HealthGate Articles

CMOs and CMIOs Say, “Money Is Not the Main Issue”

As a means to improving quality of care and in preparation for CPOE implementation, many healthcare organizations are looking to standardize, consolidate and manage large volumes of documentation. Oftentimes, the failure of such initiatives is quickly attributed to a lack of funding. We disagree, and so do the 60 hospital leaders who participated in our recent research study on committee work and efficiency in healthcare.

Culture of quality now preponderant

Eighty-six percent of study participants reported that their organizations boast a culture that is focused on quality (see Figure 1). In such quality-focused environments, numerous efforts are undertaken to consistently maintain and improve the quality of care provided to patients.

Figure 1

Standardization viewed as key to improved quality of care

One very common quality improvement effort is the management, consolidation and standardization of documents (e.g., order sets, policies and procedures, clinical materials used at the point of care). Of the 60 study participants, 79% agreed that better managing, consolidating and standardizing documents (like order sets) will improve the quality of care that is provided by their organization (see Figure 2).

Figure 2

Such an affirmative response signifies the importance of being able to effectively and efficiently manage documents. But, do organizations have the resources (time, money, personnel), skills and tools (document management/collaboration systems) to do so?

An impressive 64% of participants stated that they have the resources, skills and tools to better manage, consolidate and standardize documents (see Figure 3); however, only 47% of participants reported investing adequate time, money and personnel to help these efforts succeed (see Figure 4).

Figure 3

Figure 4

Recognizing the real issue

These findings suggest that the roadblocks often met while implementing quality improvement initiatives, as they relate to document management, standardization and organization, is not likely attributable to the often touted “lack of money,” or even to the inability to secure tools and skilled labor. Sadly, failure or delay in implementation of document management activities that have the potential to improve quality of care can likely be attributed to the poor management of existing resources—particularly time, money and personnel.

Based on our research findings, existing time, money and personnel are likely not utilized effectively or efficiently for quality improvement initiatives (e.g., document management) due to a general lack of organization and follow-through, especially with respect to committee-related activities.

More than half of the study participants (58%) reported that their top personal challenge is “managing time and maintaining focus.” When asked about the top challenges in working with committees, 52% mentioned “building action plans and having good follow-up” and 58% said “making meetings productive and managing time.”

A suggested solution for CMOs and CMIOs

CMOs and CMIOs should explore collaboration technologies. Collaboration software and techniques can be used to maximize the efficiency and effectiveness of existing time, money and personnel within an organization by:

• Expediting review and standardization of documentation
• Tracking committee performance
• Interpreting committee decisions
• Finding/comparing documents for evaluation and review
• Promoting consensus throughout a committee or organization
• Making sure that systems are interoperable within existing workflows

Although many hospitals and health systems still don’t have a sense of the full value that collaboration can bring to their organization, having an understanding of this potential and being able to effectively communicate these advantages to an organization’s decision-makers, is a big first step towards using existing resources to improve the quality of care.

Study background and participants

Completed in January 2007, the two-month long study was conducted on the premise that the volume of committee work in which healthcare providers are asked to participate is growing, but the effectiveness, efficiency and economic burden of such work is poorly understood, documented and articulated.

Participants in the study were affiliated with 60 hospitals or health systems within 27 states, and held positions of Chief Medical Officer (CMO), Chief Medical Information Officer (CMIO), Vice President of Medical Affairs (VPMA) and Medical Director. They were asked a variety of questions pertaining to:

• Their involvement in healthcare-related committee work, and the greatest challenges related to such work
• Satisfaction with current approaches to team-based interaction and decision making
• Technologies and resources that are deemed most useful for collaboration and committee-related activities
• The perceived quality of care within their organizations, resources dedicated to quality improvement activities and successes and failures associated with such activities

Findings related to committee work and technologies used for collaboration were presented in the February 2007 issue of the HealthGate Compass. This issue features findings associated with quality of care and quality improvement initiatives.

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