Healthcare organizations and physicians are continuously striving to develop programs focused on quality and the patient experience that will differentiate them in the community. The development and promotion of specific product lines is one way of accomplishing this recognition. Recently, a variation on this trend has emerged with the development of “Centers of Excellence.” While many healthcare organizations are already developing these programs, two questions remain:
1. What exactly is a Center of Excellence?
2. How do you become a Center of Excellence?
A Center of Excellence is an organization that is viewed as a preferred place of treatment for a specific condition. This preference stems from delivering comprehensive, evidence-based care that is multidisciplinary, and yields exceptional outcomes and high patient satisfaction. To put it simply, a Center of Excellence provides more effective and efficient care, and has the evidence to support this claim.
So who designates an organization as a Center of Excellence? The designation can come from patient-focused groups (third party payers) and accrediting bodies (Joint Commission). All have different criteria and standards for an organization to obtain a Center of Excellence distinction. Third party payers (Aetna, Blue Cross Blue Shield, Cigna, and United Health) provide their clients with the ability to research hospitals that participate in Center of Excellence programs and meet the required quality standards. This allows patients to make an informed decision about the best place to have a particular procedure or treatment. An accrediting body (such as the Joint Commission) provides disease-specific certification and ensures an organization has a comprehensive program in place that is focused on providing safe and effective care of the highest quality. A Center of Excellence designation is meaningful because it signifies an organization’s commitment to meeting certain performance standards.
When developing a surgery Center of Excellence, there are some key components that must be included: physician leadership, defined mission and vision, multidisciplinary team approach, standardized processes and clinical practice, long-term tracking of patient outcomes, and a focus on creating a unique patient and family experience.
It is important that physicians are engaged at the emerging phase when creating Center of Excellence program. The physicians’ leadership, expertise, and guidance are needed for developing a successful program centered on education, research, and the use of new technology.
Defining a mission and vision is necessary for a Center of Excellence to be successful. This needs to be developed in collaboration with physician leadership and other key stakeholders. A unified message and commitment from the healthcare team will instill confidence in the patients and families served, provide the foundation for the program’s strategic focus, and help define goals for measuring success.
A multidisciplinary approach to delivering care involves a team of healthcare experts working together toward a common goal with the patients’ needs as the focal point. A multidisciplinary approach includes doctors, nurses, physical therapists, and case managers collaborating on patient care. A true Center of Excellence will have a multidisciplinary steering committee that provides leadership and strategic guidance for creating a multidisciplinary program and setting standards of excellence.
Creating standard processes for clinical practice will help ensure every patient and family that enters the Center of Excellence will receive the same high level of care before, during, and after surgery. It is at this point that research plays a key role in the functioning of the Center of Excellence. Treatment protocols must be supported by evidence. Post-surgical physician order sets are an example of how a process can be standardized for most patients. Developing standard orders to instruct on what type, how much, and when medication should be given for pain or nausea will streamline care for the patients. Not only will nurses be able to respond faster because orders and medications are already present, but the patients’ needs will be addressed in a way the evidence shows is most effective.
Another role research plays in a Center of Excellence is the tracking of long-term outcomes. Collecting and analyzing data on the patients from before they enter and after completing the clinical pathway will show how well the Center of Excellence is able to treat patients who have come through the program. This data becomes especially important when attempting to earn designations from patient-interest groups and accrediting bodies. Outcome data also allows programs to benchmark themselves against others from around the country.
In order to create a unique patient and family experience, the Center of Excellence must stand out in terms of the professionalism, education, and customer service that is provided to everyone who enters the program. These behaviors will leave no doubt in the patient’s mind that they received their treatment at the best facility.
These components are necessary in developing a Center of Excellence. They all work toward the same goal -- creating an experience that meets the needs and exceeds the expectations of both the patient and family.
Timothy Czarnecki is continuum of care coordinator for Memorial Spine, a center of excellence for spine surgery.