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Why your care standards may be failing—and how to do them right

October 18, 2017

    Most clinical leaders confess that despite investing significant time and energy in achieving clinical consensus and building the "perfect" care standard, these standards are often left sitting on the shelf.

    At most organizations, poor standard adoption isn't rooted in clinical resistance. Often, it's just too difficult to integrate new care standards into daily workflow. For example, most care standards require physical therapists to assist post-op total joint patients with same-day ambulation. But what happens to patients with late-day procedures when the physical therapist goes home at 4:30 p.m.?

    One of our members put it best: "We put so much effort into creating the standard—we reviewed the evidence, sought input, came to consensus—and it still failed. We realized we didn't fail because we didn't have a standard; we failed because we didn't have a functional standard that could actually be adopted."

    Innovative organizations address this adoption challenge by creating care standards that account for workflow realities. You can rethink your care standard design by following two steps:

    1. Frontload workflow considerations

    Don't wait to map clinical specifications to workflow until after the care standard is approved. Instead, map them to workflow before approving a standard for roll out.

    Pulling forward workflow considerations gives you the ability to run a feasibility check, unearth any hidden challenges, and adjust your clinical guidelines as necessary to meet existing workflows.

    2. Invest time in understanding workflow realities

    To get a better idea of potential barriers to adoption at the frontline, devote more time to the design phase. It's just as important to figure out how your clinicians are supposed to follow a guideline as it is to figure out what the guideline should be. This doesn't mean that you have to extend your entire care standard development creation process. Most times it's just a matter of reallocating time from achieving clinical consensus to understanding workflow realities at the front line. It takes less time and effort to work a standard around workflow than to change workflow to match a standard, and getting it right the first time will save you from frustration down the road.


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