Moving from Volume to Value Track

​​​​​​​​​​​The transformational shift from volume to value is well underway and gaining steam. ​​Accelerating a health care organization’s ability to thrive in value-based care is the National Forum's Moving from Volume to Value track. Specific topics include:

  • Promising approaches to continually drive out waste and unnecessary variation while improving quality and efficiency
  • Evolving care models to continually meet the needs of the population served under value-based care
  • Utilizing data to identify, drive, and sustain performance improvement under value-based care
  • Engaging with clinicians, patients, and community partners in transformation efforts​
Session selection is open. View all Moving from Volume to Value sessions below or see the full program here. ​You can also view this year's 10 Forum tracks.​

Moving from Volume to Value Sessions

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Translating Toyota: Individual to Organization

Translating Toyota: Individual to Organization

Great care is graceful and creates gratitude. Poor care is awkward and leads to disappointment. Expert faculty introduce the capabilities for complex adaptive change to achieve exceptional performance at every level, from individual to whole organization. We will challenge attendees’ thinking and simulate the critical skills and leadership required for high performance. Case studies will include the Baldrige Award–winning Charleston Area Medical Center with the opportunity to be coached in Toyota’s Oobeya management approach.

After this presentation, you will be able to:

  • Identify why system complexity requires us to take a methodical approach to system design, operation, and improvement
  • Propose specific applications of translated Toyota methodology to achieve graceful care
  • Be able to implement the knowledge and skills to address the quality and affordability of health care

Presenters: Steven Spear, BS, MA, MS, PhD, Senior Lecturer, Massachusetts Institute of Technology, IHI Senior Fellow, Massachusetts Institute of Technology; Tom Downes, MD, MBA, MPH, Clinical Lead for Quality, IHI Fellow, Sheffield Teaching Hospitals; Pinckney McIlwain, Chief Medical Officer, Charleston Area Medical Center

Designing High-Impact Value Improvement Projects

Designing High-Impact Value Improvement Projects

In this Learning Lab, participants will work collaboratively among interprofessional teams to design and critically evaluate pragmatic value improvement projects. Our interprofessional team will review best practices for combining clinical insights and c-suite directives. Using a Costs of Care project development template, participants will work collaboratively to develop their ideas, pitch their ideas to a panel of experts, and receive immediate feedback on their value improvement projects.

After this presentation, you will be able to:

  • Identify and prioritize institutional opportunities to provide better care at lower cost
  • Utilize our “COST” framework to develop interprofessional, high-impact value improvement projects
  • Design a high-impact value improvement project that could be adapted and scaled in the context of your own institution

Presenters: September Wallingford, RN, MSN, Operations Director, Costs of Care; Neel Shah, MD, Executive Director, Costs of Care; Chris Moriates, MD, Implementation Director, Dell Medical School, University of Texas at Austin; Vineet Arora, MD, Education Director, University of Chicago Medical Center; Reshma Gupta, MD, Outreach and Evaluation Director; Jordan Harmon, Director, Hospital For Special Surgery

A Values-Driven Approach to Accountable Care

A Values-Driven Approach to Accountable Care

Regardless of the politics and punditry, most patients, providers, payers, and policymakers agree on the ultimate goal: better health, better care, lower costs. During this highly interactive session, participants will hear from accountable care organization (ACO) leaders who will share their successes and challenges in moving away from an economically unsustainable fee-for- service driven environment toward one that rewards cost-effective care that better meets the needs of patients and populations.

After this presentation, you will be able to:

  • Identify common challenges and solutions to running a successful ACO
  • Discover opportunities to accelerate your efforts to achieve cost- and quality-related improvements at scale
  • Engage in active peer sharing and learning

Presenters: Saranya Loehrer, MD, MPH, Head of the North America Region, IHI; George Kerwin, CEO and President, Bellin Health; Evan Benjamin, MD, Senior Vice President, Quality and Population Health, Baystate Health

The Accountable Care Journey: What to Do and When

The Accountable Care Journey: What to Do and When

While the industry continues to create and promote value-based payment models, most providers are unprepared to adopt financial risk and lack direction on how to effectively prepare for success in such an environment. To help provider leaders know how to strategically sequence investments to transform care delivery, the Accountable Care Learning Collaborative presents a step-by-step competency implementation glide path that includes over 150 unique care competencies necessary for success under risk-based payment.

