What is Clinical Intervention and When Should it be Used?

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For most people, the thought of intervention seems downright intimidating and uncomfortable. This is not the case here; we are looking at a more internal business intervention. So then, what is clinical intervention as it relates to clinical quality improvement?

Measure Twice, Cut Once

Clinical quality improvement is a continuous action which leads to a measurable improvement in care services and the outcome status of specific patient groups. The intervention aspect is the matter of helping people to navigate the process getting better. To do this, it is essential to keep track of outcomes, especially on a long-term basis, because it is impossible to know what does and doesn’t work without data tracking.

In this situation, learning from prior mistakes or inefficiencies leads to better outcomes, but not just on a patient level. Internal work processes need to be understood and fine-tuned when necessary, because at some point internal workings translate to patient care and efficiencies. Patient care and outcomes learn from the past and should be recorded in a manner that provides insight quickly. One of the most effectual ways to do this is Statistical Process Control (SPC)

SPC is defined as a control chart where data is recorded to give a visual account of events. This image helps in a number of ways to find patterns, show outliers, point out inefficiencies, and bring forward patterns that are positive.

Don’t Jump Too Quickly

This kind of tracking is not so much for seeing short-term changes and trying to refine the process from there, but is for long-term views to establish a baseline, understand patterns within that particular organization and making comparisons. Too many facilities have been tempted by changes reflected on a SPC graph reflecting big changes in short amount of time and have tried to tweak their process flow too soon. The implemented changes required many people to change routines or generally inconvenienced various positions, only to find out later that the short-term results were more of an anomaly.

The strong suit of Statistical Process Control as it relates to clinical interventions are:

  • Process variations over time
  • Differentiate between random, special-cause and assignable variations
  • Identify and eliminate unwanted assignable variations
  • Assess effectiveness of changes

The Selection

Selecting an area or areas to which improvement processes should be implemented isn’t as arbitrary as a gut feeling. Clinical quality improvement processes are developed to find the greatest return on investment. This may sound a little harsh, especially when talking about the healthcare practices, but no company or organization can run in the red and still remain open to serve the public. Additionally, many areas of service may already be running very efficiently and thus do not require any sort of improvement course of action.

When selection a project or region to focus on, there are a number of steps in the planning stage that must be considered.

  1. Establishment of project selection criteria
  2. Identifying of all potential projects
  3. Assignment of points and ranking system set forth
  4. Selection of project(s) made based on rank and availability of resources

As careful consideration is made, it is also helpful to know that following this method has proven time and time again to improve clinical outcomes, increase patient satisfaction levels and reduce costs. This kind of assurity helps to offset many feelings of risk versus reward scenario.

The Pendulum Swing

With patience in tow and data-driven decisions being made, clinical intervention can take place. This is another time where incoming results from SPC information may feel like it warrants action; just because numbers improve dramatically doesn’t mean immediate success, and just because numbers don’t immediately reflect changes doesn’t indicate failure. Corrections take more time and patience, plus added vigilance to recognizing what areas should expect changes. There could be a hugely positive initial reaction, but later more fine-tuning will be required.

Let things play out for a while, all the time taking in patient and professional feedback, and learn from what is happening. As comprehension to clinical interventions are received, more understanding about other areas of concern may be answered. Clinical quality improvement happens slowly over time.

What is Clinical Intervention

It is the culmination of time, patience, insight, want for more quality, desire to change and even acceptance of some risk (with the help of data-driven information). Interventions don’t have to be uncomfortable or difficult, because they can produce a more efficient and effective organization that serves it purpose for anyone seeking better care and those providing that care.

Image courtesy of FreeDigitalPhotos.net/jomphong

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