June 15, 2018

High-value health care initiatives are transforming health systems throughout the country. At Johns Hopkins, clinical collaboration is integral to driving this shift. Across 20 clinical departments, high-value care leads identify opportunities to develop care pathways and improve diagnostic and therapeutic efficiency. The team guides these efforts through staff member engagement and shared resource support, paving the path for systemwide implementation of successful value-based quality improvements.

Susan Peterson, associate medical director for patient safety and quality in the Department of Emergency Medicine, has managed the creation of 55 evidence-based diagnostic and management pathways in Epic. “We have individual goals for each guideline in development, such as reducing unnecessary hospitalizations for patients presenting with syncope or deep vein thrombosis,” she says. Since emergency medicine routinely works with other departments, an integral part of constructing these pathways is organizing and executing both evidence-based and operational guidelines. “Centralizing information into electronic medical records that is specific to our clinical environment, such as guidelines for a procedure or the location of an important resource, increases efficiency and helps the departments stay on the same page,” Peterson says.

Engaging faculty is imperative to ensure staff members are properly informed about high-value care protocols. According to Emily Boss, director of pediatric surgical quality and safety, this includes providing transparent and relevant data to clinicians. “Culture change is challenging,” Boss says. “It takes commitment to interpreting and transparently presenting data so that outcomes are meaningful for each specialty.” Boss believes provider and staff engagement is a big reason why Johns Hopkins is a leader in high-value surgical health care. “I see new people becoming more involved all the time,” she says. “Their passion for improvement transforms the programs. It’s very exciting!”

The value leads participate in monthly meetings led by Lisa Ishii, chief quality officer for clinical best practices at Johns Hopkins Medicine, and Pamela Johnson, physician lead on the Johns Hopkins Health System High Value Care Committee. They address the needs of the clinical departments and support resources including program managers, data analysis and EPIC support. “Before the meetings, I wasn’t aware of the resources we could use on the pediatric side,” says Marquita Genies, director of the Johns Hopkins Pediatric High Value Committee. “When I first worked on creating a pathway for bronchiolitis, I manually looked up medical records to collect data relevant to our value-based initiative,” Genies says. “As a result of the meetings, I am now connected with members of a value-based analytics team, who are able to build specific dashboards to automatically and routinely pull this data from Epic.” Genies believes this information will dramatically change Johns Hopkins Health System’s ability to track improvements and rapidly identify when changes are needed.

Peterson, Boss and Genies are all excited about the support for their departments, which helps to ensure implementation of projects and ultimately, the best care for our patients.