My name is Megan. Good afternoon, everyone. Thank you for joining us today. My name is Megan Monahan, and I am a policy manager in NCQA's evaluation programs policy implementation department. I'm very excited to host today's conversation, which centers on how organizations can operationalize person centered outcomes to improve quality of care. NCQA is honored to host Veronica Burgess to discuss how person centered outcomes can be integrated into an organization's workflow using a three layer framework. Sharonica has a master of science in health administration from Virginia Commonwealth University, and she has more than eighteen years of health care industry experience, including previously here at NCQA. So welcome back, Sharonica. I'm glad we didn't scare you off. Sharonica is also the founder and principal of the Barcliffe Group, where she partners with health plans and provider organizations to design integrated quality operating systems that align NCQA accreditation, PEDIS measurement, and outcome based accountability. Sharonika's current work focuses on embedding person centered outcomes into existing governance and quality infrastructure, with the goal of eliminating duplicative workflows and strengthening payer provider collaboration. Sharonica, thank you so much for speaking with us today, and we are very excited to hear what you have to say. Thank you. Thank you, Megan. I'm very excited to be here. I'm hoping that my time, talent, and treasures over the past years would be a benefactor to everyone who's joining and who's endeavoring to actually put person centered outcomes at the epicenter of their organizations. So I am excited to get started. Alright. And I believe there's some Zoom housekeeping, in terms of questions. There's a q and a icon at the bottom that you can submit questions. Your question will be responded to someone live or one of the presenters or the moderating and host panel as well. So let's get started. So we'll be spending our time today going over the challenge, the framework, the client journey, the practical tool kit, and key takeaways. But before we can get to those elements and understanding what I call the wizard behind the curtain of how to embed person centered outcomes, we first have to define and understand the ecosystem. We are all a part of the health care ecosystem and consumers of health care in the past, present, and future. And so one of the main bedrock components of moving towards improvement in person centered care is understanding that it's not they, them. It's us. We go from what's in it for me to what's in it for us. So a person is not just an alphanumeric that you find in terms of your membership or on a member letter in the community you serve. They're actually human beings who are endeavoring to have the best quality of life. That could be a loved one. It could be a spouse. It could be a child, an elderly parent. It could be ourselves. And so once we have that paradigm shift of knowing that everyone has a desire to have the best life well lived and that we are part of the ecosystem and not above or below it, that's where we get the battery in our respective bags to drive and gear one of the some many of the components that we'll be speaking of today. So we're gonna take that perspective and the posture of this discussion today. While it is a live broadcast, what I hope and endeavor is that it's buffet style. Take what serves you and your organization and leave what doesn't. But my ultimate hope is that you leave belly full ready to drive meaningful impact in your organizations and have some type of tool kit and idea of how you're gonna do that, not just what. Alright? So the challenge. A lot of times, we know what we want to measure, but sometimes our processes are just fragmented. And so when we're speaking of person centered outcomes, we're speaking about we wanna get on the same definition of what we're speaking of. So, conversely, to quality or clinical measures, person centered measures incorporate the individual's voice. And to incorporate a voice is a very different stature than just a clinical measure of breast cancer screening or diabetes. Person centered outcomes are centered on things like health related quality of life, functional independence, personal satisfaction with care. And those outcomes shift the focus from just standard clinical checklist to what an individual defines as personal successful life and wellness goals. So when we think of quality of life, we're speaking of emotional well-being, reduced feelings of depression, anxiety, stress, overall sense of peace and happiness. Functional independence. I know we've all heard of ADLs, activities of daily living, regaining and maintaining ability to eat, dress, bathe, and move around independently. We are also speaking about personal goals achieved. Are they reaching self identified milestones, returning to working, driving, or managing personal hobbies? And we can even go into mobility improvements, walking faster, climbing stairs safely, reducing the physical need for assistance from family members. Care experience and personal choice, which is what I call the bedrock in terms of personal care outcomes, is decision making power. Having direct control over your personal schedule, living space choices, daily clothing and life plans, including your your practitioner care plan, trust and communication, reporting high satisfaction with how well doctors and practitioners listen. Do they explain conditions? Are they walking you through your care plan? Do you understand