2023 Acclaim Award Honoree

Transforming into a More Customer-centric Medical Group

Baylor Scott & White Medical Group was recognized an Acclaim Award honoree for the following initiatives:

• Developing an integrated care model that enhances the quality of care and life while improving customer satisfaction and efficiency
• Implementing new service-focused standards that foster exceptional experiences by identifying issues, collecting real-time feedback, solving problems before they surface online or in surveys, and continually tracking progress
• Evaluating data to improve outcomes and affordability, with a focus on tightly tailored, actionable and evidence-based solutions
• Embedding multidisciplinary teams in Community Care Clinics (CCC) to provide comprehensive care to the underserved to help communities stay well
• Reducing the documentation burden to improve provider well-being

The Baylor Scott & White Medical Group is part of Baylor Scott & White Health and is comprised of nearly 3,800 providers. The system promotes the health and well-being of every individual, family and community it serves. It is committed to making quality care more accessible, convenient and affordable through its integrated delivery network, which includes a health plan, research institute, accountable care organization and a leading digital health platform

As part of the application process, each group was asked to detail their project narrative. See Baylor Scott & White Medical Group’s narrative below.
 

Improving Performance with a Clinic Analysis Tool

Baylor Scott & White Medical Group was named an honoree for the 2023 AMGA Acclaim Award. As part of the Acclaim Award application process, healthcare organizations are asked to submit narratives describing major system-wide initiatives that exemplify the goals of the award. One of the narratives from Baylor Scott and White’s’ application, “Transforming into a More Customer-centric Medical Group,” is summarized below.

Baylor Scott & White Health is a healthcare system based in Dallas, TX. Formed in 2013 from the merger of Scott & White Health with Baylor Healthcare System, it became the largest nonprofit healthcare system in Texas and one of the largest in the country.

Access issues shape customer perceptions about a “broken” healthcare system. When patients say things like, “It took five weeks to see the oncologist,” it reflects a negative effect on both the patient and the brand.

With no single evidence-based, reliable source on access issues that showed trends, historical data, and the relationship among variables, Baylor Scott & White Medical Group built its own to deliver an exceptional individualized experience that is consistent and predictable.

Introducing the CAT

Baylor Scott & White built an in-house clinic analysis tool (CAT), which is a dynamic dashboard that displays performance at various levels of detail down to root causes. It provides actionable data for operational improvement and growth, identifies best practices, and aggregates performance metrics at the organization, region, clinic, specialty, and provider levels. CAT is the primary tool to advance practice standardization, ensuring that all patients receive the experience they deserve.

Using a 12-month Agile process, Baylor Scott & White united resources from across its organization—analytics, operations, finance, and clinic leaders—to build a dashboard to advance its understanding of how clinics perform overall, rather than simply reviewing financial performance.

Chief among obstacles was the creation and maintenance of myriad interfaces from the multiple applications that populate CAT. The organization sources data elements from its electronic health record (EHR) and proprietary systems, grouped by weighted category. The five categories—Health, Affordability, Alignment, Experience, and Growth—represent key areas of clinic performance and adjust dynamically depending on the filters applied.

Baylor Scott & White takes care of its patients holistically and views its clinics through a similar lens. Within each category, individual metrics can be compared to benchmark, prior year, or prior fiscal year. Individual metrics can be drilled down to display underlying data while top-level data show gap to goal—the strategic areas for improvement. Categories, in turn, are combined to display a composite score. For example, embedded in the Experience category is the Service-Clinic Composite.

CAT in Action

Clinic and executive leadership meet monthly by region to evaluate each clinic’s performance. They look at individual category elements and their potential relationship with elements from other categories. Clicking the right arrow next to an element drills down into the data to the provider level. For example, using CAT, they may discover that quality is improving while access is declining, suggesting a throughput issue.

At the clinic, huddle boards display subsets of CAT data, a central topic of the 20-minute weekly meetings with the entire care team. Subsequent CAT data evaluates effectiveness and encourages iteration. Ultimately, solutions that positively affect the patient experience are spread across the organization’s clinic network.

Expanding Access

A key focus in 2022 was access. CAT access-related metrics that help identify best practices and areas of opportunity include Press Ganey for ease of scheduling, schedule utilization, new patient lead days, provider panel size, and same-day access. For scheduling new patients in a timely manner, Baylor Scott & White set a 14-day scheduling window (the 75th percentile from Epic benchmark data) as its target. In addition, it set a target of 95% for those patients seeking same-day access. 

A key attribute of the CAT is its ability to identify best-performing and low-performing clinics. An analysis of identified high-performing clinics suggested a range of interventions, from leveraging the Baylor Scott & White’s digital app for self-scheduling and 24/7 virtual urgent care services to enhancing care team roles and ratios.

For a low-performing clinic, the intervention included:

• Providing more virtual visit options for all patients, new and existing
• Adapting schedule workflows to meet patient needs
• Targeting increased facility utilization by extending hours and staffing to reduce the ratio of exam rooms per provider
• Revising the support staff-to-provider ratio
• Optimizing cost control opportunities

For the low-performing clinic, the organization changed its model to include expanded care teams, more virtual care options, new providers, and extended hours with minimal added expenses.

Results

The clinic’s professional net revenue increased 115%, while operating expense rose only 59%. Schedule utilization increased from 87.7% to 89.8%, while same-day access remained high and slightly increased from 97.5% to 97.8%.  The intervention led to reduced referral delays (while keeping 85% of patients in network). New patient lag time for primary care outperformed the Patient Access Collaborative 75th percentile benchmark.

This success is resulting in the intervention’s phased deployment across more than 700 primary and specialty care clinics within Baylor Scott & White’s network. By leveraging “big data,” organizations like this one have the information readily accessible to supercharge clinics by advancing quality and improving the patient experience. Solutions like CAT can lead to redesigning processes and empowering customers.