1. University of Utah Healthcare Value Management System Bob Pendleton MD FACP Chief Medical Quality Officer

2. Goal: Exceptional Value

3. UUHC: Becoming the Provider of Choice
INPATIENT: Rate this Hospital 1-10 (% total patients choosing 9-10)
UHC National %tile Rank
UHC National %tile Rank

4. UUHC: Nationally Ranked Outcomes
* UHC Quality & Accountability Annual Scorecard 9 4 7 1 37 50
*Ranking out
of >98 National Academic
Medical Centers

5. Payers of Healthcare & a sample of Value related Initiatives
Use of Color
Payers of Healthcare & a sample of Value related Initiatives
Government
Insurers (e.g. Regence, etc.)
Employers
Public
Medicare
(CMS)
Medicaid
HEDIS
Direct Contract
Direct &
Rankings
ACO
IPPS
OPPS
CMMI
PQRI
OQR MU
IQR
VBP
HAC
HRRP MU
PQRS MU

6. Growth of National Value Metrics
700
Measures
& counting…
614 measures
464 measures
402 measures
Message POSITIVE: The Little Engine that Could is a children’s story used to teach the value of optimism and hard work. This slide illustrates UUHC progress as measures climb.
Based on real numbers from 2003 – 2015 (projected). Sharp vertical arrow at top right is for effect (648 in 2015 is the real end point).
Attribution: Slide courtesy of University of Utah Health Care Quality & Patient Safety Department.
Questions contact: Geni Chariker ( ,
277 measures

8. Value Management System:
System Management
Resource Management
Measure, Analyze, Improve
Service Delivery
Service Delivery
Service Delivery
Inputs
Outputs

9. Basic Structure of our VMS
Clinical Services
Safety Committee (QM.8)
HCEC
QMOC (QM7)
Document Control Cmt
Value Core (QM.7)
Value Council (GB.1)
Hospital Board
Value Creation Team
Management Review:
Audit results
Corrective actions
Measurement
Analysis
Governing Body:
Operational oversight of clinical delivery system
Medical Board
Support Services
Basic Structure of our VMS

10. Clinical Services
Chief Value Officers
Rob Glasgow - Surgery
Peter Yarbrough - Medicine
Chris Pelt- Orthopedics
Susan Baggaley - Neurology
Meic Schmidt - Neurosurgery
John Bohnsack -Pediatrics
Jerry Hussong- Pathology
Howard Sharp – OB GYN
Bernadette Kiraly – Family Medicine
Mark Eliason - Dermatology
Jim Ashworth- Psychiatry
Dave Gaffney- Rad Oncology
Value Council (GB.1)
GME
Value Council

11. System alignment
System goals
System mgt.

12. Measure & Analyze at the Department level…

13. Entitlement Typical approach to system performance & improvement:
BUT- isn't every patient entitled to optimal performance?
Poor value
Average value
Optimal value
Standard value

14. Value Management System: Focus on Improving Processes
Focus on Results  Problem Solving (Reaction)
Focus on Process  Problem Prevention
Fix Problem 1
Fix Problem 2
Fix Problem 3
Redesign Process to Prevent Problem 1
Build Standard Work & Forcing Functions
Monitor Results
Improve Process Further
Redesign Process to Prevent Problem 2
Build Standard Work & Forcing Functions
Monitor Results
Improve Process Further
Redesign Process to Prevent Problem 3
Build Standard Work & Forcing Functions
Monitor Results
Improve Process Further

15. How? Value Improvement Methodology: (re-)Define Problem & Goals
Analyze & Investigate
Design & Implement
Impact 1
Improve Value 2 5 1
Improve Value 2 5 4 3
Traditional sources of deviation include the 6Ms. 1
Improve Value 2 5 4 3 1
Improve Value 2 5 4 3 4 3

16. VALUE SUMMARY

21. YOU (& your residents) voice & input is critical:
GMEC sponsored group to facilitate two-way input on UUHC value efforts
Coordination with the CVO in your Departments
Should CRIT (empowered CMRs) remain a vehicle?
System use of Value Summary
Core training from Value U
Safety event reporting & subsequent management