After this presentation, you will be able to:

  • Identify the specific care delivery competencies necessary for success under value-based payment
  • Prioritize and sequence care delivery competencies in an actionable glide path for provider organizations of various types and maturity levels
  • Equip provider representatives of all levels to implement the competency glide path to meet the unique needs of their organizations

Presenters: Jordan Asher, MD, MS, Chief Clinical Officer and Chief Innovation Officer; Bruce Meyer, Executive Vice President for Health System Affairs, University of Texas Southwestern Medical Center; Valerie Overton, CNP, RN, Vice President, Quality and Innovation, Fairview Health Services

Hospital Flow: Right Care, Right Place, Right Time

Hospital Flow: Right Care, Right Place, Right Time

Addressing vexing issues of patient flow in hospitals is essential to ensure safe, high-quality, patient-centered care. Failure to provide “the right care, in the right place, at the right time” puts patients at risk for suboptimal care. Poorly managed hospital flow also adds to the already taxing burden on clinicians and staff and diverts their attention from clinical care. This session will present a framework for improving the hospital-wide patient flow that is critical for increasing value for patients, clinicians, and health care systems.

After this presentation, you will be able to:

  • Understand and describe how to apply a conceptual framework for system optimization to improve hospital-wide patient flow
  • Utilize an approach for “sense making” regarding the multiple strategies for improving hospital operations and patient flow throughout a hospital
  • Analyze organizational capability, change concepts, and successful interventions to create a sustainable system for system-wide hospital flow

Presenters: Patricia Rutherford, RN, MS, Vice President, IHI; Frederick Ryckman, MD, Senior Vice President for Medical Operations, Cincinnati Children's Hospital Medical Center; Karen Murrell, MD, MBA, Assistant Physician in Chief, Kaiser Permanente South Sacramento; William Browder, MD, FACEP, Emergency Medicine; Katharine Luther, RN, MPM, Director of Quality, University of Texas Health Science Center at Houston

Driving Success in Bundled Payments

Driving Success in Bundled Payments

Bundled payment models provide opportunities for efficiencies such as reducing unnecessary costs and encouraging patient-centered care. They can also pose challenges in redesigning care, managing stakeholders, and building partnerships outside your system. Expert faculty will take participants through four key aspects of excelling in bundled payment arrangements: understanding the policy environment; operations and administrative models to support bundles; physician stakeholder engagement; and clinical care innovation, including post-acute integration.

After this presentation, you will be able to:

  • Identify key elements of successful operations management in a bundled payment environment
  • Demonstrate approaches to engage physician stakeholders in successful bundled care
  • Name three ways clinical care innovation and redesign can support effective clinical care under bundled payments

Presenters: Molly Bogan, MA, Director, IHI; Trisha Frick, RN, MS, Director, Bundled Rate Contracting, Johns Hopkins HealthCare; Stephanie Calcasola, MSN, CPHQ, Senior Director of Quality, Baystate Health, Baystate Medical Center; Evan Benjamin, MD, Senior Vice President, Quality and Population Health, Baystate Health

Create a Population Management Platform in Context

Create a Population Management Platform in Context

Have you struggled to develop a population management platform? Have you had difficulty learning from successful organizations because their context (resources, infrastructure, etc.) is different from yours? In this session, a population management paradigm will be presented highlighting examples from Emory Healthcare Network and Brigham and Women’s Primary Care Center of Excellence. Participants will then develop a plan for implementation in their local context. A debriefing session will follow, with examples from participants’ local constraints.

After this presentation, you will be able to:

  • Describe a general paradigm for population management
  • Identify successful implementation of population management interventions
  • List strategies for transforming population management interventions in a foreign context into ones that respect local constraints
  • Formulate plans for implementation of successful population management interventions in your local context

Presenters: Kristie Koch, BS, Director of Value Management, Emory Healthcare; Richard Gitomer, MD, Director, Primary Care Center of Excellence and Vice Chair, Primary Care, Brigham and Women's Hospital

Measures that Matter: Simplifying Clinical Quality

Measures that Matter: Simplifying Clinical Quality

Studies have found that physicians feel overwhelmed by the demands of quality reporting. Humana representatives will discuss this issue and how, in response, Humana has implemented a company-wide program (the Clinical Quality Metrics Alignment program) to streamline and standardize the set of clinical quality metrics it uses for physicians. Humana consolidated 1,116 quality metrics from 29 different data sources across the company down to a set of 208 key quality metrics by analyzing for duplicates, inconsistencies, and clinical relevance.