them? And respect for personal values. And another component, of this is treatment adherence, feeling confident and comfortable enough that I know my care plan and able to stick to whatever is involved, including medications, therapies, and that my voice is actually evoked in that process. So we get into the nut and bolts of things. Right? So you say, okay. We're here. We understand what person centered outcomes are. We understand the impact. We understand that we are part of this very sophisticated ecosystem. It's us, not they, them, not higher below. It's all centralized. So where do we start? I call it the trilogy. It is a three point framework, and so it incorporates governance, operations, and accountability. Now while this is a live broadcast, I can hear and sense some of you like, well, this isn't the eighth wonder of the world, Sharonica. You know, we've discussed this in our leadership meetings. It has matriculated down to our work group and committee meetings, and it still isn't working within our organization. Well, here's where I want to bring empirical and live experience to show not just what the framework is, but to walk through and define and how it can be used. That how is really important. So if we agree that person centered outcomes are the goal, right, the next question becomes, how do we actually operationalize it? In my experience, organizations don't struggle because they lack talented people. They struggle because the work is fragmented. And over the past fifteen years, I found the organizations that consistently perform outperform others have all three of these components, governance, operations, and accountability. So think of these less as three departments and more as three gears in the same operating system, working in tandem and singing from the same song sheet. Governance, where everything starts, the bedrock. And governance is misunderstood in committees, meetings, and approvals. That's not essentially those are components of government governance, but not essentially what it is. I actually believe governance is much simpler than that. It's simply how an organization decides what matters. It creates accountability, not bureaucracy. Governance doesn't create more meetings. It creates clarity, and that's what we wanna work towards. It answers questions like who owns the outcome, who makes decisions, how often do we review performance, and what happens when performance isn't improving. K? Measure what matters to people most that you serve. One of the biggest shifts happening across health care is moving beyond asking, did we deliver the service? That's bottom, not the ceiling. We need to move to asking, did this service improve the person's life? That is where person centered outcomes become powerful. Let's take a look at leadership because this is a very pertinent area that I get a lot of inquiry about, and it's one of the first conversations that we have when working with client partners. And now essentially say, leadership commitment turns strategy into outcomes. Culture follows leadership. This is central to moving forward. If executive leadership reviews person centered outcomes with the same discipline as financial performance, the entire organization changes. If leadership treats it as another project, everyone else will too. They will follow suit. So once leadership has established what matters, the next question becomes, how do we consistently execute it? And here's one of my favorite sections. It's operations. This just gets my gears going. Those three gears we were speaking of, operations is where strategy becomes reality. I often tell client partners strategy is only valuable when someone can execute it on Tuesday morning. Right? Is it executable? So we want to move from being executable to fixing the process, not the person. And this is one of the more passive components of operations because oftentimes you wanna say, okay. Well, said sorts and such person didn't do this, thus and so. We didn't meet our benchmarks, or we're not progressing. But let me give you a paradigm shift. Health care is full, and I'm sure your organizations are full of incredibly committed people. Most performing problems are not people problems. They're process problems. And design systems really shouldn't, what I call, depend on heroics. There shouldn't be any individual group committee or department colloquially diving on the sword to make meaningful improvement. So now everyone can sigh and silently take the cape off your backs because there's no one person that owns the entire progress or, forward movement in terms of embedding person centered outcomes. It is essentially a enterprise wide collaborative experience. Find the root cause, not the symptom. Many organizations spend enormous amounts of time fixing symptoms, another dashboard, another committee, another policy. But if the workflow itself broken, you'll continue to solve the same problem over and over again. And I think that meets the definition of insanity, and that's not what we want. Alignment and execution beats strategy alone, one of my favorite sayings. Alignment without execution is just an agreement. Right? Execution without alignment creates chaos. It's like planes flying in the air without air traffic control. No one synchronized. We aren't singing from the same song sheet, and it seems like we have movement. We're checking things off the checklist, but it's not giving that meaningful inertia and positive impact that we're endeavoring to have. So sustainable improvement requires both. Now we've decided what