Quality is more than a checkbox – can better workforce skills reduce costs?
The healthcare industry faces multiple pressures simultaneously, including ongoing labor shortages, rising costs, an aging population and changing patient preferences.
Another fundamental problem with health care is that despite advances in technology and coverage, the quality of care does not appear to be improving at scale. Provider organizations tend to view quality and safety as boxes to be checked or expenses to be managed rather than strategies that can improve performance, Stephanie Mercado, CEO of the National Association for Healthcare Quality (NAHQ), noted in an interview last month at the Reuters Total Health conference in Chicago.
In her opinion, the quality infrastructure of most providers is underdeveloped and retrospective. She believes they tend to focus more on compliance and reporting rather than proactive improvement.
Mercado asserted that patients expect high-quality care, but legacy systems and fragmented processes make it difficult to consistently meet this expectation.
“I think that's what patients expect from airlines – high quality and safety. But our systems are not built to deliver that. They're very complex and N-of-1 based. Every patient brings their own person to that situation and then healthcare has to deal with that,” she commented.
She believes that when hospitals invest in their employees—for example, by strengthening their skills or clarifying roles—they can provide safe, higher-quality care and improve their financial performance.
Mercado said advances in artificial intelligence, automation and data reporting are valuable, but without a skilled workforce to interpret and act on that data, improvements won't happen.
She noted that quality is often the common denominator connecting many healthcare challenges, such as readmissions, revenue cycle woes, capacity management and patient throughput. Treating each issue in isolation can lead to a “whack-a-mole” approach, but addressing quality issues systematically can create more sustainable solutions, she said.
Mercado noted that NAHQ’s Workforce Accelerator Program and Healthcare Quality Competency Framework serve as guides to systematically assess, define and advance workforce skills across an organization. She cited the VA, Kaiser Permanente and Christus Health as examples of organizations that have successfully applied the program.
“VA has significantly improved their CMS Star Ratings – one of the reasons they are outperforming private sector organizations like never before – is because they are implementing our approach to systematically organize their workforce, define roles and responsibilities, set performance expectations and improve the capabilities of their workforce,” Mercado explained.
She added that VA's CMS five-star rating has increased 42 percent since partnering with NAHQ.
She also noted that Kaiser Permanente saved $6.53 million over two years by reducing avoidable costs associated with poor quality and safety, such as preventing infections, patient falls and other hospital-acquired complications. Christus Health reported $3 million in cost savings and a 50% reduction in serious safety incidents.
Mercado said the partners praised NAHQ's program for helping health systems standardize roles, reduce performance fluctuations and improve skill levels across the team.
She hopes more health systems will recognize that the path to stability, both financial and clinical, often requires having a stronger, more technically stable workforce.
Photo: Westend61, Getty Images