After this presentation, you will be able to:

  • Show how refining clinical quality measures can increase efficiency, lower costs, reduce burden for physicians, and ultimately improve health outcomes
  • Through the lens of Humana’s Clinical Quality Metrics Alignment program, walk through specific ways that health care organizations can simplify quality measures
  • Demonstrate how simplifying clinical quality measures will help physicians currently in fee-for-service agreements with Humana, in their transition to value-based care

Presenters: Misty Roberts, MSN, RN, PMP, Partnership Leader, Humana Insurance; Worthe S. Holt Jr., MD, Vice President, Humana Insurance

Collaboration Is Key to Increasing Surgical Value

Collaboration Is Key to Increasing Surgical Value

Many facilities struggle with effective communication with physicians and key stakeholders as they work toward increased value in health care. Presenters will describe Intermountain Healthcare’s Surgical Services Clinical Program, which has created specialty-specific development teams that are led by key physicians who practice in the system. Through these teams, transparent data is analyzed, variation in cost and outcomes is discussed, and quality improvement initiatives are developed to increase the value in surgery.

After this presentation, you will be able to:

  • Identify key components of a successful multidisciplinary collaborative team
  • Give specific examples of how collaboration across specialties in surgery have reduced cost and improved surgical outcomes
  • Discuss how data cohorts are created and maintained to make the data meaningful to the development teams so they can look at variation in practice and discuss best practices with their peers

Presenters: Katie Liljestrand, RN, BSN, MBA, RN, Project Manager, Intermountain Medical Center; Wendy Gort, BSOE, MBA, Statistical Data Analyst, Intermountain Healthcare; Jeannette Prochazka, MSN, ACNS-BC, Surgical Services Operations Director, Borgess Medical Center; David Skarda, MD, Surgical Services Medical Director

Lessons Learned from Choosing Wisely’s First Five Years

Lessons Learned from Choosing Wisely’s First Five Years

We have learned many lessons from the Choosing Wisely campaign that can be applied to the implementation of waste reduction initiatives in clinical and community environments. These efforts are built largely on a framework of complexity theory and self-determination theory — such as simple rules, engagement and empowerment of clinicians and patients, and a bottom-up approach. Attendees will hear stories and lessons learned so they can advance activities to reduce overuse at their institutions.

After this presentation, you will be able to:

  • Evaluate challenges to reducing inappropriate care and the cultural and technical changes needed
  • Describe strategies learned through the Choosing Wisely campaign that can engage clinicians, consumers. and health systems in efforts to reduce waste and overuse in health care

Presenters: Daniel Wolfson, MHSA, Executive Vice President and Chief Operating Officer, The ABIM (American Board of Internal Medicine) Foundation; Elizabeth Mitchell, President and CEO, Network for Regional Healthcare Improvement

Learn How Community Partnerships Cut Emergency Department Use by 33 Percent

Learn How Community Partnerships Cut Emergency Department Use by 33 Percent

The goal of the New York State Delivery System Reform Incentive Payment (DSRIP) program, a Medicaid waiver program, is a 25 percent reduction in preventable readmissions and ED utilization. Learn how innovative partnerships with a local food pantry and community dialysis center reduced ED utilization by 33 percent and admissions by 88 percent among super-utilizer patients at two safety-net hospitals participating in the state’s Medicaid Redesign Team–sponsored rapid-cycle-improvement collaborative. “Action” team collaboration extended beyond the project — improving communication, workflows, and efficiency across multidisciplinary hospital departments.

After this presentation, you will be able to:

  • Categorize key characteristics of the super-utilizers subgroup of populations
  • Identify key collaboration opportunities with community organizations based on population characteristics
  • Highlight additional benefits of multidisciplinary "action" team participation, including breaking down silos and improving communication, workflows, and efficiency across hospital departments

Presenters: Damara Gutnick, MD, Medical Director, Montefiore Hudson Valley Collaborative; Lisa Hanarhan, DNP, RN, Vice President, Quality and Risk Management; Kathleen Sheenhan, RN, BSN, Director of Emergency Services; Natalee Hill, Director of Quality and Innovation, Montefiore Medical Center; Glynis Cowart

Safety Culture 2.0: Upgrading Our Tools

Safety Culture 2.0: Upgrading Our Tools

This session presents our combined results across the state of Michigan and the Duke University Health System. We have found that SCORE (Safety, Communication, Operational Reliability and Engagement) results predict infections, patient satisfaction, turnover, and preventable harm. We have also tracked improvement in inpatient, outpatient, and primary care work settings on a large scale. Here we share our lessons learned as using safety culture matured from fumbling about to assessing and improving with a plan and with precision.

