Operationalizing Arch Collaborative Data

Leverage all the help you can: Share your KLAS Arch Collaborative EHR Experience survey results with your EHR vendor and other key vendor and firm partners that support your clinician EHR satisfaction initiatives (KLAS will share this data on your behalf once you sign a data-sharing agreement). Invite these partners to the action planning call with KLAS.

Focus your efforts: With your project team, identify the areas of improvement you will address. Review KLAS Deep Dive findings and commentary analysis. Read clinician comments (Dr. Heidi Twedt from UW Health presented her strategy for leveraging clinician comments at the 2024 Arch Collaborative Learning Summit). Identify differences between your current state and evidence-based practices in the Arch Collaborative’s provider and nurse guidebooks. Work with your Arch Collaborative representative to identify applicable case studies, reports, and webinars. With your Arch Collaborative representative, determine which organizations to connect with to understand deeply how and what they implemented to successfully overcome similar challenges.

Identify quick wins (e.g., store all current education materials in a central, easy-to-access location, promote broader personalization tool adoption, participate in vendor-led EHR education). Leverage the KLAS report Easy Lifts for Quickly Improving EHR Satisfaction.

If this is a repeat measurement, use trending data to highlight the impact of the work you have already completed. Use comments, raw scores, benchmarking, charts, and scorecards to prove your work.

Position your organization to be a leader in EHR satisfaction to raise the bar for all of healthcare. If your organization benchmarks high on the EHR Experience Survey, and there are few or no obvious needs, review raw scores. Even if your organization benchmarks higher than others, raw scores may be low and need improvement. Clinician comments underscore additional improvement opportunities.

Secure your leadership team’s buy-in: Socialize the Arch Collaborative EHR Experience Survey results with organization leadership (e.g., clinical, operational, financial, regulatory, quality). Highlight scores and benchmarking, what is going well, what needs to be improved, and what areas you plan to focus on.

Lean on the KLAS Deep Dive deck and Executive Scorecard as a foundation to share this information. Include direct clinician quotes from the survey results to highlight successes and improvement opportunities. Ensure the deck aligns with organizational goals and objectives.

Tie improvement efforts to existing strategic objectives and initiatives (e.g., lower clinician burnout and turnover, higher clinician EHR satisfaction, improved clinician efficiency, faster patient care, improved patient throughput).

Secure support and resources for the identified improvement efforts by sharing the costs at stake (e.g., clinician burnout and turnover) using your Executive Scorecard data, assigning a dollar amount to the money that your intended improvement efforts could save the organization.

Identify leadership champions for selected improvement initiatives. Throughout the improvement process, determine when and how to leverage these individuals.

Socialize the Arch Collaborative EHR Experience Survey results with clinicians: Thank them for participating. Use the deck created above to broadly share results. Include clinician quotes so they see their voices were heard.

Use multiple communication methods to disseminate the information, including posters, emails, flyers, and videos, like this example from The University of Kansas Health System. Highlight scores and comments to show what is going well and what needs to be improved. Include one or two improvement areas you plan to focus on. Leverage resources like the “We Heard You” document (your KLAS representative is happy to share this with you).

Identify a process-improvement team for each opportunity: These teams will assist in the design of changes, identify pilot groups for testing, communicate and champion changes to leadership and end users, etc. Team members should be passionate and persistent (i.e., unlikely to give up under pressure).

Lean in to your shared ownership structure to identify clinical champions via informaticists, superusers, and other engaged clinicians. Ask for volunteers. Help clinicians tie their participation to meaningful EHR improvements.

Ensure the improvement team includes clinicians at all levels, from end users to clinical and operational leaders.

Establish a regular meeting cadence for your process-improvement team: Ask team members to commit to and adhere to the schedule. Ensure they have dedicated time to participate.

As an improvement team, watch the 2024 Arch Collaborative Learning Summit presentation Putting Arch Collaborative Data into Action by Kay Burke (UCSF Health) and Alan Nebeker (KLAS Research). Download the associated PowerPoint presentation to gain complimentary access to UCSF Health’s Action Planning Resource. Incorporate ideas from these resources. Begin formulating your next steps and a project timeline.

