Prescription for Change

Hear from Banner Health leaders on achieving system-wide clinical standardization

Last September, Banner Health announced six new system-wide clinical standards. They all went live, on the same day, at all 25 of their facilities. And now, those standards are part of the “Banner way” of practice. This happens every month at Banner, with their system-level Care Management structure overseeing the constant creation and implementation of care standards.

The rigor and resources Banner dedicates to clinical standardization efforts is enviable—but it wasn’t always that way. Banner started as a fragmented system post-merger in 1999 with few physician leaders and little cohesion across the medical staff. Now they are a national leader in taking a system approach to reducing care variation.

Hear from Banner’s physician leaders about the three strategies that turned the dial on this clinical, and cultural, transformation.

1. Securing physician commitment to care reliability

If you analyzed the mission statements of different health systems, you wouldn’t find too many substantive differences. Every organization dedicates itself to clinical quality, but, too often, this is mostly lip service. Many organizations don’t invest the upfront will and resources to build a system-wide infrastructure that holds all facilities to a consistently high level of quality and safety.

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Banner has taken its mission a step further, turning it into a clinical vision of providing reliable, high-quality care system-wide. Employed and independent physicians alike support this vision because it aligns with their values, including:

  • Fixing the system, rather than blaming individual physicians for underperformance
  • Putting physicians at the forefront of developing system-wide clinical strategy and care standards
  • Implementing care standards that are based on the evidence or clinical consensus, with rigorous outcomes monitoring
  • Ensuring every patient in the system receives the best possible care

Notice—these efforts all focus on improving the quality of care. Banner does not incorporate cost reduction into its clinical vision, though cost-savings is a positive externality from Banner’s standardization efforts.

2. Building a clinician-centered infrastructure

Too often, systems create clinical guidelines and leave adoption to the local levels—leading to variation in implementation and outcomes. In contrast, Banner has built an extensive “machine” to create and implement a “Banner way” of practice.

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They have a centralized (but inclusive) clinical leadership infrastructure that decides what standards clinicians should follow. And they provide wraparound supports such as process engineers, data monitoring, and clinical workflow tools to ensure every frontline clinician can easily adopt those standards.

3. Integrating independent physicians into organizational culture

What’s perhaps most impressive about the Banner story is that, with an 85% independent medical staff, they’ve created a culture in which all physicians participate in efforts to reduce care variation.

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Banner encourages independent physicians to participate in Clinical Consensus Groups—and gives them the authority and support to truly transform clinical practice. Even though independent physicians are paid a per diem rate to participate, less than a third end up submitting their time sheets for compensation.

Of course, some physicians will be resistant to change. In those cases, Banner has embedded clear adherence expectations into OPPE and peer review, and will have escalating performance conversations with outlier physicians.

Learn more at our national meeting

National meeting for physician executives

Want to learn more about the Banner model? Join us April 16-17, 2015 at the Physician Executive Council national meeting in Washington D.C.


Clinical Consensus Group Charter Template

Banner Health uses a Clinical Consensus Group Charter to inaugurate each new Clinical Consensus Group. The charter defines the work of the group, which focuses on defining system-wide clinical practices. Download and print this template.