matters. We built the processes. There's one final piece, and that's accountability. And this is where organizations either sustain improvement or they slowly drift back to those old habits that we tucked away and tossed out. So we wanna own the outcome, not just the task. And I always encourage leadership and team members to stop asking, did we finish the project? Did did we hit the deadline? And instead ask, did the outcome actually improve? Those are two totally different conversations. Measure progress, adjust quickly. One thing that I've learned and picked up, during my season at NCQA was that the highest performing organizations do not typically wait until survey season to start to learn how they're doing. They're continuously reviewing performance and making adjustments in an iterative process, and that's one piece of accountability. That's one of the bedrocks moving forward. What gets measured gets improved, and it's analogous to, my nursing clinicians. What gets documented is what happened. If it wasn't documented, it didn't happen. So when we're thinking about what about measurement and improvement, measurement should exist to improve care, not just merely exist to satisfy accreditation. So dashboards aren't report cards. They're utilized to be decision making tools, which is a very different component. So bringing it all together, it's the integration of governance, operations, and accountability, which I call the trilogy, that drives transformation in organizations. And that's exactly what happened in the case study that I'm gonna share with you all today. They didn't implement another initiative. They redesigned how quality work happened across their enterprise. And once governance, operations, and accountability became connected, which I call singing from the same song sheet, person centered outcomes stopped being just another program or a tumultuous task or another initiative to carry out. They essentially became part of the organization's operating model, which is the core engine driving all things exterior. So everything I'm gonna show you in the client journey is simply these three pillars that brought everything to life. So that is the wizard behind the curtain that's that's driving person centered and blended. So let's take a look at the client journey. In our case study, I want to lead off that, this organization was a large regional integrated health plan. They had commercial Medicare and Medicaid lines of business and over one million members. And, again, their challenge, person centered outcomes were fragmented across departments. Leadership needed one aligned quality strategy. So what we did, our approach, governance redesign. And they were quite surprised to hear that this was the next step because often they heard, well, let's do a gap analysis, or let's move into getting into standards and elements and and looking at reports. But one of my first questions was, can you tell me your organizational structure and how you currently coordinate and work with one another? And that's how we began to have discussions about operational alignment, accountability frameworks, and putting things in place that made sense and was curated specifically for their organization, the goals they were trying to reach, and the population they were serving. So the impact was improved executive visibility. And the reason this is important is because when we think about stakeholders, stakeholders go go from our executive leadership down to the member patient that we're serving. Everyone is considered a stakeholder who is a benefactor or could be a detriment of how we're delivering health care services. So once we establish a broad scoped understanding of who the stakeholders are, that actually gave great insight to executive leadership on how to make the right decisions, appropriate decisions where they're in right. So with that insight, we standardized decision making across the department that came better alignment between clinical and operational systems that created a sustainable infrastructure and supporting ongoing improvement, and, of course, they did perform well on their NCQA survey. And before we move on, I do wanna take some time to emphasize that this process, when we speak about this case study, this took a measure of time. It was not an overnight sensation. This isn't a project or initiative or an endeavor that, could be done in a few months. This particular engagement took thirty months. It's about two and a half years. I know. I just felt that sensation come through. But, what I wanna emphasize is because in our Colorado microwave society, we download, we stream things immediately, and we wanna have instant gratification, instant results. When we're thinking about and endeavoring to actually move forward and catapult person centered outcomes, it is a labor of love and of sweat equity. It takes a measure of investment, not just financially and not just staff wise, but it takes investment in terms of, commitment from all stakeholders and investment of time. And another, piece about that is time includes being iterative. So during our two and a half years together working on this initiative, we had to go back and say, hey. This marker moved. We looked at key performance indicators. We had to choose which ones were important. We had to prioritize. There were times where we had to do what I call the Pareto principle, where twenty percent of our efforts would drive eighty percent of the positive impact that we're seeking to to attain. And all those conversations can take up to