Building an Enterprise Risk Management System [Case Study]

Before implementing Performance Health Partner’s enterprise software system, Ochsner Lafayette General, the largest non-profit regional health system in Acadiana, Louisiana. struggled to address the challenge of siloed technology systems. Across their six hospitals, there was a desire to find a solution that could address the unique needs of individual departments, while still promoting a sense of cohesiveness and providing clear data from which to draw insights across the organization.

The Challenge

When Ochsner Lafayette General began evaluating potential health IT vendors, they knew they needed a comprehensive system that would solve several key challenges.

First, they needed to eliminate the silos in their existing technology infrastructure by uniting all their systems and processes into one centralized solution, regardless of the department or facility location. Utilizing the same software solution for all the hospitals in Ochsner Lafayette General’s network was important not only for training and implementation, but also so that leadership teams could have the same benchmarks for analyzing data and making informed decisions.

While the system needed to be unified across facilities, it also needed to be robust enough to adapt to the unique requirements of each department and team.

Ochsner Lafayette General also had a need for a partner who could quickly create cost-effective solutions that would grow and scale with the organization over time. In the age of modern healthcare delivery, rapid innovation is key. Therefore, it was critical for the leadership team to be able to easily add on additional solutions over time without having to transition to a different software system.

Across the Ochsner Lafayette General hospital network, the areas of highest priority were incident reporting, performance improvement, and compliance.

Patient Safety

One of the biggest areas of opportunity for Ochsner Lafayette General was in Patient Safety. Although they had a process in place for incident reporting, they faced several challenges when conducting follow-up management. Prior to implementing Performance Health Partner’s Incident Reporting system, their incident follow-up was managed primarily through emails and printed documents stored in file folders. The lack of consistency in accessing and sharing documents made it challenging for risk management to effectively follow-up on events.

Paper records were easily lost or misplaced, and it was common for 2-3 weeks to go by before the risk manager even received notice that an incident had occurred.

• Prioritize which events need to be followed up on first. For instance, high priority incidents may include a death within 24 hours of submission, medication errors, or a patient complaint. Certain events, such as patient grievances, need to be reported to the state within a certain amount of time or the organization may face a penalty.
• Create and hold staff members accountable to timelines
• Create a database of incidents to identify trends

Additionally, the lack of specific event timelines and audit trails created vulnerabilities within the system. Leadership did not have data visualization tools such as dashboards or reports, making it difficult to truly understand what was going on and identify specific areas for safety improvements.

Requirements 

1. User-friendly interface that captures incidents, events, and near misses for patients and employees
2. Automated routing and notifications to decrease response times following reported incidents, events, and near misses
3. Robust follow-up management and capability to create improvement plans
4. Real-time dashboards and reporting that highlights trends
5. Ability to train staff of over 4000 employees across 6 hospitals quickly and easily

Outcome

When Ochsner Lafayette General implemented Performance Health Partner’s Incident Reporting system, they were able to greatly streamline their incident reporting process. Team members immediately had access to a robust follow-up management process with real-time dashboards, and due date reminders ensured that incidents were followed up on quickly.

The average turnaround time for following up on events decreased by 80%, from 30 days down to just 6 days.

Real-time dashboards have allowed them to drill down into the details of safety events. For instance, after implementing Performance Health Partner’s Patient Safety solution, Ochsner Lafayette General saw that most of their patient falls were occurring within outpatient surgery centers. This was unexpected because the patients in this department were generally healthy and not physically prone to falls. However, many of the patients recovering in this department had never undergone a major surgery before and were therefore not asking for help getting out of bed post-procedure, which resulted in higher fall rates.

This knowledge prompted the organization to increase patient education on fall prevention, which led to a 60% reduction in falls within 12 months. The fall reduction translated into over $800k in cost savings through risk avoidance.

Another win for Ochsner Lafayette General was that they were able to identify and resolve a key challenge related to medication errors. After implementing Performance Health Partner’s Incident Reporting system, the pharmacy department identified that a high volume of medication errors occurred because the wrong medication doses were being selected from the medication formulary list. The solution was to turn that responsibility from the nurses over to pharmacy technicians, who were able to select a more precise drug from the formulary list. The number of medication errors drastically reduced within a few weeks of making the change, and patient safety improved as a result.

