Our early approach has been to begin the process of creating an enterprise data repository and put in place data management standards. Since we have grown through acquisition, our heath care system has interested a tremendous number of disparate data management methodologies. Having a standard approach to data collection and management has been an important first step.
Our next step was to put usable data into the hands of more clinicians and managers. We use a data visualization tool, Tableau (http://teableau.com) [I have nothing to disclose], that allows end users to navigate large data sets in a way that makes them easier to digest. By creating more dashboards and visualization tools we are starting to create a culture that relies on data for decision making instead of anecdote.
We have found that our physicians get flooded with email and, as a results, tend to see it as a noisy channel that they avoid when they can. We are working to design a process that splits the communication strategy and improves targeting of information. Our goal is to have only critical communications go through email (push strategy) while information communication is posted to an internal web-site that serves as an organizational newspaper. By organization this site carefully, it can allow users to navigate to just the information they want. It also creates a permeant repository which can be easier to search/navigate than an email inbox/archive.
We have also found that, since our physicians are on staff at a number of different system hospitals, they get flooded with redundant messages. We are working with moving some of these communications to the corporate structure to avoid this redundancy.
We have prioritized the need for collaboration when developing standard protocols. One important goal has been to allow many to collaborate and make changes to process documents. We’ve used wiki software to manage this kind of collaboration as it allows for the linking and easy navigation of interrelated process documents. The tools are flexible and can be learned without a lot technical background. There are many free/open source solutions: https://en.wikipedia.org/wiki/List_of_wiki_software.
In the time I have been leading a clinical department, I have wanted to bring greater financial transparency but have found it to be a double-edged sword. In my organization there are long-standing histories of inter-departmental transfers that can be difficult to explain. As a profit center, the notion that departmental funds may be used to offset deficits in other departments engenders anger and mistrust.
With regard to salary transparency, I have seen it limit the ability of a manager to properly reward individuals who are overall high performers in arenas where their high performance cannot be demonstrated clearly with “metrics”.
Our organization has opened several dozen “Urgent Care” centers in a geography that mirrors our hospital locations. These facilities were designed with patient convince and experience in mind so patients with lower acuity clinical problems have been highly motivated to make use of these facilities. As a result, we have seen declines in our total ED visit volume as patients with less severe clinical problems are seen first at these locations. The patients are typically managed at the time of presentation or referred for additional ambulatory services.