Center for Improvement in Healthcare Quality Newsletter
April 2022

CIHQ-ARS Article

CIHQ Presents an Interview with Partner, Prista Corporation Part 2 of 2

Don Jarrell and Billie Anne Schoppman, Prista Corp.
In March, we met Don Jarrell and Billie Anne Schoppman of Prista Corp. They discussed the initiative to develop ActionCue CI and how hospitals and facilities have benefitted through their 10 years in business. Read Part 1
Billie Anne: We discussed how ActionCue CI is easy to use, was efficient and provided a collaborative, insightful and effective solution for chief quality officers and risk managers. Our platform focuses on data collection, reporting, getting actionable insights from information, and tracking performance improvement actions. But it leaves the details of improvement and change strictly to manual and human efforts. There’s a vast difference.
Don: One of the biggest changes we have seen is that by introducing this performance improvement workbench, the return on investment is occurring for them. We are going to save them time and give them the ability to improve how they use the ‘extra’ time.
Billie Anne: It’s all about performance improvement. It’s about fixing things.
Don: That’s an additional effect in why we are rolling up to the c-suite. Previously all these separate functions were looking for department-level solutions. We drive the data into this performance workbench. ActionCue CI is an enterprise level solution, and that is a shift in the minds of potential buyers.
Billie Anne: I said before, quality is quality, it’s a workflow. If they want to find where a particular piece of information or performance measure was derived from, you get a reading and see that something is critically underperforming. It’s easy to find out the exact details and what has been done to improve that performance measure. There is a natural progression from seeing the initial number, the comparison to its benchmark, and the details of a PI plan. We believe in being proactive; ActionCue CI can help do that. The information is always right there.
There are also improved financials; the ROI is easy to identify because they are tracking events. Consider safety events that are nationally reported from an expense perspective. How much do they cost? If you have one infection, this, (x) is (on average), is what it is going to cost you. It is also going to cost you to improve it, and we track both. ActionCue CI looks at processes for evaluating return on investment, so it is happening all the time.
Don: We structured the application with administrative controls. Many companies in the industry will rely on customization. We understand that as time goes on, the setting, environment, and size of the operation is going to change. Revisit our blog about the Gift That Keeps on Costing. For any application, there is a mental image of what the app is and how it needs to function. When the application does not cause the user pain, they engage much more effectively. That’s one way it pays off and was a part of the fundamental design. That makes us different from our competitors. Easy to get going = low ‘Total Cost of Ownership” = great ROI.
Billie Anne: The chief quality officers, risk managers, or compliance officers are our first contact at the organization. They’re in the most evolved positions, responsible and accountable and can give us the most information about their current processes, what their pain is, and what they are looking for. We are able to filter that information and identify the need. We don’t just sell software… If they don’t have pain, there will be minimal adoption for multiple reasons. Many times, while department managers are the ones using Action Cue CI the most, these are not the high-level decision makers. Action Cue CI facilitates them getting their job done more efficiently and the information into the hands of the decision makers.
Don: Whoever our initial contact is through (a middle manager or CEO), we want to get them both involved. The department manager has a department level budget, but we are talking about an enterprise application, and will need higher levels of budgetary decision making. However, the department managers or CNO can best articulate the pain of the organization. They become our contact; we want validation that department managers are getting their functional needs satisfied. It makes for an interesting decision-making process, but steers toward collaboration they may not have experienced before - up and down the ladder. Our business model and contracting process also makes these decisions easier.
Billie Anne: I am the last step in the buyer’s journey, adding a personal touch with the deep dive into ActionCue CI. I show them what day-to-day processes will look like and how the platform is going to help them. “The PI committee meetings are going to become more efficient; it only took me 15 minutes to get ready! We actually work. We became a working committee and we’re fixing things!” and “My Infection Control nurse is going to love this” are common reactions. There are always ‘wow’ moments. We also get feedback about enhancements, ‘Can it do this?’ Well, that’s a really good idea. We try to turn things around right away, so by the time they’ve signed the contract and they’re up and running, they might have the enhancements they asked for. That’s phenomenal.
Our contracting process makes us very different. We do not have long term contracts or additional fees for maintenance, and there is no buy out clause. Prista ActionCue CI is not a capital budget item, there is a simple month-to-month subscription fee. If you decide to not work with Prista any longer, we ask for 90 days’ notice to gather and provide your data. Our cost is near what hospitals pay for in paper… that makes the sales process at the end a little easier, too.
