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Becker’s Healthcare Podcast
Proving the ROI of Quality: Building a Stronger Healthcare Workforce
00:20:17
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- [00:00]
A
Hi, everyone. This is Lucas Voss with Becker's Healthcare. Thanks so much for being here today. It's great to have you. Today we're going to talk about elevating quality, workforce and innovation in healthcare. And I'm very excited to be joined by Stephanie Mercado, CEO at the national association for Healthcare Quality. Stephanie, thanks for being here today. It's great to have you.
- [00:21]
B
Thank you. I'm delighted to spend a little bit of time with you this morning.
- [00:24]
A
Absolutely. If you could introduce yourself to our audience and just share a little bit about your work in healthcare.
- [00:30]
B
Sure. As you have already mentioned, I'm the CEO of naq, the national association for Healthcare Quality. And I've spent the better part of 25 years advancing my passion and a really important agenda in healthcare. My early career began with supporting physician organizations and really sort of sinking my teeth in and understanding the issues that are present in what I would like to define as the front of the house of healthcare. And since working with naq, I have had the opportunity to really dig into quality and safety and finance and all of the administrative complexities of how the business of healthcare is run. And that's given me a really great perspective on what I would call the back of the house of healthcare. So together, both having experience in the front of the house, in the back of the house and, and really just being super passionate about advancing quality and safety and lowering healthcare costs has been the focus of my work. I'm a builder, I'm an innovator, I'm an improver. And I think we can do better in healthcare. I think we must do better. And I also think that when we talk about ways to do better, we can really weave workforce into the mix. And that's a very passionate focus here, not only in my role, but at NAEP as an organization, because as you well know, the workforce is the biggest investment that we make in healthcare. And I think that people, our workforce can really represent the biggest impact that healthcare can achieve as well.
- [02:13]
A
Yeah, absolutely. And I love that combination that you just mentioned. Again, so much experience. It's fantastic to have you on. I want to touch on the ROIQ report, which, by the way, I recommend everybody take a look at lots of incredible information there. So the RIQ report reveals really a powerful financial returns from investments in quality and safety, which is incredibly important. Looking at that report, were there any findings that stood out to you? And how's the conversation around quality and safety shifting right now? What are you seeing?
- [02:45]
B
Yeah, in terms of findings that stood out, I'm going to give a blanket statement and I'm not trying to take the easy way out on this question, but honestly, it's the truth. What findings surprised me? All of them. And the biggest one being that we could prove finally and sort of once and for all that precisely planned roles, precisely planned functions in healthcare quality and safety and that a precision targeted learning approach, a skilling approach, a coaching approach, can demonstrately impact quality outcomes and improve the performance. And I'll tell you what, nobody thought that this was possible and to our knowledge, nobody's ever tried to do this on the scale that we did it, which was really about connecting workforce to quality, to safety and to finance. And it was amazing. It's absolutely amazing. And if I can, can I tell you why this has been so elusive? Because I've spent the better part of a decade trying to figure out why we haven't figured this out already. I mean, I'm quite serious. But, but I, but I think we, we, we've crossed the threshold and we have figured it out, which is so, so quality has been really, really elusive over the years and really seen as a compliance or a mandate. And I don't think, I think people sort of conceptually thought, you know, always thought it was a good idea and conceptually thought a lot of good things would come of it. But there has been very little attention to two things. One, focusing on quality and safety on scale. So before we did this project, this program, this workforce accelerator methodology that we created, most organizations were approaching quality and safety on a project basis. And I know you know this like they would go in and focus on improving sepsis, reducing falls and many other things and we absolutely need to do that. But the big thing that no other organization has kind of like developed methodology for and that that few organizations have really achieved outside of those who have worked with us as early adopters of our workforce accelerator program was to prove that we could actually improve quality, safety and finance programmatically we could do that across the board for the entire system. So yes, are projects involved in that? Do we want to continue to improve on item by item, initiative by initiative basis? Of course we do. But we also now know that it is absolutely possible and I think critical that we do that on a system level and program level improvement. And that's really the basis of the ROIQ report. And what we proved out is this is achievable and there is a way to do this effectively.
- [05:48]
A
Yeah, you've mentioned sort of the elusiveness in the beginning and trying to find it. What's been the industry response to this report so far. Now that, that you've made that connection.
