Jamie Harkins began her college career as an engineering major. Although she eventually left that behind in favor of a career with more personal interactions, she has been building a lot of bridges lately, at least in the metaphorical sense—first in her role as vice president of risk management for OSF HealthCare, and now in her current position as vice president of quality, safety, and risk management.
OSF is a faith-based health system that currently includes thirteen hospitals and other facilities serving people in multiple states. But, until 2017, each had separate systems for tracking data on events such as falls in the facilities and patient complaints. As part of its efforts to standardize and streamline practices, OSF purchased a raft of software and services under the Midas Health Analytics Solutions care performance platform that it rolled out to all its facilities in the summer of 2017.
“I think we were previously failing to leverage our power as a system by looking at our performance system-wide, and that’s really what this offered us,” Harkins says.
But the implementation process proved a bit more challenging than expected, in part because OSF’s diverse holdings include hospitals, a large multispecialty group, an expansive home health care practice, and more. Project planners first had to find a way to implement the same processes across a diverse array of settings before it was even practical to use the same performance platform to collect and analyze clinical quality data.
“For example, each facility had event reporting and had a totally different way of doing it, and everybody had strong opinions about the right way of doing it,” Harkins says. “There had to be a recognition that we had to find one way of doing things and, if it didn’t advance patient safety, it wasn’t worth doing.”
OSF’s senior leadership team saw the value behind standardization and played an integral role in establishing guiding principles and prioritizing the project, she says. The resulting platform has elements that don’t apply in every care setting in order to offer what each facility type needs. It’s also more laser-focused on using clinical data analytics to improve patient safety and the reliability of care rather than collecting data with a focus on report writing, trends, and record keeping.
Along with the implementation of a new event reporting system came a new philosophy from leadership. “We’re really trying to steer away from just counting events reported and using that as any kind of assurance of our level of safety, because it’s not a reliable measure,” Harkins says. “Just because fewer falls were reported doesn’t mean fewer falls actually happened. We are now looking beyond the events themselves and rather trying to understand what caused it to happen in an attempt to learn how to prevent harm.”
Coordinating clinical data and analyzing it at the system level allows the information to be examined by everyone from clinicians in hospital settings and other facilities within the OSF network, to leaders, quality and safety experts, and risk management specialists in OSF’s headquarters in Peoria, Illinois. Sharing system-wide information allows every facility to better identify opportunities for improvement. It also makes it easier for the management team to devote dollars and other resources to the areas where they will have the biggest impact on improving patient care and reducing the likelihood of adverse events, Harkins says.
“If the same thing causes more than one event, then we failed to learn from the first one. It’s not just about counting. Now, the whole system can learn from one hospital, whereas that was more difficult in the past,” she said.
As part of its overarching strategy to leverage its strengths as a larger system, OSF is also moving to standardize its peer review process, which is being rebranded as professional practitioner evaluation. Peer review is a long-standing practice in the healthcare industry and was already part of the culture in OSF’s medical group and at the hospitals OSF acquired, Harkins says, but there wasn’t a system-wide way of doing it.
“If there is a performance problem at one hospital, we’d like to be able to implement any intervention or corrective action at all our hospitals,” she says. “And, if there is a practitioner having difficulties in a particular area, we want to support them in improving performance early and proactively. To accomplish this, we needed similar processes, language, and a shared philosophy.”
Details of the system-wide evaluation process are being finalized now in a process that Harkins has found surprisingly smooth.
“I thought there would be more resistance to the change because physicians and medical staff are notoriously autonomous,” she says. “But, at the same time, if you present them with something that makes sense and isn’t overly laborious, they really will get on board, because they have a lot of ownership into their own performance and quality of care and they believe in the review process.”
Just as with clinical data, all the evaluation information will eventually be housed within a single system, simplifying and supporting processes including physician recredentialing. Data on everything from clinical events, claims information, and patient complaints to physician performance will be easily accessible across the entire OSF network and will allow leaders to more thoroughly assess the reliability of systems impacting the organization.
Considering so much information will be collected in a single database, it makes sense that Harkins’ official job title has recently expanded to include quality and safety. Although she’s supported activities in each area for a while, OSF HealthCare’s increasingly data-driven approach to improving patient care will make it easier to coordinate functions across the risk management and quality and safety teams. And the two already experience a lot of crossover when it comes to factors like patient safety event investigation and risk assessments, Harkins says. In her newly branded job, she will be working closely with both teams and continuing to hone OSF’s focus on operating as one coordinated system. Beyond that, she tries not to get too caught up in titles and formal job descriptions.
“I’ll just do what’s best for the organization—whatever I can do to help the organization provide the best care to patients and fulfill its mission. I figure I can’t go wrong there.”
