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GreenLight Network    LEAD

The Challenge: A major barrier to adoption of patient safety solutions is the lack of financially responsible decision-support information. This program provides models and examples that hospital leadership teams need in order to confidently "greenlight" investments in patient safety. The "accountable care movement" represents a seismic shift in the multi-trillion dollar market from provider-centered volume driven forces to patient-centered value-driven forces. Profit centers will become cost centers overnight – challenging even the most sophisticated.

The Greenlight Network: World class organizations and individual experts from quality, certification, and purchasing organizations provide clinical, operational, and financial expertise and data. Employers and consumers will play an important role in our work and will be fully represented.

The Collaborative Initiatives:
Greenlight Provider Models: Our leadership decision-support investment models will address clinical, operational, and financial performance for typical hospitals and ambulatory care systems. They provide structure and flexibility: the structure to address specific patient safety gaps, while providing the flexibility of givens, assumptions, and variables to adjust forecasts for care providers' unique situations. The ultimate objective is to provide what is necessary for CFOs and finance teams to vote "yes" to greenlight investment in patient safety initiatives, with the confidence in the ROI and financial impact of those programs. "CFO-validated factors" will be developed through a consensus process with input from leading CFOs.

Consumer and Payer Decision Support Tools: Our work will provide critical information so that patients and purchasers can choose the right providers at the right price so that they will receive the right care in every community every single day. To view collaborator organizations' video clips from the TMIT documentaries, click here.

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High Performance Imaging

Program Deliverables to Healthcare Collaborator Organizations: Participating healthcare supplier, provider, payer, and purchasing collaborators will receive great information, benefit from national collaborative sharing, and have costs to national meetings waived.

  • Performance models they can apply to their own organizations to optimize imaging and radiation safety.
  • Consolidated Collaborator Information – to allow them to compare themselves to others.
  • Certain costs will be waived by national and global meeting conveners at meetings where some of the models will be presented.

What Provider Collaborators Contribute to the Program: Participants will be required to provide data regarding imaging services. Current collaborators include Mayo Clinic, Cleveland Clinic, Vanderbilt University, Brigham and Women's Hospital, Catholic Healthcare Partners, and community and rural hospitals.

  • Data: Certain data from some of the collaborators on certain performance gaps and opportunities for reduction of over-use, misuse, and under-use will be submitted. Financial data include revenue, cost from activity-based accounting systems, and attributable costs/givens/variables. All data will be de-identified, and strict confidentiality of data will be maintained. Hospitals, payers, and purchasers may decide to share data with TMIT only, and not with other hospitals in the collaborative. Data sharing agreements will be signed between TMIT and the collaborators.
  • Patient Scenarios: For certain common scenarios used in the models, participants will have their finance teams calculate the cost and revenue for such standardized patient scenarios.

Deliverables of Constituent Collaborators to Program: Participants representing constituencies from providers, quality, certifying, and purchasing sectors will provide data and subject matter expertise.

  • Collaborator Data: Membership organizations such as the American College of Radiology, R.S.N.A., and other organizations such as third-party payers, will provide data and analytics not typically available to health services researchers that will be analyzed by TMIT.
  • Subject Matter Expert (SME) Advisory Support: Subject matter experts in imaging, patient safety, financial analytics, and imaging performance will supply special expertise and validation to the findings.

Program Deliverables to Global Community: The Greenlight Program will have certain deliverables to the global community beyond the participants.

  • Conversion of Waste to Value and Harm to Healing: An aim of the program will be to immediately address the waste and harm generated through over-use, misuse, and under-use of imaging so that current waste and harm can be converted to value for every dollar spent and reduction in untoward harm through ionizing radiation and ineffective use of tests. These deliverables will be first deployed through its collaborators, then to the global community.
  • Publications: High-level concepts, tools, and resources will be published in journals interested in performance improvement, quality, patient safety, and leadership-related issues. A Special Issue of the Journal of Patient Safety will be published in 2013 addressing some of the results of the ongoing collaborative. A Special Issue of the British Medical Journal (BMJ), to be published in late 2013, will include articles having global impact and scope.
  • Concepts, Tools, and Resources: Deliverables of the program will help suppliers, providers, payers, and purchasers improve the opportunities for the right test, through the right order, performed the right way, so that the right report will generate the right actions for every patient every day. The 5 Rights of Imaging™ initiative will generate continuing education modules for multiple caregiver groups including physicians, radiology technologists, nurses, pharmacists, and trustees.
  • Cost and Value Calculators: Impact and Value Calculators will be developed and deployed to the national community for free that will address multiple modalities, including ultrasound. For instance, a cost calculator produced by TMIT will be available on the SafetyLeaders website.
  • Multimedia: Video, print, and presentation materials will be developed for a worldwide audience of imaging administrators, practitioners, and radiologists.

Collaboration Approach: Starting with a core faculty team and selected organizations, an initial set of Greenlight models will be developed and tested at Centers of Evidence (COEs). They will then be provided to other organizations for feedback. Collaborators in this program will be entitled to cross-collaborate with other TMIT Greenlight programs, such as the 5 Rights of Pain Management™ initiative, which addresses high performance pain management.

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