three to four months initially as we're as departments are starting to communicate one another, as executive leadership is actually being brought into the room and having conversations with other departments and clinical department ops, everyone is actually looking at the same dashboard, the same goals, and looking at how we wanna move forward. So that is the investment of time and the investment of sweat equity. K. So we're gonna spend a little bit of time on this, because I feel like we spoke about the trilogy, about the domains that were important. We spoke about the background context behind the organization that's being referenced, in this scenario. But let's really talk about results and impact. And one thing I always say to client partners is that accreditation or whatever regulatory endeavor that they're seeking isn't the outcome. It's just the validation. Right? The real outcome is a stronger organization that consistently delivers better care and better experiences for the people or population that it serves. So when we intentionally measure success across four dimensions in this example of results and impact, sustainable transformation helps in multiple levels, so not just clinical. And the reason I wanted to embed the clinical measures is to show that I understand, we understand, and the question is out there, will we have multiple initiatives of concurring at the same time? And they all can sing from the same song sheet, but not without governance, not without accountability, and not without operations. That trilogy is even more important to to see that through. So organizational alignment. Transformation always begins with alignment. So before we ever saw improvements in quality measures, we had to ensure the organization was moving in the same direction, and that's really speaking to the fragmentation of it all. So one of the most significant changes was we implemented an enterprise governance model. Now organizations come in many different sizes, many different levels of leadership and sovereignty. And so our first few months into the first year was understanding that sophisticated, and I use sophisticated intentionally, not tumultuous, because there's a different connotation that that comes off. Sophisticated hierarchy to understand who are the stakeholders, how do they communicate, and how we can bring everyone so we can be on board and make sure that the entire enterprise is successful. So rather than having multiple departments making independent quality decisions, leadership began to having a single government structure with shared priorities. And one thing that I want to emphasize about this component is that it wasn't a one and done. So there were times where they go back and say, hey. There's an initiative or a priority that needs to be incorporated. But the beautiful thing about that is they were had a seat at the table, and they were have a voice in terms of it. So there was intrinsic motivation when one department was able to come in and say, hey. This has been a priority for us over x, y, z, and we're able to contribute to this centralized enterprise governance structure. Next, we also established an executive quality dashboard. I call it well, it's RAG in project management, red, amber, green, but I call it stoplight. And the dashboard really isn't just another report card. It became what drove decisions as we met on a regular basis. If it was red, yellow, or green, it helped us to understand were we tracking in the right direction, were we regressing, where the components that need to be implemented, again, being an iterative process, having that indicator, and also viewing it not as a report card. Because when you come into a meeting and you see red all over your stoplight, it could make the environment or culture become, you know, tense. And so that's not what we want. So when we're coming to these these meetings and these organizations and trying to understand, these are decision making tools that helps us to navigate to get to our North Star. So with this organization having the amount of membership that they had, they were able, for the first time, executives, stakeholders, committees could see performance across all departments in one place. They were able to identify emerging trends earlier and make coordinated decisions instead of isolated ones. And so, again, the core principle is that not to operate in isolation, but in cohesion and have one governing structure to which we can then place operations and then have the accountability. So in totality, that is the power of governance. It creates organizational clarity. K? So once leadership began became aligned, operational excellence, it naturally followed. So this is where strategy became execution. One of the biggest, improvements was standardizing how performance was reviewed across the organization. There were several types of dashboards. Some were using Power BI. Others were Excel gurus. They loved to have their, metrics in Excel. And this can be different from your organization to the next, but for them, we decided on what that standardized performance component would be. So instead of every department evaluating quality differently, there was one consistent cadence, one decision making process, and one shared understanding of priorities. We also reduced the time between identifying a performance opportunity and implementing a performance action, And that's incredibly important because improving quality isn't just about identifying the gaps. Remember when we spoke about earlier gap analysis? It's