In September, Misty Roberts, Associate Vice President at
Humana and Clinical Quality Officer, and Faith Green, Director of Enterprise
Clinical Quality, took the story of Humana’s mission to improve quality on the
road. They presented their work on building a culture of clinical quality to
1,400 peers at the National Association of Healthcare Quality’s annual
conference in Phoenix.
“Clinical quality is about improving health outcomes,” Roberts
said. It has always been important, of course, but never more than now, as
health care transitions from a fee-based system to a value-based system, where
payments are based on health outcomes.
Roberts has been at Humana since 2010 and moved into the
Office of the Chief Medical Officer in 2014, where she was asked to form a new
department focused on clinical quality. Her role was to lead Humana’s internal
response to a new national challenge to identify a set of meaningful and
efficient quality standards.
“At that time, the number of quality measures was
overwhelming, and reporting requirements were inconsistent,” Roberts said. She
and her new team set out to transform Humana’s quality measurement
They discovered that 46 groups around the organization were
setting and measuring standards. The quality team knew they had to simplify.
After six months of meeting with representatives from all
those groups, the team found they could pare down their combined list of 1,116
quality measures to 208 meaningful ones. That was an 80 percent reduction. “Because
of company silos, associates in one area had been unaware of quality
measurements in other groups,” Roberts said. “That had resulted in duplication
and inconsistencies across Humana.”
Last year, Roberts and Green told the story of that process of
aligning measurements in an article published in the American Journal of
Medical Quality (“A Health Plan’s Journey to Identifying Meaningful Quality
Measures”). They told the story again at the meeting in Phoenix but added another
The title of their new presentation was “Infuse, Empower, Lead,”
and the subject was the bigger lesson they learned about creating a culture of
clinical quality. The advantage of being an organization with a culture of
clinical quality, say Roberts and Green, is that it will keep the excitement
about improving quality alive. It will push people to be proactive. It also
will lead to a holistic view of what quality is.
Here are the steps they recommend:
- Infuse your organization’s culture with the
mindset of continuous quality improvement and collaboration (communicate; spark
- Empower and motivate employees to make decisions
and act with purpose (get them engaged; unleash their courage)
- Lead your organization and industry in making a
cultural shift (have a vision; offer guidance; inspire)
The primary measure of success, however, will always be “the
impact on patient health and clinical outcomes,” Roberts said.
“Everything we do has the potential to impact patient
outcomes,” she said. “Building a culture, creating a mindset – that’s how we continue
to improve quality across the enterprise.”
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