Leverage your process-improvement team to understand the depth and breadth of each identified improvement opportunity: Perform a comprehensive root-cause analysis to deeply understand the challenges and what departments and specialties are impacted. Brainstorm potential solutions. For example, if the opportunity is to improve ongoing EHR education, identify the groups most in need of an improved experience and the changes that could be made.

Round on-site with end users, especially with the most dissatisfied group(s) and the survey participants who agreed to share their names, to observe and ask questions to ensure you focus on the correct issues (i.e., are EHR education scores low because content is not specialty specific, because clinicians don’t understand what EHR education is available and how to access it, or because clinicians don’t have dedicated time to participate?).

While focus groups and governance councils are valuable sources of feedback, using them as the only source of end-user feedback limits your perspective. While rounding, deliberately speak with clinicians you do not know to expand your understanding of the challenges.

Understand what is working and what is not working (i.e., What are the barriers? What have you already done to address them? What has worked and what hasn’t?).

Work in close partnership with your EHR vendor to seek feedback, diagnose challenges, and drive improvements (e.g., ensure you are on the latest EHR version, leverage vendor-led EHR education, use the vendor’s diagnostic tools to address configuration challenges). Review these vendor and firm resources to understand how other organizations have leveraged their vendor and firm partners for improvement.

Create your process-improvement plan: Include the changes you will implement and which locations, units, departments, and specialty areas will be part of the pilot group. In addition to your improvement team members, determine who else should be included in this effort (e.g., the organization’s IT team, leadership champions, regulatory specialists). Utilize the communication plan created in step three as needed.

Leverage information from the Arch Collaborative report on successful improvement efforts/sprints.

Use the Arch Collaborative’s Success Pathways to guide your efforts.

Share your plan with the KLAS team and ask for feedback.

If you would like deeper help and guidance, consider engaging KLAS in a consulting project, such as Expert Guidance.

Execute your plan:

Use relevant data (e.g., fewer clicks, higher percentage of same-day chart-closure rates, higher patient satisfaction) to show why change is necessary, communicate wins, and show progress.

Determine how to measure your success (e.g., Arch Collaborative survey, decreased turnover, increased patient throughput).

Leverage KLAS pulse surveys, pre/post surveys, and the Education Quality Benchmark to check progress, validate efforts, and point to needed adjustments. Partner with your Arch Collaborative representative to successfully use these resources.

Identify and communicate a few early wins (i.e., easier lifts) to clinicians and leadership to build momentum. Look for low-hanging fruit (e.g., clarification for clinicians on submitting fix tickets, increasing clinician awareness of existing resources).

Regroup with your process improvement team(s): Discuss adjustments. Iterate with test groups until you are ready to broadly roll out changes.

Share successes broadly with clinicians and leadership: Continue to tie initiatives to the organization’s strategic objectives.

Remeasure via the Arch Collaborative EHR Experience Survey

Self-Examination Questions—Operationalizing Arch Collaborative Data

On a scale of 1–5, rate your agreement with the following statements (5 means “strongly agree” and 1 means “strongly disagree”):

