The Bridge

Providers seek standardization, usually

by Lisa Perlmutter

While clinical standardization is not a new concept, it is now the top priority for provider executives. In a recent Advisory Board survey of over 150 hospital and health systems strategy execs, CXOs rated driving clinical standardization as the most challenging and most crucial initiative for organizational success.

Defining clinical standardization

We know clinical standardization is a top hospital priority. But what does clinical standardization actually mean in practice?

Broadly speaking, clinical standardization is defined as delivering care according to an agreed-upon protocol in order to promote consistent quality. The components that make up clinical standardization include:

  • Putting in place care standards that are supported by definitive evidence (aka “evidence-based practice”)
  • Having clinicians develop consensus-based care standards based on their collective expertise, even when there is a lack of evidence
  • Pursuing ongoing evaluation to track outcomes and appropriately evolve the standard of care

This is a short list, so why does clinical standardization remain elusive? There are many reasons why clinical standardization is hard, but usually it is a combination of leadership, culture, and measurement that are to blame.

The goal is not complete standardization

Adopting clinical standardization should not eliminate flexibility. In fact, provider organizations know that the goal is not 100% standardization—the goal is to promote use of the standard as the default, but enable clinicians to opt-out when the standard is not appropriate for a given patient. Some providers cite 70-90% adherence to guidelines as a good target range.

This encourages compliance while acknowledging that different patients may need slightly different care. The surest way to lose physician engagement is to leave no wiggle room for appropriate variation. Advanced organizations study opt-outs to evaluate if diverting from the standard yields better outcomes for certain patients and if the original standard should be modified.

Why should suppliers and services firms care?

You should care because the path to clinical standardization impacts how providers select and use your products and services. Eliminating output variation means controlling input variation, so providers will look more and more to streamline the products and services for a particular procedure. Even if your product or service is selected as part of a care standard it does not mean that it will be the standard forever. Care standards are dynamic decisions that evolve as new evidence is collected.

Providers are looking to industry for the data and clinical expertise to develop standardized clinical pathways. In a recent Advisory Board Company survey of over 50 supply chain executives, respondents ranked “vendors’ ability to partner on clinical pathways” as a key offering that influences their purchasing decisions.

Full results from our 2015 CEO survey

Learn six shifting priorities you can expect to see from hospital executives.