about shortening the time between insight and thereafter action. And the the underbetter of that is being able to make decisions based off the stoplight and other tools that we're gonna share later. The faster an organization can learn and adapt, the greater their ability to improve outcomes. K. Quality metrics. Once governance and operations were aligned, we began seeing measurable improvements in traditional quality performance measures. For this organization, it was recommended to focus on two measures because they did have a lot of concurrent initiatives going on, and they saw an improvement of eleven percent in breast cancer screening and fourteen percent in blood pressure control. Now this is over the span of thirty months, so this wasn't in the first year or second year. Again, this is an iterative process. This is also embedded in terms of organizational alignment, operation, and person centered. So those improvements were a result of one intervention. So you can see how implementing a governing structure was able to have a positive impact on multiple tree branches of this organization. Essentially, better governance led to better execution, and better execution led to better clinical performance. K? And while those clinical measures were incredibly important, they still don't tell the entire story. And so there's one more section, which is why we're all here, and that's person centered results. So what excited me most about this engagement were the improvements in person centered outcomes. So patient activation increased by eighteen percent, meaning individuals became more engaged and confident in managing their own health. We also saw a twelve percent increase in shared decision making, reflecting stronger partnerships between patients and their care teams. So those are powerful indicators because they measure something beyond just clinical effectiveness. They're measuring whether people feel heard, informed, and empowered in their care, and that's exactly what person centered outcomes are intended to equate in CAPTCHA. So when we step back and look across these four categories, a pattern begins to emerge. We didn't start by trying to improve breast cancer screening. We didn't start by trying to increase patient activation. We started by redesigning how this enterprise worked. Governance became clearer. Operations became consistent. Accountability became ingratiated into everyday decision making. And so those organizational improvements ultimately over time translated to better clinical outcomes and better experience for people in the organization that they serve. So that's why I believe organizations shouldn't think about person centered outcomes just as in another initiative. They should think about them as, I would say, the natural result of a well well designed operating model. Organizations don't achieve better outcomes by chasing better metrics. They achieve better metrics by building better operating systems. And that is the secret sauce that I want to deliver to you all who are attending today. K? So we're going to take a look at a few tools, and these are templates, that are used. And to set the palette and take, give you a inside scoop, these are not the exact templates you have to use. You can tweak them and curate them to what works best in your respective organizations. They're meant to be the springboard to getting the conversation started around governance, around how do we get this going in our organization, and to get a a a catalytic component to moving forward. So let's see. So we'll start with our governance checklist. So we were speaking about earlier in terms of having those initial conversations, identifying stakeholders, what initiatives were important, do we apply the Pareto principle. So in this document, this is a very simple word checklist, not too sophisticated. It's just a very simple and what I call the dignity of simplicity of getting things moving within your organization. So it could have, who is the executive sponsor? Have they been identified? Have they been made aware that they're their is their executive sponsor? It has the status not started and progress complete and who is the owner. And one thing about this entire concept of the Trilogy framework, you will always have a space to designate who's the owner or who is the lead person to take on each respective component. Other things like governance charter and these don't have to be, again, sophisticated or complicated documents. It's just the initial catapult to understanding how do we currently work and how should we be working to achieve the goals that we've set out? Here's what I wanna highlight. Person centered outcomes define and align to strategic plan strategic plan. So that helps to have what are the organizations at the top that the leadership is speaking about. Does that map to each department? And, again, are we singing from the same song sheet in terms of how we're operating? Quality dashboard, data ownership, health equity. Again, this can be modified to what works for your organization, but it's a very handy tool and what I would recommend to start with, to get going in your respective organizations. So I have some more goodies. We'll take a look at workflow integration. So we spoke about earlier about not having more meetings, not having more reports, not having more, other ancillary pieces. What I love about this workflow integration canvas is that it is a waterfall component to the governance checklist. So once you have the governing checklist decided, you've had those