We’ve been hearing a lot about clinical integration lately—and with good reason. Clinical integration promises advancement toward highly reliable team-based care, cohesive operations, and a symbiotic relationship between a hospital’s supply, financial, and clinical counterparts, which is necessary to thrive in today’s changing healthcare environment. But while the need for increased clinical supply chain integration is clear, the method for getting there may not be. If you’re not careful, the immense potential for supply chain to make a greater impact on patient care can overshadow the strategically planned out steps that need to be taken to make this cultural shift successful.
AHRMM’s Definition of Clinical Integration
“Clinical integration in health care supply chain is an interdisciplinary partnership to deliver patient care with the highest value (high quality, best outcomes, and minimal waste at the lowest cost of care) that is achieved through assimilation and coordination of clinical and supply chain knowledge, data, and leadership toward care across the continuum that is safe, timely, evidence-based, efficient, equitable, and patient-focused.”
Facing daily challenges (typical and atypical) leaves little time to make such necessary changes. But the shift toward a clinically integrated supply chain doesn’t have to follow such a drastic approach, nor does it have to be a daunting task. In fact, it’s the small, calculated modifications that make clinical integration possible in the first place.
The pathway to clinical integration can be seen as a three-pronged approach. Tasks can be broken up into three areas: people, structure, and data.
The Right People & Culture
The right culture opens the door to being able to have the right conversations with the right people.
Executive support at the C-suite level is a must. An executive sponsor can help communicate the importance of your clinically integrated initiative and help remove any roadblocks that become apparent. A physician champion in a related service line is someone who is going to be able to motivate their clinical counterparts and generate feedback and buy-in for any changes that may occur. Additional physicians who are central to the specific initiative (or the related procedure) should also be a part of an open and ongoing dialogue in which opinions are sought and concerns are heard.
Supporting players in clinically integrated initiatives will vary by institution, but generally, you can expect to include representatives from Accounts Payable, Risk, Quality, Compliance, Infection Control, Nursing, Finance, and additional staff from Supply Chain (analysts, sourcing, contracting). Remember, when talking to physicians, the clinical and operational benefits of clinical integration should be central to the discussion—not cost reduction.
Clinical integration is all about relationships. Your effort should be all about working with colleagues across departments to achieve a goal that benefits the organization. Be polite and professional, and keep in mind that there may be a learning curve.
The Right Structure
Clinical integration should comprise a methodical approach with appropriate checks and balances built in. A well-established organizational structure that lends itself to communication, productivity, transparency, and accountability—in other words, action and decision—is an essential asset for a winning clinical integration.
Do you have a set meeting schedule that requires certain parties to attend? Do your agendas follow a standard format and are they distributed before the meeting along with items that are expected to be discussed and decided? Are meeting minutes recorded and disseminated along with next steps and action items? These are just a few questions you can ask yourself as you begin to think through your formalized approach.
Structure (combined with executive support) is a prerequisite for accountability. If anything is to be accomplished (and if your efforts are going to be replicated for other initiatives), accountability must be built into the structure you’ve created.
The Right Data
We are data rich and information poor. Despite having copious amounts of data at our fingertips, it is effectively meaningless unless we can make sense of it by relating it to the bigger picture—an end goal. Start by thinking about the story you’re trying to tell.
Use your data to evaluate where there are opportunities for clinical integration. Ask yourself which of those opportunities makes the most sense as a starting point. Choose a preliminary, small-scale initiative that can serve as an incubator.
Perhaps you pick total knee. You’ll need product, vendor, spend, utilization, physician, outcomes, and cost data to present a story about the issue at hand to your physicians and clinicians. It should cover what you are trying to accomplish and why, and how you plan to get there.
Remember, data is plentiful; time is a valuable but limited resource. Approaching discussions without a succinct, clear story will leave you hard pressed to find support from necessary stakeholders—clinicians or others.
Final Thoughts
Clinical integration is a process. A process means that there are a series of steps that flow from one to the next until an end result is achieved. Data, people, and structure cannot exist in the silos we have become so accustomed to in healthcare—they are interdependent parts of your bigger picture. Melding these three components is what makes clinical integration challenging. It is also what makes clinical integration achievable.
It’s an overwhelming time for providers. Much is being asked of you right now. But successful clinical integration is within reach when your approach is broken down into smaller parts and given some forethought. Slow down, take a step back, and start with your story.
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