Is a Medical Writer the Missing Accelerant to Your Outcome Improvement Efforts?

Is a Medical Writer the
Missing Accelerant to
Your Outcome
Improvement Efforts?
Kirstin Scott
Tracy Vayo

© 2018 Health Catalyst
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
As healthcare organizations pursue greater
efficiency and shift focus from volume to
value, quality improvement efforts are more
important than ever.
If improvement efforts are poorly managed
or executed, projects can easily stall out
and take up valuable time, money, and
resources, while returning little in the way
of results.
Enhancing Outcome Improvements

To combat this, Health Catalyst recommends
a Seven Guiding Questions Framework for
Outcomes Improvement.
This framework leverages the Three
Systems: the systematic integration of
analytics, best practices, and adoption
functions to drive transformation in
healthcare.
However, even improvement efforts that
have the right people, processes, and
technology in place can struggle to make
sufficient progress.

Cross-functional teams, while vitally important,
take time to reach a shared understanding
because of their varied backgrounds, frames of
reference, and even vocabularies about why
and how to tackle specific improvement projects.
Improvement teams can struggle to identify and
select manageable chunks of work to focus on.
Momentum slows and enthusiasm evaporates.

What is the improvement team missing that
can help speed time to adoption and value?
A medical writer with healthcare knowledge
and strong information design skills may
be the missing accelerant to outcomes
improvement.

Medical writers with the right skills can fill an
invaluable role on healthcare improvement teams.
They can help teams investigate the problem,
standardize processes to address and
measure progress, and unite best practice,
analytics, and adoption systems to drive
improvement.
Functions a Medical Writer Can Fulfill
and Why They Matter

Mike Noke, Senior Vice President of Professional
Services at Health Catalyst, said about working
with writers in this setting,
When working in complex healthcare environments,
relevant and clear communication and documentation
is essential, but requires a skillset often not inherently
found on clinical and technical teams. Medical writers
combine healthcare domain awareness with effective
communication skills that assist in articulating the
intent, the methods, and value of improvement
teams so that these may be more broadly understood
and leveraged.”
and Why They Matter

So, what exactly can a medical writer in
this setting do?
Here are four skills that a writer with strong
information design skills brings to an
improvement team:
Synthesizing and summarizing massive
volumes of information.
Integrating different types of information
in simple, often visual ways.
Facilitating the discussions of an
improvement team.
Positioning the team for standardization
and collaboration.
and Why They Matter
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Synthesizing and summarizing massive volumes of information
and Why They Matter
For example, many diabetes guidelines
are long, complex documents with
hundreds of recommended practices.
In an effort to standardize processes for
improvement, a writer can boil down and
organize the material in a way that helps
teams know where to start.

Integrating different types of information in simple, often visual ways
and Why They Matter
This helps everyone get on the same page
by showing the connections between
technical, strategic, clinical, operational,
and financial issues and concerns.

Facilitating the discussions of an improvement team
and Why They Matter
Writers can help teams with rapid cycle drafts
and reviews, a problem-solving model used for
improving a process or carrying out change.
Facilitating this process helps build
engagement and buy-in and facilitates
effective change management.

Positioning the team for standardization and collaboration
and Why They Matter
Writers are often instrumental in developing
“tools for transformation”—checklists, order
sets, process flow posters—materials that
encapsulate standard practices and make it
easy for people to collaborate and adopt the
newly designed way of working.

Examples of Output of Medical Writers
in a Healthcare Setting
The unique skill set of medical writers/information
designers in the healthcare domain is best
illustrated with specific examples from their
work on improvement teams, specifically:
Synthesizing and Integrating Information
Facilitating Discussions
Positioning the Team for Standardization
and Collaboration
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Writers can create artifacts that helps answer
questions such as:
• What does a work process look like?
• What are the most important best practices?
• For the greatest positive impact, where should
we measure and manage?
An example of this is the CAUTI Prevention
Care Process Improvement Map shown on
the next slide in Figure 1.

Figure 1: A CAUTI Care Process Improvement Map is a good example
of how information designers synthesize information.

The care map draws on multiple source documents:
• clinical guidelines
• systematic reviews
• meta-analyses
• cohort and cross-sectional studies
This helps to orient team members to the scope
of a care process, the major outcomes it affects,
and the application metrics that support work
in this area of care.

Overlaying analytics, improvement opportunities,
and clinical practice in a single, simple visual, the
map communicates across disciplines—helping
data experts, administrators, and clinicians get
on the same page.
This accelerates quality improvement
around the care process.

As writers document the improvement teams’ work
and plans through iterative drafts and reviews, they
can use plain language to help people focus (and
re-focus) on what matters most.
• Does the team understand the problem?
• Do they know what to change?
• Are the changes resulting in improvement?

Writers can also absorb and reflect the
concerns of the multidisciplinary team
members to create materials that
support change.
What do stakeholders need to know in
order to act?
Figure 2 shows a page from the
handbook Implementing Governance
for Outcomes Improvement.
Figure 2: This page from the handbook “Implementing
Governance for Outcomes Improvement” suggests how
medical writers can help teams manage complex ideas.

To develop the handbook on governance,
writers worked with subject matter experts
(SMEs) from a range of backgrounds.
They organized the copious amount of input
from SMEs, including anecdotes, research,
and recommendations, and, in an iterative
process, developed a set of actionable steps
applicable to any organization.

Just as in client organizations that work with
writers, the Health Catalyst team found that the
shared development work powerfully engaged
team members and helped them become more
knowledgeable and empowered—and ultimately
led them to become effective champions of our
organization’s approach to governance.