After this presentation, you will be able to:

  • Effectively measure and use culture data to predict and improve your clinical and operational outcomes
  • Create the “nudge”: Effectively engage leaders, managers, physicians, and front-line teams in culture improvement
  • Execute simple strategies that will measurably impact culture and outcomes across your organization

Presenters: Sam Watson, MSA, CPPS, Senior Vice President, Patient Safety and Quality, MHA Keystone Center; K. Carrie Adair, PhD, Associate in Research, Duke University Health System; Bryan Sexton, Director of Patient Safety Center, Safe & Reliable Healthcare

Health System–Level Accountability for Triple Aim

Health System–Level Accountability for Triple Aim

This session will focus on creating a portfolio of population health initiatives across multiple payers and settings to pursue Triple Aim results, and providing the keys to developing the macro and micro systems to successfully deliver on accountable care organizations (ACOs) and bundled payment. Key drivers and learning experiences from MemorialCare across five ACOs will be discussed, including galvanizing leadership, creating the “360ROI,” developing a roadmap, constructing an overall “system of care,” assembling key quality and utilization data and care infrastructure needs, and governance.

After this presentation, you will be able to:

  • Construct a driver diagram to guide system-wide focus on moving from fee-for-volume to fee-for-value
  • Discuss the creation of a portfolio of population health initiatives across multiple payer segments with differing requirements and assessment criteria
  • Leverage lessons learned from MemorialCare to bring back to your own organization

Presenters: Regina Berman, RN, MA, VP Population Health and Accountable Care, MemorialCare Medical Centers; Helen MacFie, PharmD, FABC, Chief Transformation Officer, MemorialCare Medical Centers

Driving High-Value Care via Clinical Pathways

Driving High-Value Care via Clinical Pathways

The reduction of variability can lead to improved quality, decreased adverse events, enhanced resource utilization, and cost efficiency. The effects of standardization can extend far beyond the individual patient encounter, however, driving positive economic results and advancing the strategic mission of health care organizations. this session will look at building logic and rules to determine whether pathway elements were met — versus the traditional method of monitoring order and order set usage — to enable understanding of care that is actually being delivered, and drive process improvement.

After this presentation, you will be able to:

  • Implement clinical pathways that will lead to critical process improvement as well as advance the strategic mission of your organization
  • Identify measurement tools that integrate outcomes, practice pattern, and cost data to achieve maximum impact of pathways of care
  • Develop clinical pathways that span and link the entire continuum of care, including primary care offices and community resources

Presenters: Andrew Buchert, MD, Medical Director, Clinical Resource Management, University of Pittsburgh Medical Center; Gabriella Butler, RN, MSN, Manager, Clinical Resource Management, Clinical Analytics, and Data Science, Children's Hospital of Pittsburgh

Methods for Identifying a High-Need, High-Cost Population

Methods for Identifying a High-Need, High-Cost Population

Currently there is no consensus in the field about whether it is best to focus on person-level characteristics, high utilization rates, or an in-house hybrid algorithm as a method for identifying individuals with complex health needs and high health care costs. Join us for a lively panel discussion aimed at examining these different controversial viewpoints for targeting a population for advanced care management.

After this presentation, you will be able to:

  • Describe the benefits of a care-management approach targeted at populations with complex health and social needs and high health care costs
  • Identify the pros and cons of different methods for identifying high-need, high-cost populations

Presenters: Catherine Mather, MA, Senior Project Manager, IHI; Kedar Mate, MD, Chief Innovation and Education Officer, IHI

Utilizing Data to Transform Health Care

Utilizing Data to Transform Health Care

Our 800-bed health care organization providing quaternary care implemented innovative strategies to engage and empower its clinicians in transforming health care. Using the Plan-Do-Study-Act performance methodology, data on patient satisfaction, clinical quality, and staff engagement were utilized to create improvements resulting in outcomes that outperform the national benchmark. Structure and processes were implemented to ensure data was available, understood, and used at the unit level to drive and sustain performance improvement under value-based care.