Don: Take Childress Regional Medical Center as a case study in ROI practicality. It’s not just financial and medical errors that save this much money. Childress looked at a process that wasn’t working right, so they drilled down into each step in the process and made multiple changes. They were able to reduce the cost of hazardous material expense but also improve an inefficient process - keeping track of this or printing this and doing this - was resolved. This is relevant. Clients say, “Things that may have been going on for a long time, but we didn’t realize it. ActionCue CI pointed it out to us because we started tracking it. Now we can focus on things that NEED to be done.” It’s almost impossible to put a dollar amount when people tell us we have made their lives easier, more efficient, and stopped doing the inefficient things they hated to do.
Don: It becomes a change that you realize over time. You don’t fire three people when you get ActionCue CI, but you can rearrange the human resources you have. Clinical managers spend less time wrestling with data, chasing unfulfilled reports or unrealized steps in a workflow process, and creating reports ahead of a board meeting. It’s easy enough for users to carry out the steps, and there is built-in monitoring to see who has not checked in on reports that they need to contribute to. Managers can see which monthly data obligations are late, and those users get notified.
Billie Anne was saying these efficiencies set in sometimes unconsciously. When facilities sit back and say, “This year we did (x) and it was so much easier, and less costly, for the hospital than what we were doing last year.” Consider that real dollar returns on investment are saved in time and efficiency.
In the evening reports, consider adverse events a hospital does not want to happen at all or as limited a number as possible. When adverse events begin racking up costs through insurance claims, increased insurance premiums, legal expenses, and/or providing uncompensated care for someone harmed by something in the hospital… These adverse events have a cost on the organization from multiple sides. We provide a means for helping them understand net real dollar financial improvements because the changes they make will have cost. They are leaping over a lot of human analytical work and getting them to the insights they need. Compare those to the reduced cost of adverse events. By eliminating or reducing adverse events, there are many ways getting ahead of them help costs go down.
Billie Anne: We adjusted Prista’s direction by immediately creating and implementing a tool for tracking vaccines. This tool was extremely helpful to put staff into a worksheet. They can pull metrics - what percentage of my employees are vaccinated, How many refused, how many had contraindications… with the click of a button. The pandemic was also a disaster… ActionCue CI includes disasters as a performance measure with an improvement plan that you have to track. We helped many of our facilities create and document everything during that disaster. Sometimes it was daily, sometimes weekly, but they had to track supply chain, employees, testing, re-testing… everything. ActionCue CI allowed them to have it in one place, organized for surveyors or the state. The pandemic also identified many opportunities for improvement. “We don’t have this in place very well.” or “We are not meeting the best processes.” They were able to make changes, which was very helpful.
Billie Anne: During that period of time, we found that hospitals were way too busy to do anything other than COVID. We tried to provide for them without bothering them or requiring all of their time. We did some writing and sent out educational documents. We audited the application for them, helped them fix things, encouraged things, and reminded them to not forget certain aspects that must be kept up. We tried to support them and not demand that they be available; I think that was appreciated. We went through a year without losing anyone, aside from a client that was bought out. They were all willing to stay on and saw the value of having this information even though they were not reporting it like they wanted to. The only thing they were reporting was COVID but knew ActionCue CI was still going to be of value.
Don: The pandemic also brought a sublime recognition of improvements - back to fundamentals and doing business - in a different way. When staff were getting sick, clinical managers had to get involved in patient care and had less time for normal administrative duties. Many non-patient care delivery people were also staying home, and it was difficult to work around meetings where information was exchanged, and collaboration was based. There was less time wrestling with data, and it didn’t suffer entirely even though nurse managers were providing care.
Most people in healthcare have a lot of work to do and it needs to be done efficiently, with fewer people and less reliance on face to face. These meetings were essentially a no-no for a variety of reasons, so they are recognizing that our model, the functionality and workflow modes are better.
Billie Anne: It was helpful for executives because everything is in a virtual, dynamic dashboard. They can be anywhere, and so can ActionCue CI. We now have many medical directors and governing boards that are users now. They can see information in real time, not 3 or 6 months later - or never if they do not go to the committee meeting. It’s right on the desktop, and they can even see many reports on their phones. Given the scope and depth of the application, organizations get feedback from their involved and engaged governing boards because they know what is going on. This is a tremendous efficiency, because the governing board is ultimately responsible for quality, but historically are the last ones to find out.
Billie Anne: Speaking of engaged and involved, our relationship with CIHQ started years ago. I have a direct relationship with the owners. We worked together in the same organizations and promoted each other, and recently decided to solidify our partnership again. We have a lot in common and I have recommended several clients that have signed on with CIHQ. Our educational focus aligns.
Don: We were intrigued that CIHQ was so engaged with their clients on the same kinds of improvements that we were. It’s more than being an exhibitor at their Summit; they really wanted to understand what we did for our customers. We find so many connecting points there, and it is a strong relationship.

Author Bio:
LinkedinPrista Corporation
LinkedinDon Jarrell
LinkedinBillie Anne Schoppman