- [05:59]
B
The overwhelming response from the industry has been, thank you, Naq. We are getting calls from the public sector, we are getting calls from the private sector, and all of them are asking, how did you do this? What is the methodology that you used to improve quality and safety and finance on this scale? They're saying things like, we don't want to play whack a mole anymore, and we can, we're, we have an untold amount of quality and safety projects going on. I mean, I was at a system the other day, and they had 150 quality projects going on. Not to say that we don't need to improve 150, you know, things. But everybody is ready to scale, right? They're ready to stop playing whack a mole and to come at this in an over the top sort of way. And so the response has been absolutely overwhelming and to the point on the methodology. And they're asking, well, how did you do this? Tell us more. What's the one thing? Because our ROI Q report actually outlines five strategies. But in speaking with leaders at cms, they're like, but what's the one thing that you did? The one thing is we developed a methodology to define what quality and safety is, how to get your workforce aligned to that, how to get them doing the right roles, the right functions, with the right skills at the right time. And we figured out a way to then pull that through and measure it on quality and safety and finance outcomes. So that methodology that we have through our workforce accelerator program is like the one thing. So the industry's been excited, and I could just tell you, NICU's board is excited about this. Our headquarters staff is excited. This is big news for the industry, and we're so excited to be a part of it.
- [07:58]
A
Yeah, it's such an interesting report. Again, I recommend everybody take a look at it because it's, it's fascinating to see that scalability and to see that connection, which is important. You've mentioned something that is also very important, which is the fact that it starts with specializing folks, it starts with people, it starts with, with training, et cetera. And again, the workforce accelerator program emphasizes that upscaling piece of teams and reducing variability across the board. Can you touch a little bit on what that looks like in practice and, and how it then in turn really influences outcomes?
- [08:28]
B
Yeah, I sure can. And I will tell you a couple things. So I'll tell you broadly and then, or maybe yeah, broadly. And then I'll go a little deeper. So, first of all, it is a somewhat complex methodology that we make simple, right? So there is a whole sort of 12 month process that gets an organization ready for this type of focus on quality and safety and that also prepares leaders to lead this initiative within their organization so that NICU can come in and be an enabling force for them. And also that then guides them through our method, which includes assessments and trainings and development and coaching programs and communities of practice, like guided by a NICU navigator, which is a person who's, who's sort of like a coach for the systems to help get them set up and situated for success. But, but what I will say outside of that sort of broad representation that there is a program, it is robust, it is effective. I will tell you a couple things that this program does. So very practically, I know everybody who's listening to this podcast can relate to this statement, which is quality is everyone's job. And that is true. I believe that wholeheartedly. But before this workforce accelerator program was developed, the industry did not define what that meant. And so we were left with the ambition to advance quality as everyone's role, but we didn't actually have a way to do that. And what I've observed too, again, like I said, I spent a better part of a decade trying to figure out why we haven't figured out and figured out how to solve this problem yet. And one of the things that I've realized is that health care as an industry has invested millions of dollars, probably billions and billions of dollars as an industry in training and development for quality. But here's the, here's the punchline. We've let learners choose their own adventure in learning. They choose how they're trained. They decide what courses to go to on their own without any guidance, support, or precisely targeted lear. Worse, they maybe are trained by a predecessor who also learned their job on the job. And also as we've learned the quality competencies and skills through training and peer support, we have focused so much, and rightfully so, on quality and on safety. But what we haven't done well enough is communicate the financial return on investment, which is particularly important right now when efficiency is critical, not only because that is a priority of the Trump administration, but because it's the pathway for sustainable health care. And so, you know, I think this defining the roles, targeting the learning, making sure that we connect it to an ROI so that people understand this is a worthy investment that pays untold dividends for their organization. I think is really, really important and that they're most important is there's a way to do it now and it's.
- [11:52]
A
It'S, it's effective, there's a pathway to it. I think that that's really one of the big keys to it as well. And again, the ROI piece you mentioned is so important, especially from a leadership perspective. And you touched on sort of the programs that you have in place for leaders to be able to, to fully take advantage of this too. Can you touch a little bit more specifically on that too in terms of how the workforce accelerator really benefit C Suite leaders and some of the examples that you could share to that really show that value for executives?
- [12:21]
B
Yeah, sure. And I'll take us back as a quick reminder to quality is everyone's job. You know, that is something. So C Suite is responsible for leading the entire operation of healthcare where they work. And to say quality is everyone's job before. And I think everyone, everyone, everyone believes that, but that has been elusive. C Suite have a concrete way to make that actionable. Right? That's what the Workforce Accelerator does. It takes the guesswork out of figuring out how to get their teams ready to be more high functioning. Also, we have made a lot of gains with C Suite by helping them to understand how to organize their workforce, how to activate their workforce in ways that were previously complex. Like, we have broken that down into a consistent, reliable method. And we have made something that is complex, simple. And we've done that with the Veterans Health Administration, we've done that with Kaiser Permanente, we've done that with Christus, all sorts of organizations who have followed the workforce accelerator methodology and we've proven that it works. And so I think C Suite right now, another thing is they're looking for solutions and they know that they need to kind of break the mold, be creative, try new things. But the challenge is that there's not a lot of tolerance for risk and failure. Right. Like a lot of people don't want to put their neck out on the line and say, I have an idea and then to not have it work out. We don't have the time, kind of luxury of time and money that maybe we thought we had before to quote, unquote, waste on something that may or may not work. And so I think for C Suite, not only is the, the program really focused on roi, which brings a ton of value to them as individuals to be able to bring that forward to their organization, but we've eliminated the risk associated with trying a new program. Not only we have naq, but so did all the other leaders who implemented the program. Vha, Kaiser, Christus. All sorts of organizations are listed in our ROIQ report and on our website. They've proven this out. They took the risk and they've proven that NAQ as enabling force with the workforce accelerator. It works. And so I think that C Suite can take comfort in knowing that there is a safe solution out there for workforce readiness and quality and safety.