After this presentation, you will be able to:

  • Understand innovative concepts to drive change across your organization
  • Identify best practices and strategies to improve service, quality, and employee engagement
  • Understand and use data to identify and sustain performance improvement

Presenters: Elena Memoracion, DNP, RN, NEA-BC, Senior Administrative Director, NorthShore University Hospital; Kerri Scanlon, MSN, RN, Deputy Nurse Executive, NorthShore University Hospital

Bundling and Value-Based Care: How to Get Started

Bundling and Value-Based Care: How to Get Started

Bundled care and new payment models are the new normal in health care delivery and reimbursement. To compete, organizations must tightly couple clinical decisions with financial performance. This approach can lead to many advantages for health care organizations, including cost reduction and patient-centered process improvements. This session will present examples and tools that you can use to help your team understand how to improve the quality — and value — of the care provided to patients and populations in a bundled payment environment.

After this presentation, you will be able to:

  • Describe how the University of Pittsburgh Medical Center’s Bone and Joint Center coupled clinical quality, financial performance, and process improvement efforts with patient-centered tools to compete in a national bundling program
  • Access the tools available to determine the true cost to deliver care in any care experience
  • Understand how to shadow your patients and families to determine the current state in your organization, identify opportunities for improvement, and create an action plan

Presenters: Anthony Digioia, MD, Orthopedic Surgeon, University of Pittsburgh Medical Center; Gigi Crowley, RN, Director, Bone and Joint Center, Magee-Womens Hospital of the University of Pittsburgh Medical Center

Patients at Home Hours after Total Joint Surgery

Patients at Home Hours after Total Joint Surgery

Patients after elective surgery recover better at home than in the hospital, where they can become disoriented and deconditioned lying in bed. We have decreased our hospital’s length of stay by incorporating and standardizing best practices into a tightly choreographed workflow. As a result, 75 percent of the patients who can be discharged within a few hours after their surgery, are going home! Come and learn how to implement this at your hospital.

After this presentation, you will be able to:

  • Implement workflows that will work at your hospital for same-day discharges after total joint replacement
  • Develop strategies to help change behavior and culture around same-day discharges
  • Identify opportunities for other surgeries that can be appropriate for same-day discharge

Presenters: Ashima Garg, MD, PhD, Orthopedic Surgeon, Kaiser Permanente Santa Clara Medical Center; Chris Boyd, BA, MPH, Senior Vice President, Area Manager, Kaiser Permanente Santa Clara Medical Center

Project ECHO: Action for Improvement

Project ECHO: Action for Improvement

Project ECHO is increasingly being seen as a strategy to develop improvement capability. This workshop will feature two diverse case studies in which traditional improvement strategies partnered with Project ECHO to achieve better outcomes and improvement capability. A demonstration of ECHO methods on the video-conferencing platform will provide a realistic view of how these combined strategies work. Principles for incorporating virtual coaching and mentorship for improvement will be discussed.

After this presentation, you will be able to:

  • Describe how Project ECHO and traditional quality improvement strategies and methods have achieved results
  • Discuss the benefits and challenges of using ECHO methods with along with other improvement methods
  • Identify lessons learned from the case studies to apply to your work

Presenters: Cory Sevin, RN, MSN, NP, Senior Director, IHI; Elizabeth Clewett, Program Specialist, Project ECHO

Improving Quality and Safety Through Formal Graduate Education

Improving Quality and Safety Through Formal Graduate Education

Unnecessary variation in clinical practice, disparities in health outcomes, and adverse events are some of the most challenging difficulties facing modern health care delivery. Solutions require on-going education, careful monitoring, and an environment of accountability and action. To help support these efforts, graduate programs across the US have developed a range of master’s degree programs in health care quality and safety. In this session, academic administrators discuss “lessons learned” partnering with health care providers and administrators to improve quality and safety, new challenges and opportunities on the horizon, and the future of health care quality and safety education.

After this presentation, you will be able to:

  • Discuss the causes of unnecessary clinical variation, health disparities, and adverse events
  • Identify the importance of advanced training in health care quality and safety

Presenters: David Nash, MD, MBA, Dean and The Dr. Raymond C. and Doris N. Grandon Professor, School of Population Health, Thomas Jefferson University; Mary Reich Cooper, MD, JD, Associate Professor, School of Population Health, Thomas Jefferson University; Deirdre McCaughey, PT, PhD, MBA, Program Director and Associate Professor, University of Alabama at Birmingham; Donna Woods, PhD, Professor, Northwestern University; Kenneth Harwood, Associate Professor, George Washington University