1. We are passionate about elevating the clinician EHR experience because we understand that successful EHR use lowers clinician burnout, decreases clinician turnover, improves clinician efficiency, and improves patient care.
2. We persistently help our leadership team connect our KLAS Arch Collaborative survey results and clinician EHR satisfaction to our broader strategic objectives to engage the leadership team and obtain resources for EHR-improvement efforts.
3. We carefully select our leadership and clinical champions based on their skills, capabilities, reach, and desire.
4. We build multidisciplinary process improvement teams to best understand how changes impact all areas by choosing clinicians who understand multiple perspectives, are passionate about the EHR, and deeply understand clinical workflows and how the EHR functions. We then pair them with team members from other areas of the organization who are familiar with quality metrics, regulations, and nonclinical workflows.
5. Our EHR communication strategy prominently includes why we are making a change, is cohesive (e.g., consistent look and feel, is sent from a trusted source), and is distributed in various ways (e.g., emails, newsletters, meetings, intranet, posters around the building, videos).
6. We use our communication strategy to build trust with our clinicians and our leadership team members as we celebrate wins, vulnerably share improvement opportunities, and actively engage clinicians and leadership team members in our change management processes.
7. We leverage our superusers/EHR ambassadors/informaticists/IT analysts to reinforce communication.
8. When we communicate with our clinicians and leadership team about EHR process-improvement opportunities, we bring relevant data (e.g., EHR data, feedback from surveys, cost information) in an easily digestible format.
9. We are willing to fail fast and learn from feedback and test pilot initiatives to build a better EHR that meets clinicians’ needs.
10. We have invited our Arch Collaborative representative to be part of our process improvement and to share related reports and case studies as well as connect us with organizations that have successfully tackled some of the same issues we are working on.
11. We leverage our Arch Collaborative membership for pre/post and pulse surveys to measure and verify our improvement efforts.
12. We maximize our Arch Collaborative membership and send six attendees each year to the annual Arch Collaborative Learning Summit held in Salt Lake City to learn from peers and KLAS.
13. We leverage the Arch Collaborative Learning Center and stay abreast of reports, case studies, and webinars as we continue to optimize our EHR success strategy.
14. We share identified improvement opportunities with our EHR vendor and other vendor/firm partners who support our EHR initiatives and ask for feedback, guidance, and best practices. We leverage their resources and support as we plan and execute on our improvement opportunities. We have accessed our vendor’s available resources via the Arch Collaborative (located on the left-hand side of your My Files page on the Learning Center).
15. As needed and applicable, we review the KLAS framework reports—EHR Education Software and Services, Clinician EHR Efficiency Software and Services, and EHR Governance Software and Services—to identify potential partners to assist in our improvement initiatives.
16. We actively encourage peer-to-peer promotion of our EHR education program and shared ownership structure to bolster our change management success similar to the University of Virginia Health System, MetroHealth, and Kaiser Permanente Southern California.
17. We prepare specialty-specific communication for our clinicians so each understands how they will be uniquely impacted by decisions and changes. When we create tip sheets and other materials about changes, we celebrate incorporating clinicians’ voices by including on the materials who requested the change (e.g., directly by name, by department, by unit).
18. When we run a pilot within a unit, group, location, or specialty, we recognize that clinicians may need to work under a reduced schedule to accommodate the changes and feedback necessary for the success of the program.

Total

Scoring

Self-Examination Questions—Operationalizing Arch Collaborative Data

1. We are passionate about elevating the clinician EHR experience because we understand that successful EHR utilization lowers clinician burnout, decreases clinician turnover, and improves patient care and safety.
2. We actively encourage our customers to participate in the KLAS Arch Collaborative.
3. We persistently help our customers, including their leadership team, connect Arch Collaborative survey results and clinician EHR satisfaction to their broader strategic initiatives to engage the leadership team and obtain resources for EHR-improvement efforts.
4. We actively and regularly provide information to our customers from the EHR, such as user-efficiency data, in easily digestible and actionable formats and suggest opportunities for EHR education and optimal EHR configuration.
5. We proactively work with our customers after their Arch Collaborative measurement to align with their identified improvement areas and position ourselves to assist them based on user-efficiency data, their unique survey results, and our experience with other organizations’ positive changes.
6. We consistently ensure our customers have an optimal EHR configuration. We make regular suggestions for changes to improve EHR speed and reliability, provide means for them to enhance external interoperability, and aid them in improving user efficiency.
7. We regularly meet on-site with our customers and round with their clinicians to better understand how we can improve clinicians’ EHR satisfaction.
8. We are willing to fail fast and learn from our customers’ feedback to build a better EHR to best meet clinicians’ needs.
9. We offer clinician specialty- and role-specific EHR education at no additional cost to our customers.
10. We leverage our Arch Collaborative membership to attend the annual learning summit to connect with our customers and understand their needs.
11. We utilize the information from the Arch Collaborative Learning Center, including reports, case studies, and webinars.
12. Our EHR communication strategy prominently includes the reason we are making a change, is cohesive (e.g., consistent look and feel, is sent from a trusted source), and is distributed in various ways (e.g., emails, newsletters, meetings, intranet, posters around the building, videos). Our communication materials are easily adaptable by our customers for their own internal use.
13. We prepare specialty-specific communication for our customers so each clinician will understand how they will be uniquely impacted by decisions and EHR changes.
14. We regularly review our customers’ usage of our complimentary resources to ensure they take full advantage of the resources to enhance clinician EHR satisfaction.