- [15:01]
A
Yeah, I love that you mentioned again, that risk factor. And again, like time, we don't have. We don't have time. Right. It's. Everything is about funding and ROI and risk. Right. What risks are we taking, what risks are we not taking, etc. I think this becomes especially important when you're looking at organizations that might not have the resources. Right. They're becoming even more discerned about where are my investments going. Can you touch a little bit on what programs or solutions are particularly valuable for some of those organizations that might struggle with either smaller teams, smaller workforce, but then especially also limited resources?
- [15:35]
B
Yes, 100%. So we work with organizations large and small, and I will tell you with 100% confidence, every single one of them, the biggest of the biggest, the smallest of the smallest, the. The most immature organizations and the most mature organizations all struggle to some degree with activating quality and safety and finance. And. And it's real. You know, each organization has a different amount of resources. So a couple thoughts. So one is, you know, we work with smaller organizations. We have worked with King's Daughter. We have worked with El Paso Medical Center. We have worked with Columbus Regional. These are organizations on the smaller side of system size. Right. Some single sites. And we've worked with organizations I mentioned as big as the Veterans Health Administration. So on the small side, the one huge thing that organizations could do would be to help their teams become CPHQ certified. So the CPHQ is the only accredited certification in healthcare quality. It's NAICU's certification held by more than 15,000 individuals today and growing rapidly not only in the US but around the world. And it's a wonderful program. In fact, the CPHQ was endorsed by the Joint Commission just this past November. In fact, the Joint Commission has endorsed naiku's entire competency framework and is wildly supportive of the ROIQ report and all of the efforts we're doing to drive quality and safety, safety and healthcare. So CPHQ is a great opportunity. We also have a lot of other learning resources available to people, including a huge event that both sort of Rallies the the healthcare quality workforce and prepares them for what's next. It's called NAQ Next. So that event is virtual. It's very affordable, very accessible. A few hundred dollars per person instead of hundreds or thousands for registration and travel and flights and all the things. Get about 5,000 people a year to attend that event in September. And then, of course, you know, there's the workforce accelerator program, which is, you know, a bigger commitment from an organization, but effective. And I would say one more thing, which I think this is, I think it's super important and worth mentioning is, you know, we hear a lot, especially from people working in quality departments, that budgets were cut, we're not doing discretionary spending, training is on hold sort of thing. And what I would say to that is two things. Number one, there is a ton of spending going on in healthcare. Millions and billions and trillions of dollars are being spent on healthcare. So while there are cost pressures that are absolutely real and I understand them and I appreciate them, people are choosing what to spend money on. And I think that it's important that they choose to spend money on developing their workforce and having sustainable systems to not have this whack a mole situation going on in quality and safety and healthcare as it is oftentimes. And I would also say, too, there is a return on this investment. So it used to be reasonable to say we don't have money to spend on things like this because There wasn't an ROI established, but now there is, and now it's 6 and 10 and 20 times the investment. So I think that what we need to get healthcare leaders to be doing and people working in quality is to get innovative and brave and bold and say, yeah, everything costs money in healthcare, but we should be spending on the things and investing on the things that are gonna return for this organization, return for our patients, and return for their families. So large and small, you know, mature and immature. There's all sorts of organizations needing support. And all of them I, you know, really need to commit to their workforce and to the outcomes and to our patients. And this is a great way to demonstrate that commitment.
- [19:51]
A
Yeah, absolutely. Again, proving the roi, making that financial connection, I think, is a great starting point. Thank you so much for your time and insights today. This was a fantastic conversation. Thanks for being here.
- [20:02]
B
Of course. I loved it. Thanks for the opportunity.
- [20:04]
A
Yeah, it's great to have you. And we also want to thank our podcast sponsor, naq. You can tune into more podcasts from Becker's Healthcare by visiting our podcast page at beckershospitalreview Com.