Performance Improvement

In addition, Ochsner Lafayette General needed a solution to standardize safety huddles.  Each hospital and team also had a different method for performing safety huddles between each shift. Some teams were documenting their safety huddles on paper and posting notes in the nurse station, while other teams were verbally performing the huddle without providing any further documentation.

Ochsner Lafayette General needed a way to streamline their processes and track whether the various safety huddles were effective. The solution had to determine if the right questions were being asked during safety huddles and provide real-time data showing whether patient safety had improved because of the safety huddles.

Requirements

1. Standardization of safety huddle process, including compatibility on mobile devices and dictation feature
2. Ability to quickly communicate safety huddle key learnings to the leadership level
3. Capability to implement corrective action plans
4. Dashboards for trending the effectiveness of huddles and quick insight into where to apply resources

Outcome

After implementing Performance Health Partner’s Safety Huddle tool, Ochsner Lafayette General’s care teams have been able to identify and proactively discuss key areas of patient care.

Instead of tracking safety information on paper or Excel, nurses now use a tablet or mobile device.

The organization’s new electronic safety checklist addresses key safety concerns such as:

• Quality: How many patient shave Foleys and are at risk for CAUTI?
• Safety: Are there any good catches to share?
• People: Are there any staffing needs or issues?

Compliance 

Lastly, Ochsner Lafayette General needed a solution that could address their compliance challenges. One of the main areas of concern was manual manipulation of audit reports. Prior to implementing Performance Health Partner’s compliance solution, the compliance department documented and tracked over 300 internal and external monthly audits in one Excel spreadsheet. This left the audit process vulnerable to inaccuracies and manual data manipulation. The lack of access control also presented a challenge, as anyone who had access to the file could view and edit other team member’s entries.

Additionally, using Excel to track audit reports introduced the risk of being unable to recover lost data from files that were not backed up. With no audit trail in Excel, human error is difficult to prevent and detect. Ochsner Lafayette General needed an audit management solution to ensure consistent and timely audits. The solution also needed to archive versions so that any deleted data could be easily recovered, as well as include an audit trail to track any user changes.

Requirements

1. Improve record integrity, transparency, and compliance through audit trails
2. Standardize audit process across locations
3. Decrease risk of manual data manipulation
4. Ability to immediately assign and manage action plans while gaining insight into status reports
5. Ability to identify trends and potential areas of risk through real-time data analytics and executive and management dashboards

Outcome

Since implementing Performance Health Partner’s Compliance solution, the compliance department has seen a 25% increase in productivity during monthly auditing. The solution streamlined the compliance process, so it is easier for auditors to complete their review.

With all audits completed in a centralized system, the leadership team has better insight into their compliance program as a whole and can more easily communicate with and monitor employees.

Now, they have a better handle on the specific risks the organization faces—which means they can better address issues before they become full-fledged problems. Additionally, Ochsner Lafayette General is able to add new audits into their audit programs as regulations and areas of concern change.

Key Benefits

Since working with Performance Health Partners over the past 5 years, Ochsner Lafayette General has developed 52 applications over a variety of departments and teams. Applications range from tracking transfers in and out of the emergency department, mortality reviews, hand hygiene observations, and safety checklist walkthroughs. Ultimately, Performance Health Partners was able to help Ochsner Lafayette General build an enterprise software solution that could grow and scale with them over time.

Key benefits of Ochsner Lafayette General’s solutions include:

1. Rapid implementation
2. User-friendly interface
3. Robust follow-up management
4. Real-time dashboards and reports
5. Strategic communication

Since implementing Performance Health Partner’s solutions, communication among team members has improved and Ochsner Lafayette General has been able to make significant strides in their patient safety, performance improvement, and compliance outcomes. They have been able to address the challenge of siloed technology systems with a centralized solution that meets the unique needs of individual departments while promoting unity across the organization.

Performance Health Partners Solutions

Performance Health Partners helps healthcare organizations provide the highest quality care in the safest possible environment. Our enterprise software solutions are built to grow and scale with you over time to fill organizational gaps and drive quality outcomes. To learn more,  schedule a demo.