Article

Where the care continuum breaks down impacting value-based care

Each transition between healthcare settings is an opportunity for gaps and possible failure points that can significantly impact patient outcomes. With so many people involved in a real-world care setting — from physicians, nurses and care assistants to discharge planners, social workers and so on — each movement in the patient journey can potentially rely on a different decision maker or caregiver operating under different protocols with a different level of experience. As such, ensuring that acute and post-acute care plans are properly communicated and adhered to is paramount to maintain consistency.

Variation in products and protocols represents another potential failure point in the patient journey. In order to maximize total value throughout the continuum of care, IDNs must ensure consistent product quality and patient experience in every healthcare setting to achieve value-based care at scale. Failure to do so creates opportunity for human error and poorer outcomes, as well as patient confusion and anxiety. Standardization in products and protocols helps promote seamless transitions across the continuum of care and supports total value for both patients and providers.

Inconsistent care leads to inconsistent outcomes

This lack of communication, coordination and consistency has the potential to seriously jeopardize value-based care for IDNs. Without standardization throughout the patient journey, IDNs face challenges collecting reliable data to improve best practices. As a result, failure points in the continuum of care may go unnoticed or unaddressed for extended periods, leading to adverse results such as

• longer patient stays
• higher readmission rates
• and poorer patient outcomes.

Product standardization removes one of the major variables in assessing patient outcomes, helping IDNs maximize total value across the patient journey and ensure top care standards are maintained.

Inconsistent outcomes drain hospital resources

Over the last decade, CMS has implemented multiple programs which associate reimbursement penalties with facility performance. This is designed to incentivize better patient care and provide guardrails against poor outcomes. Naturally wound care has emerged as a top priority, given that pressure injuries, HAIs and excessive readmissions are closely watched by CMS.^2,3 In February 2022, CMS announced it is imposing penalties to 764 hospitals due to their HAI rates, resulting in a 1% reduction in their Medicare payments over 12 months.⁴ In 2021, 82% of hospitals evaluated for readmission rates received CMS penalties, costing hospitals an estimated $521 million.⁵

Aside from CMS penalties for poor performance, patients with multiple co-morbidities are simply more expensive to treat. Inconsistent care may result in more complex case mixes — which require a disproportionate share of healthcare resources. The correlating costs can be significant, impacting areas such as physician access, nursing overtime and medical supplies. Pressure injuries, for example, are estimated to account for nearly $43,180 per incidence in additional treatment costs to a hospital stay. Given that these preventable injuries are the second most common source of lawsuits in the healthcare industry behind wrongful death, a standardized, value-based care approach offers substantial opportunity for cost savings and improved outcomes.⁶

It’s time to look at healthcare holistically through the Total Value lens

By implementing a value-based approach across the continuum of care, IDNs can see:

Clearer measurements

Standardized products and practices help promote consistent experiences and results. Consistent results provide IDNs with more reliable data that can be used to pinpoint and rectify training gaps, generate new best practices and improve efficiency throughout their facilities.

Improved clinical outcomes

Formalizing communication and care protocols throughout the patient journey will go a long way to preventing skipped steps and bedside “guesses.” When clinicians have clear guardrails and best practices to follow, there is less chance for error — and differences in clinician education levels become less paramount. All of this sets the stage to decrease readmissions, improve quality metrics and increase overall ratings.

Enhanced clinical acumen

Standardizing protocols and products allow IDNs to reinforce best practices across the continuum of care — improving both patient outcomes and clinician performance.

• Reduced training time: With everyone on the same page, the training process can be streamlined. Education is one area of standardization that is key to helping produce better outcomes at a lower cost.⁸
• Increased clinician efficiency: Clinicians can work more efficiently when they can count on using the same products every time, no matter what hospital area or facility they’re in.
• Improved clinical safety: Healthcare workers may interact with thousands of products each day, leading to confusion and mistakes. Standardizing products can help prevent workplace injuries from common sources like patient handling, needle sticks and infection exposure.⁹

A connected acute/post-acute network

When post-acute providers develop partnerships with healthcare networks, they typically come with their own way of doing things. Allowing post-acute facilities to continue their pre-established protocols may offer the path of least resistance, but this laissez-faire approach ultimately harms both patient outcomes and network operations. By closing the gaps between acute care and post-acute care through standardization, IDNs can improve clinical outcomes through shared and informed decision-making.

Greater purchasing power

Standardizing specific patient care products across multiple lines of service or facilities can streamline inventory and reduce waste — resulting in substantial savings.

• Simplified supply chains: The average hospital manages around 8,000 SKUs of inventory in-house alone, with up to 35,000 SKUs on the product formulary.¹⁰ A streamlined inventory reduces the complexity of logistics and helps ensure a consistent supply of quality products. 
• Improved pricing with higher volume: IDNs already know the benefits of bulk purchasing for hospitals. Between 2016 and 2020, surgical supply expenses increased 5% for IDN-owned hospitals, compared to 5.7% for independent entities.¹¹ By expanding this practice and purchasing products as a healthcare system rather than as individual entities, IDNs can leverage order volume to maximize buying power.
• Reduced redundancy and increased efficiency: With fewer SKUs to manage, IDNs can more effectively oversee existing contracts and streamline vendor relations.

Implementing total value across the continuum of care

It is clear that a harmonized approach across all care settings results in better performance across the board. By standardizing best practices and ensuring alignment between acute and post-acute care, IDNs can create opportunity for significant improvement in health and financial outcomes.

Mölnlycke provides solutions tailored to the most pervasive issues within the continuum of care, including pressure injury management, standardization, and infection prevention — to help IDNs identify and close gaps in care within the patient journey. By working to address these common failure points across all healthcare settings, IDNs can improve patient outcomes, reduce waste of facility resources, and achieve total value across the continuum of care.¹²