Technology & Innovation

Scripps Health: fostering a data-driven culture

Africa

Africa

“In healthcare, it’s not ’big data’,” says Dr Jim LaBelle, corporate vice-president of quality, medical management and physician co-management at Scripps Health, the San Diego-based health system that includes 5 hospitals, 2,600 physicians and more than 13,000 employees. “It is a tidal wave of data. And our ability to restructure and change our culture is almost entirely informed by these data,” he says.

For the last several years, Dr LaBelle has been overseeing an effort to change the culture at Scripps, from one in which quality is measured almost entirely by the performance of physicians to one in which quality is measured by the performance of the processes, systems and teams that support them. “We don’t want our physicians to be exclusively responsible for quality,” says Dr LaBelle. “We want quality to be measured by the team. So we are looking at monitoring variation around processes and driving out waste and supporting better care by developing a management system and partnership with the medical staff.”

To inform its approach to these changes, Scripps collects and analyses variation data, or information about whether a particular process was in control. For example, in anticipation of re-engineering its emergency room procedures, Scripps collected and analysed massive amounts of data on wait times (such as the door-to-doctor metric), and cross-referenced the information against the type of injury, tests that were ordered and how long it took to discharge the patient. “We plotted the variability, and looked at it over time, by shift, hour of the day and against different events, to determine how that variability got in there,” says Dr LaBelle. “Then we did extensive simulation of our processes using real-life data, modelling how new and different processes might work.”

Scripps found that the triage process added an unnecessary and wasteful step in getting patients from the door to a doctor. It was adding time and cost to the system, and not adding significant value.

So the company eliminated it. “We were able to reduce the critical door-to-doctor time, add capacity to our emergency rooms and improve the quality of our service,” says Dr LaBelle. “We’re building a new hospital right now, and we’re looking into whether we even need to build a waiting room in the ER.”

 

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