conversations, you've established a meeting cadence that isn't a tumultuous or a countercurrent to how you're operating, this is where the rubber meets the road. This is where the prioritization comes out into mapping a plan, which is why it is called a canvas. What I like to to share about this is that it will change. It will evolve rather. So when we're thinking about our strategic priority, this is where we have all parties, in consensus in deciding these are our top three. One way that we use in the case study was, hey. Let's not try to tackle five measures across three lines of business. Why don't we synthesize this to say one or two? Again, what if our twenty percent of our efforts to get eighty and grab the low hanging fruit so that we can mobilize? Those are the types of discussions that should be had that should be had with this canvas. Your current workflow, your owner, key measure, whether that be HIE DIS, person centered, or CATS, and your review cadence. The last column is your improvement actions. And so I know there are a lot of techie folks on this call today, this session, and what I want to share is that these documents are in word or embody the dignity of simplicity for a reason. You can't, and I recommend once you have your governance, your operations, and your accountability structures in place to move these two, softwares that engage different components like AI, Asana, Power BI, Tableau, or, incorporating perplexity. But I would safeguard doing that before you have it mapped out and solidified because it'll introduce components to your process that may deter from getting that solid foundation, from getting everyone edified and comfortable. All those are major components that will help in the end in terms of moving forward. But one thing that I have done is for current workflow, sometimes if you have a SharePoint or you have some type of cloud, service provider or or dashboard, you can place a link to whatever your workflow or if there is a diagram or flow so that it's captured in the same place and that all parties, again, in its governing structure, could go to that one centralized place that they know is tried and true and the bedrock of truth to understand what is the current workflow, and then they have the insight of knowing what's to come. K? And I'm tracking time. Two thirty six. K? I have one more. If you can't tell, I love, love, love, this stuff. Okay. So, speaking of quality scorecards, this is just an example. I know that some of my client partners joining today are probably snickering because they've seen these little dots, these current status, these trend markers. I have different derivations of, that are utilized for each organization depending on, where they are in the process, where initiatives have been outlined. But as an example, you will list your strategic domain, your current status, and whether you're meeting twice a month, once a month, once a quarter, whatever cadence works for you, I would highly recommend using the same format. So you say, Veronica? Why is that important? Because as you're engaging multiple departments, you begin to communicate in the same language. That is how you get to sing from the same song sheet. So when leadership joins in, they're looking for an executive summary and something that is aesthetically pleasing to understand where we are, the cadence becomes familiar, and so they know what to expect. Committees, department staff, all parties know what to expect when they're coming into these, this cadence meeting and be able to, review and look at them in totality and be able to equate and discern what's needed, speaking points, and so forth. So some of the discussion prompts that I recommend are what is improving. Right? What is at risk? And you're able to see those by looking at the current status radio buttons. And then your trend column can say this is going up. It's moving forward. It's going down. Not so good. This is working well. What decisions are required today? It's a great one. What barriers require executive intervention? Again, engaging stakeholders and keeping them, engaged. What actions will be completed before the next review? And that all is contingent upon the cadence. But those are some executive discussion prompts that can be spoke about can speak about during your meetings. Alright. Let's see. So if you scan a QR code that's located on the phone, you can actually download the templates and use them at your respective organizations. Feel free to curate them for how you need them to be implemented, to prove to improve your cadence and and your outcomes. They are there for you to enjoy. And, I welcome the opportunity to, you know, continue the conversation. So, if you're thinking of ways and opportunities to engage your organization and just unsure of how, when, why, you can scan the QR code that you have there, the contact information to reach out to us. We would love to be of service and to help you with those initial discussions. And I'll turn it over to Megan for q and a. Oh, wow. Well, thank you, Sharonica. That was, that was an amazing presentation. Thank you. We I'd like to get started by just asking you a few questions, and then we'll move on to what's in the in the q and a chat from some of our participants. What are the biggest barriers that organizations face when trying to align quality strategy operations and outcome measurements? Great question. I like it. Thank you. You know, in reflection, we've spoken about it. The biggest barrier isn't usually a lack of commitment. It's fragmentation. You