The process of standardization is common practice in several industries, with its implementation in healthcare posing many, often unique, challenges. Perception with the different stakeholders varies widely and remains a major barrier. The Economist Intelligence Unit looked at recent literature how to overcome these challenges for the benefit of both patients and providers.
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Healthcare is a complex industry that needs to strike a balance between achieving consistency and catering to the variations in individual patient needs. Patients, providers, and payers typically have differing priorities, which can create tensions when implementing standardization programs. The Economist Intelligence Unit looked at the evidence base around standardization to evaluate its impact on hospital efficiency, cost-savings, and patient outcomes, and to ask who benefits from its implementation. They reviewed evidence for standardization regarding clinical care, workforce, information and communications technology (ICT), and procurement, in order to shine some light on where value accrues. Additionally, they gave recommendations how to overcome implementation challenges.
“Standardization programs can improve outcomes for both patients and providers.”
Replication frustration
Referred to as “replication frustration”, the struggle of taking results from standardization trials into clinical practice is not something that has gone unnoticed.[1] There are several factors which can influence success, ranging from attitudes of the workforce and the technologies and instruments a hospital may have at its disposal to cost restrictions. Replication challenges could also be due to study designs that are often highly specific and context-driven. Specifically, studies that investigated workforce, ICT or procurement standardization tended to be very context-specific or constructed with narrow aims in mind. And finally, one of the key barriers to successful implementation that local customization needs to address is resistance to change, at the heart of which is often the matter of perception.
“The word standardization is charged, and depending on who is asked the question, it will engender different, often emotional responses”.
Recommendations
Standardization goes to the heart of the challenge in reforming healthcare: achieving value without compromising patient outcomes. The review of recent literature provides evidence that standardization works, but only if implemented properly. In order to facilitate this, the authors suggest the following recommendations:
- Healthcare professionals respond to the language of evidence, so ensure that an evidence-based process is used to guide the standardization process, and describe it.
- Make sure local healthcare professionals are consulted as soon as possible and have the opportunity to take ownership.
- Focus on implementation and shared learnings. Authors should report not only the standardization protocol but also the implementation challenges and how they were overcome.
- Ideally, alongside a description of the standardization protocol, a local customization implementation guide should be provided.
- Future researchers should collect data on a range of outcomes that will be important to all stakeholders, including patients, payers; and providers.
- More and better-quality research is needed around ICT, workforce issues, and procurement.
