Informed Decisions Improve Patient Care - Even in a Crisis

An interview with Brightwork’s CEO & Founder, Shannan Epps

Originally published in Modern Healthcare April 20, 2020

Shannan Epps is a recognized thought leader and subject-matter expert in healthcare IT and strategic planning. Known as a program leader and strategic advisor, she utilizes her unique insights and expertise to collaborate with leaders to improve how healthcare is delivered and how it can improve patient care.

MODERN HEALTHCARE: How do organizations make informed decisions about transformation? How does that change during a crisis?

Shannan Epps: Before COVID-19, the discussion in healthcare was about how providers can disrupt the industry and innovate. Leaders need to be extremely intentional and careful when considering transformations and should weigh the benefits against the cost and strategic initiatives of the organization. Having a strong IT Innovation Steering Committee that consists of leaders is a must. They should have all the data they need to make a decision quickly, for instance, the development effort an initiative will take, whether current solutions are available (buy vs. build), cost options, vendor options, the amount of effort involved and how the effort will impact stakeholders and other projects. Scoring systems and data-driven business protocols lead to informed decisions. During a crisis, decisions are made quickly. This is when it’s most important to follow planned processes and rely on your steering committee as a command center.

MH: How do leaders determine which requests have value and are the right strategic decisions?

SE: Leaders should use scoring systems to determine how closely a proposed project aligns to strategic initiatives. If one of the organization’s strategic initiatives is to improve the health of its population, then the steering committee should ask whether the proposed project meets that goal. Members should focus on long-term outcomes and value. Does the solution have longevity? What is the cost vs the ROI of the solution? If there are multiple options, then leaders will need to assess their organization’s requirements, rate each solution and describe how it might meet those needs.

MH: How do you plan for triaging decisions during a crisis?

SE: Every organization should have a business continuity plan that include scenarios each with risk analyses, mitigation plans, and actions. Integral to that plan is a decision triage plan, which defines the people, process, and technologies needed to make informed decisions quickly. Organizations should test not only their business continuity plans, but also their decision triage plan. If you don’t have a decision triage plan, determine the critical roles that should be part of an emergency decision-making group, define the process for activating and operating this group in an emergency, and describe the technologies including communication tools needed to execute and communicate decisions up and down the chain of command. You will need to answer other questions such as when, where and how often it meets.

MH: How can risk analysis help make informed decisions during a crisis?

SE: Risk analysis guides informed decision-making because it identifies and qualifies risk and helps decision-makers prioritize action. During a crisis, decision-makers don’t have the luxury to perform full risk analyses, however, by using the risk analysis framework for making decisions and including stakeholder input, it will help guide them to make better decisions. Central to this framework is to identify the risk, identify solutions (from inaction to full action), and identify and score the benefit and risk impact for each. Practicing this decision-making during triage decision testing will significantly help implement this framework during crises.

MH: How can change management lead to better decisions?

SE: Change management is a cornerstone for effective organizational management. When making decisions, it’s important to consider barriers to change before presenting a decision. Some stakeholders will have their minds made up before the process begins. Leaders can help navigate this by using proven change management methodologies to ensure participants know they will be heard, that all options will be considered, that optimal and sub-optimal current workflows and processes will be addressed, and that the decision-making process is robust to ensure everyone’s requirements are met. This will go a long way to ensuring your stakeholders come to the table with an open mind and are ready to participate.