know? Most organizations already have talented people. They have good intentions, but those efforts often exist in parallel. You know, quality owns one initiative. Population health owns another. Care management owns another, and health equity may have its own governing structure. Right? So everyone is working hard, but not necessarily toward one integrated strategy. And so, in the case study, I hope that it came across that, you know, person centered outcomes are being measured in multiple departments using different definitions, different reporting structures, and different accountability mechanisms. So leadership had visibility into pieces of the picture, but not the whole. So in essence, it's fragmentation. Okay. So people working in silos, you could say. Exactly. Exactly. Okay. So in your experience, how can organizations ensure that executive leadership remains accountable for person centered outcomes rather than simply process compliance? You know, This requires, a paradigm shift and a question and a question of changing from one of the biggest mindset shifts is changing the questions they ask. So as an executive, you have different goals and different vantage points and different priorities. So for leadership, instead of asking, you know, did we complete the project? They should be asking, did the experience and outcomes for the people we serve actually improve? And we spoke about that in terms of their accountability structure. You know? Accountability becomes sustainable when outcomes, not activities, not just activities, are built in executive governance. You know? And so in our case study, we created an enterprise quality dashboard that allowed executives to see what's going on very quickly, not exhaustive, you know, Word documents and summaries and reports. It was a dashboard or scorecard they could look at very easily to see where the company was currently performing and where they were going. So when leadership reviews the same measures every month, they assign ownership and follow-up on action plans, accountability becomes part of the culture instead of something that only happens for an accreditation survey. Fantastic. And, obviously, as you know, here at NCQA, we're we're all about quality. It's not just about checking the boxes. It's That's right. More quality. I mean, we want we want good outcomes for patients and for everybody here, so that's fantastic. In your experience, what what governance structures are most critical for sustaining measure measurable health outcome improvement? I would say the most successful organizations build governance around decision making, not the reporting. Right? Governance should essentially answer three questions. Who owns the outcome? How will we measure success? And that's essentially how NCQA was was built. How do we measure health care? And what happens when performance isn't where we want it to be? Right? So that's essentially what I what I would recommend in terms of decision making, not just reporting. Okay. Thank you. You mentioned measure prop measure progress and adjust quickly. What are some practical examples of using real time performance data to improve outcomes? You know, one of my favorite quality improvement principles is that data shouldn't simply describe performance. It should drive the action. So when organizations receive, reports weeks or months after performance has already declined, by then, they're reacting instead of improving. You're behind the ball instead of engaging and having foresight. So, even in a case study with this engagement, leadership reviewed executive dashboards on a consistent cadence. Right? Immediately assuming proven actions were trends appeared. And so we can become proactive and not reactive, and that and that just comes from driving action rather than waiting for, you know, your annual accreditation or for your on-site or adjusting team workflows or getting some type of indicator that things aren't going well, executive visibility, decision making, and shorter cycles become the name of the game to be able to be agile is truly what it is, Megan, being agile. So you're saying that data data should be used. It's not an endpoint. It should be an endpoint. It should be an an ongoing process. Exactly. So when you receive your data, you should be able to discern the direction how you're performing, bump that against the goal. Are we reaching the goal? Are we going behind? And use that as a tool to make the next decision to get to where you wanna go in terms of your goals. Fantastic. So one last question from me, and then I think we're gonna open it up to the the q and a chat. So what does success look like when governance, accountability, and person centered outcomes are fully aligned? So a very easy question for you. I know. It's like, where do I start, though? It's easy, but it's like pulling everything out of Pandora's box. Like, okay. You know, Megan, success is when, you know, a regulatory audit or accreditation becomes a byproduct. It's not the objective. Right? You know, when client partners are able they stop preparing for surveys and just operate differently. You know? Leaders can see performance. Teams understand how their work contributes to organizational goals. Decisions become faster. Governance is clearer. Workflows, become standardized instead of duplicative. But if I had to choose one, Megan, just one, I would say, and most importantly, the people we serve experience better outcomes because policy is no longer just a separate initiative. It's actually embedded in how