A wholly owned subsidiary of VHA Inc, VHA Northeast is a regional office based in Braintree, Massachusetts. Our office services not-for-profit hospitals in Massachusetts, Rhode Island, and Connecticut, and as a network of not-for-profit health care organizations, members engage with VHA to advance their clinical and economic performance. McKesson’s High Performance Pharmacy (HPP) is built upon the same principals—by working together through the Web-based gap assessment, teams can learn best practices that result in real cost savings, increased patient safety, and improved morale—all goals VHA fully supports.

Using the High Performance Pharmacy Portal
The value of operational gap assessments is that they provide a quick way to compare current practices to a recommended industry standard or best practice without the need to manipulate large amounts of data and attempt to adhere to inflexible benchmarking definitions. Upon completion of the gap assessment, the resultant report delivers a step-by-step action plan to improving your operations.

There are case studies available in the portal’s resource library that focus on how best practices included in the High Performance Pharmacy have improved performance in medication safety and patient care services across the country. These examples can help build momentum with staff and administration and help to secure buy-in by demonstrating the kind of improvement that is possible. Also, the site contains podcasts, Webcasts, videos, and other interactive tools, which staff can download and review at their own pace to help stay up-to-date on the latest high performance initiatives. During the survey, which takes an average of 20-30 minutes to complete, the pharmacy director is lead through a series of questions that inquire as to how closely the hospital is adhering to each suggested protocol in the eight dimensions that comprise the high performance initiative.

At the conclusion of this process, DoPs receive a custom, prioritized plan outlining where to invest resources to further improve performance. These results are ranked by feasibility, expected financial return, and return on quality/safety. This comprehensive evaluation is invaluable and would be very difficult to assemble without a dynamic tool like the HPP portal.

Results of Using the Portal
Six months after we began using the portal, the directors assessed their experience in terms of the overall value of the process and the steps they were taking in response to their evaluation results. Their feedback was extremely positive. Several directors had used the portal results for formal operational planning and many others had reviewed the findings at staff meetings to identify priority projects.

I was not surprised to see that the VHA Northeast members are an over-achieving group to begin with. The data demonstrated that, in the aggregate, a lot of the low hanging fruit had already been harvested. Members scored near the 90th percentile in Leadership, Medication Preparation and Delivery, and Medication Use Policy, and scored very well in areas such as Human Resources. The greatest opportunities for impact as a group were in complex areas, such as medication reconciliation and discharge counseling; parts of the Patient Care Services dimension. The HPP team has resources and history, which demonstrate that while medication reconciliation has been a difficult process for pharmacy leaders, pharmacists do a more accurate job of reconciling patient medications when compared to nurses and physicians. That kind of information can help get a large project like medication reconciliation jump-started.

On an individual level, directors were given very specific feedback on their individual operations with recommendations as to where to concentrate their efforts to improve performance, and there were several opportunities for each organization. Many directors used this data as a basis for operational planning, and a few created long-term strategic plans from this information. Because the feedback is practice-specific, hospitals of any type or size can benefit from this data.

Feedback and Future Use
Initially, there was quite a bit of negative feedback from the directors about having to “fill out another survey,” in an already time-crunched environment. By demonstrating some of the results, I was able to convince many of the skeptical folks that investing time in this tool would save them a significant amount of time later on.

The end result is essentially the foundation of a multi-year strategic plan, which, along with team planning, can be turned into a robust, prioritized, step-by-step plan for improving hospital performance. This research can help build confidence with senior leadership and gain buy-in for longer-term projects requiring capital investment and cooperation across the health care organization.

LeeMichael McLean, SSGB, is a business development director and network facilitator responsible for marketing and collaborative performance improvement initiatives among VHA members in the Northeast. LeeMichael holds a bachelor’s degree in creative writing and a master’s degree in finance and international finance from Brandeis University in Waltham, Massachusetts.