BY, MSN, BSN, NE-BC, CCM, FAAN
I proudly hail from Louisiana, where great food is the DNA of the state. At a young age, children are taught to cook not only simple, but also complicated recipes. The fascinating part about the recipes is that often the ingredients are not exactly measured. You cook with a little pinch of this and a heap full of that, and miraculously the dishes are amazing every time! “Guesstimated” (that’s guess + estimated) measures may be sufficient for following recipes, but in healthcare, we must hone a more exact mindset and behavioral pattern to drive positive outcomes.
How many times have I heard, and eventually proclaimed, “what’s measured is what matters”? Or, “facts matter.” One of my favorite quotes as a case manager: “It is easier to manage what you can measure.” I have heard these quotes throughout my career, and I am not able to attribute them to a specific author. I acknowledge that these are not my original quotes, but they are certainly principles I live & work by. This edition of CMSA Today is filled with content related to measures, quality, outcomes and much more. As a case manager, one of the most important roles is to facilitate the patient/client’s progress toward a desired outcome. Therefore, we must know the baseline or starting point. We must implement evidenced-based interventions that will lead toward progress. The next step is to identify measures that are sensitive enough to assess the degree of change based on quantifiable indicators. And, finally we must analyze the degree to which the patient/client achieved the healthcare goals. If case managers consistently employ a metrics and measurement mindset, patient/client goal attainment is more likely and the patient’s path to self-care is more favorable. There are many tools case managers may use to measure progress toward patient/client outcomes. In addition to tools, I advocate for increased knowledge in concepts and principles that reinforce a quality-measurement mindset. After years of teaching and coaching quality improvement in healthcare, I devised a simple mnemonic to assist with the development of this mindset…the quality PILL©. The mnemonic letters represent: 1) Patient determinants 2) Industry evidence 3) LEAN principles and 4) Lead with numbers.
- Patient determinants is the mindset that ensures patient-centered goals within the context of individualized attention to social determinants of health.
- Industry evidence is the deliberate and consistent search for researched-based or proven strategies from across the healthcare industry that formulates the case management plan.
- LEAN principles focus on customer (patient) value and the alignment of processes to increase this value. LEAN healthcare is an approach that drives high quality at lowest cost and is inherently applicable to case management.
- Leading with numbers creates a mindset where case managers quantify measures, indicators, milestones and outcomes to drive change at the patient or organizational level.
This issue has a variety of articles to influence your mindset around the concepts of quality, measures, standards and social determinants of health. Even if you are familiar with these concepts, I encourage you to read about the excellent work that is occurring in the profession of case management. I also encourage you to pause…reset if necessary…and take stock of how you are organizing your work, how you play and live your life. In fact, some imprecise measures can actually be converted into exact measures, especially if you take measure of yourself and the world around you!