organizations function. Alright. Thank you. Alright. So we have a couple of questions from the chat in our LinkedIn Live. So our first live question today is, please describe or provide examples of how you standardize decision decision making across departments? I like that question because it goes back to that singular governance, and those discussions that are most often held passively. So when we're going when we're sitting down with stakeholders, we're discussing what are the enterprise's goals. From there, we're seeing what is in alignment and what isn't, and that comes by prioritization. After prioritization, you get to select your top two or three, right, that you're going to, take initiative and work on. And from there, that's where you get that unified plan that, and most often, we call it a work plan. But, work plan doesn't really embody the communication and the level of coordination that it takes. So I don't want anyone to leave this session today thinking that any of the tools that are presented by themselves stand alone would get them to having better person centered outcomes. That is not the truth. It takes iterative, agile conversations, ongoing, and being decisive. Okay. So we have another question from our chat. So you talked about the twenty percent level of work and then the eighty percent result. How do you decide what initiatives to prioritize within a large organization? Typically, those are discussed amongst all stakeholders. Right? And I can hear it and sense it. That's like herding cats, and sometimes it is. In fact, it is. The beginning conversations often do start that way. But when you put person centered outcomes at the core of those discussions, you become focused. Right? And with increased focus, you become decisive because you know how you're currently operating and where you're trying to go. So I always say there's always one or a few that have to be the focus partners. I call them the parliamentarians that keeps everyone on board to say, hey. We're speaking about purchasing our outcomes, and this is where we wanna go. So anything that's ancillary to that may not have the the the eighty percent impact. We need to focus on the twenty percent to get the eighty. Okay. So there there should be individuals accountable for this particular aspect of the work. Exactly. Exactly. K. So this is from our our friends on LinkedIn Live. Welcome, friends. Hi. When moving from strategy to culture, what are the most effective ways to break down silos between quality teams and clinical operations to ensure true alignment and execution? I love that question, and the simple answer is be sincere and authentic. At the essence of their question is trust, And that's why we began our session today saying we're not above or below the ecosystem. We coexist within it. And so once we have that paradigm shift, we understand, like, this is not what's in it for me. It's what's in it for us. And so when you gird and, interact with that type of paradigm shift, that posturing, you'll be amazed how conversations change, how environments and culture can start, but that does require change agents to be consistent and steadfast in having that posturing. Okay. So another question from our chat. They're going. I love it. They're they're with And what data points were utilized to determine an increase an increase in shared decision decision making? That's a good one. Shared decision making started from surveys. They were surveys not just electronic surveys, but there also were conversations that were being had between patient and practitioner. So they had to have a very coordinated and agreed upon cadence with their practitioners to say these are questions that were asked. And I'm glad that that question was, read because when we are going to our practitioners, sometimes we think of surveys as such concrete, you know, jot form, constructive surveys. And sometimes it's literary. Do you understand your care plan? Do you feel seen, heard, and understood? And then equating a one to five measure. So if I were going to my doctor, one of the components that we spoke about in this case study was, Sharonica, do you feel seen, heard, and understood on a scale from one to five? And those types of data points were matriculated to understand how they were ingratiating their health care. Takes effort, but it's worth it. Alright. Well, thank you. I think that is the end of our q and a. So, Veronica, before I wrap it up, are there do you have any closing thoughts for us? Thank you for having me, and engaging, and I'm just very excited for everyone who joined today because this is definitely a joint effort. If there are any questions or additional or wanting to continue the conversation again, thank you, NCQA, for always being the bedrock and initiator to continuing quality, ambassadorship. Thank you. Alright. Well, thank you again, Veronica. Thank you for such a thoughtful and insightful presentation. We we appreciate you taking the time to share this methodology with us. If you found today's session helpful, I encourage you to register to attend this year's Health Innovation Summit in Atlanta from October fourth through seventh. This year's conference will feature multiple days worth of sessions, including more content on person centered care, population health, and much more. So please be on the lookout for a ten percent off registration discount code in the follow-up email from today's call. And once again, thank you, Sharonica, and thank you everyone for joining us. Have a have a wonderful week, everyone. Fantastic.