions in duplicative testing, can be clearly defined (“hard dollars”) while others, such as improvements in staff retention, may be less easily quantified (“soft dollars”). It’s important to know how best to represent both kinds of outcomes.
Success comes when you have a strong basis for action, the data to support your approach, help from subject matter experts, a plan to move forward, and agreement on how outcomes will be measured.
The new toolkit was itself the product of collaboration. Members of the IHI/NPSF Patient Safety Coalition took this on as a signature project, with special insight and leadership provided by staff of the Healthcare Financial Management Association. With preventable harm to patients in the headlines, and a move toward payment models that place value over volume, this is a resource that can help you prepare, clarify goals, and be ready to present your case.
Have you engaged your finance colleagues for help in proposing a safety initiative? Comment below and tell us about it.
Tejal K. Gandhi, MD, MPH, CPPS, is IHI’s Chief Clinical and Safety Officer.
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