Positioning the Team for Standardization and Collaboration
Writers can devise presentation modes that help
teams negotiate a common tension in
improvement work:
How can we drive standardization and improve
reliability while allowing for warranted variation
and pragmatic innovation?”
The blueprint shown in Figure 3 is a good
example of writers’ information design
abilities to do this.

Figure 3: A blueprint created by writers that helped set the table for future improvement work.
This blueprint records an
organization’s experience with
digital innovation, centered on
its key activities and including
lessons learned along the way.
The complete blueprint covers
several dimensions and levels
of detail of the organization’s
transformation and provides
supporting artifacts that give
project details, examples, and
tools.
Ultimately, all the information in
a blueprint will be searchable
and filterable by different users.

The blueprint has a narrative structure that is
broken into phases and discrete steps.
The goal being to demonstrate the value of
new technology and make it easier, quicker,
and cheaper to replicate the innovation while
avoiding the “one-size-fits-all” prescriptiveness
that would likely generate resistance.

What Skills Does a Medical Writer Need
in a Healthcare Environment?
Writers may not have the same clinical or
technical expertise as domain experts, but
they possess many soft skills, like the ones
described in Liz Wiseman’s book,
“Rookie Smarts: Why Learning Beats
Knowing in the New Game of Work.”
One of the major tenets of the book is that
experience can sometimes be a hindrance
when it comes to collaborative thinking
about complex problems.
It’s this precise ability that writers bring to
the table for improvement teams.

What Skills Does a Medical Writer Need
in a Healthcare Environment?
Other important skills for writers in this space include:
Writing
Research
Interpersonal skills
Visual thinking
Curiosity
Commitment to the cause
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Finding This Unique Skill Set
in the Organization
Where does an organization find someone with this skill set?
While a medical writer may have past
experience in medical or technical
writing or communications, the right
person for this role could already be
part of the organization.
Look for the skills above, especially the
soft skills described in Wiseman’s book.
To be successful in this niche area,
a writer must possess a unique skill
set not often found on clinical or
technical teams.

A Missing Piece of the Puzzle
The skill set writers/information designers
bring to the table can help speed the work
of improvement teams, by:
• Helping teams identify manageable task
• Articulating the process
• Creating visual artifacts to improve
and clarify communication.
Additionally, they can help communicate
the value of improvement teams to a larger
audience and speed future improvement
projects by creating tools for transformation
that can be used again.

Dr. David Burton, former senior vice president of
Intermountain Healthcare and founding CEO of
Intermountain’s managed care plan, SelectHealth,
is a big proponent of having medical writers on
improvement teams. He said,
Writers are a catalyst to help clinicians,
administrators, financial and technical experts
digest into words and visual images the process
by which healthcare is made available and
provided to members and patients of healthcare
systems. They are an extremely important
catalyst to process improvement.”

Ultimately, adding the role of a medical writer and
information designer to an improvement team will
help keep teams focused and engaged in order to
speed improvement work.

For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

More about this topic
Link to original article for a more in-depth discussion.
Is a Medical Writer the Missing Accelerant to Your Outcome Improvement Efforts?
Healthcare Project Management Techniques: A Pragmatic Approach to Outcomes Improvement
Curt Sellk , Client Engagement, Sr. Director
How to Achieve Your Clinical Data Analytics Goals – Elaine St. James, BSN, RN, CPHQ , Patient Safety Services
Josh Ferguson APRN, ACNP, ANP-BC, VP of Clinical Outcomes Improvement
Nancy Casazza, BSN, MMI, RN, Clinical Outcomes Improvement, Director
The Top Seven Healthcare Outcome Measures and Three Measurement Essentials
Ann Tinker, MSN, RN, Professional Services, Sr. VP
Healthcare Data Management: Three Principles of Using Data to Its Full Potential
Sean Whitaker
How to Run Your Healthcare Analytics Operation Like a Business
Dan LeSueur, Sr. VP of Professional Services

Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Kirstin has a background in instructional design. She began work at Health Catalyst in 2014
after 12 years as a medical writer at Intermountain Healthcare. There she worked primarily
with Women and Newborns and Pediatric Specialty Clinical Programs.
Kirstin Scott
Tracy joined Health Catalyst in 2014 as Director of Knowledge Development, bringing over
25 years of experience in various facets of healthcare and clinical writing and education.
Immediately prior to her work at Health Catalyst, Tracy spent nearly 13 years directing the
efforts of a clinical publication team at Intermountain Healthcare – creating innovative care
process models, patient education, and implementation tools for clinical best practice
improvement. Prior to that she directed multidisciplinary education programs at Primary Children’s
Hospital and created and managed cardiac rehabilitation and wellness programs for several hospital
systems. Tracy holds a Master’s degree in clinical exercise science and a Bachelor’s degree in health
education with a communications emphasis.
Tracy Vayo

Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Health Catalyst is a mission-driven data warehousing, analytics and outcomes-improvement company
that helps healthcare organizations of all sizes improve clinical, financial, and operational outcomes
needed to improve population health and accountable care. Our proven enterprise data warehouse
(EDW) and analytics platform helps improve quality, add efficiency and lower costs in support of more
than 65 million patients for organizations ranging from the largest US health system to forward-thinking
physician practices.
Health Catalyst was recently named as the leader in the enterprise healthcare BI market in
improvement by KLAS, and has received numerous best-place-to work awards including Modern
Healthcare in 2013, 2014, and 2015, as well as other recognitions such as “Best Place to work for
Millenials, and a “Best Perks for Women.”

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