Other Voices

Assembling Practical Tools to Excel at Reform

Hospitals in Pursuit of Excellence is the American Hospital Association's go-to place for health care leaders to find advice, tools and resources on improving performance and meeting the demands of health care reform. HPOE is overseen by Maulik Joshi, president of the Health Research & Educational Trust and senior vice president of research for the AHA. He spoke with Hospitals & Health Networks' Managing Editor Bill Santamour. To view the video interview, visit www.hhnmag.com. For more about HPOE, go to www.hpoe.org.

Briefly Describe HPOE, if you would.

HPOE, or Hospitals in Pursuit of Excellence, is the American Hospital Association's strategic platform to accelerate performance improvement throughout all of our hospitals and to support health reform implementation. By working with all of our hospitals and sharing best practices, providing tools, providing leadership development opportunities and through working together on national projects, we're seeking to really accelerate improvements through all our
hospitals.

What are the main strategies?

HPOE has four major strategies to accomplish our goals. The first is around education. All of our hospitals today are making tremendous improvement across every clinical area we can think of. We want to identify the best practices that are out there and share them as broadly as possible with our community. Through our HPOE.org website we have case studies, we have webinars and we have other vehicles to engage all our peers in terms of accelerating improvement and sharing their knowledge in best practices. The second strategy is around tools and guides. Through all parts of the American Hospital Association, we have developed great guides, tools and how-tos on specific topics that are relevant to the hospital community and their leaders. So topics such as how to reduce avoidable readmissions, how to achieve high performance in health systems, how to use workforce practices to drive quality improvement, these are all examples of guides that we have produced and are available on our website for others to learn from. The third strategy is around leadership development. For the ninth year, the American Hospital Association in partnership with the National Patient Safety Foundation has a patient safety fellowship program. This year in July we have another 30-plus individuals starting that fellowship program, a yearlong, intense program to learn from each other on the science of patient safety and implement actions back at home. We are also looking to develop a second fellowship or network program for individuals interested in health reform implementation. The fourth piece is national projects. The Health Research & Educational Trust is a contractor for the Agency for Healthcare Research and Quality and is working on some major projects to eliminate infections. Right now we're working on two areas, central-line bloodstream infections and reducing catheter-associated urinary tract infections. Those four strategies are our main vehicles to accelerate and support health reform implementation: education, tools and guides, leadership development and national projects.

How Does this fit in with health reform?

Health reform gives hospitals the opportunity to really transform delivery and payment issues. HPOE's main goal about accelerating improvement is the foundation for health reform. Health reform issues, such as bundling payment, accountable care organizations, value-based purchasing, all are based upon some core fundamentals, which is performance improvement. So as strong as we are in HPOE, as strong as all of our hospitals are in core performance issues, that's our foundation to build upon our delivery and payment reform.

Can you speak more about the strategy of developing these tools?

The great part about what we're trying to do is to leverage a couple of areas. One is to leverage what's working in the field. We're not working to create brand-new knowledge. We're looking to leverage what's already being done out there. That forces us to work with national and local partners, working with our state hospital associations, working with Premier, VHA and the other national organizations that are developing outstanding work in this area. So how do we leverage that known evidence and build it out there? The second part is we are working on areas or research projects where we can generate some new evidence. HRET is working on research grants and contracts that allow us to identify great practices, review the literature and produce guides.

How have organizations used these guides?

We've had thousands of guides downloaded. People are actually reading these. We've heard countless stories from organizations and how they've used the guides. First, they've shared them with their boards. I know of one health system board that has used our guides, specifically shared it with every board member, and asked [themselves], "How do we match up to what the best practices are in this guide?" Some of our other guides, like readmissions, are shared among staff around the improvement project that they're working on. We've surveyed the field in terms of those who have downloaded the guides and [asked how they are] using them; it's been sharing and identifying best practices, and connecting with others in the field in terms of what they are doing.

What is the HPOE implementation road map that will be released at the AHA–Health Forum Summit?

We have throughout the year produced a number of great guides or tools starting in leadership and disparities, in clinical areas, workforce areas and in emerging areas like bundled payments and ACOs. We're putting together our top 10 guides in a binder that we're going to have available to every attendee at the AHA–Health Forum Leadership Summit. This 200-plus page document will be organized by major strategies. We're not just saying here are 10 great ways to do things. When you're going to work on leadership, here's a terrific resource from the Center for Healthcare Governance from their blue-ribbon panel report on competencies of governance. If you're working on disparities, here's a terrific way to think about how you collect that data using the HRET disparities toolkit. If you're starting to think about bundled payments and ACOs, here are the resource synthesis reports on bundled payments and ACOs. We are trying to take what we've developed and put it together so that a health care leader can look at the broad picture of reform implementation and improvement and know where to start and where to look.

What new guides can we expect to see in the second half of the year?

We are going to be producing one on how hospitals are using the data they are collecting on race, ethnicity and primary language to reduce disparities in their own hospitals. We are developing another guide on a prevention toolkit for catheter-associated urinary tract infections. We're developing another guide on the use and access of capital for hospitals as we think about the future. So we're trying to focus the guides on diverse areas but focused around the core performance areas of Hospitals in Pursuit of Excellence, which serve as a foundation for supporting health reform implementation. HPOE.org has a number of case studies, news stories and other ways to engage leaders.

And it is growing?

It's growing every day.

This article 1st appeared in the July 2010 issue of HHN Magazine.

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