The Center for Healthcare Analytics & Improvement (CHAI), created in 2024, strives to understand why health systems struggle to improve and develop programs to overcome those struggles.
Our Solution: The SPLICE Model
The Center seeks to develop training programs, collaboration efforts and recommend changes in the six key ingredients (SPLICE) needed to create improvement. SPLICE is an extension of Avedis Donabedian’s structure-process-outcome model and includes structure, process, leadership, insight, change and engagement. SPLICE is defined as connecting by interweaving strands. Similarly, improvement only results when all ingredients are appropriately included in the right measurements.
Structure
As an ingredient in improvement, structure requires a body that oversees these efforts, the people and their responsibilities. In the last 30 years, these structural components have exponentially expanded.
Process
The process of improvement uses data to inform change. This process uses key metrics presented to leaders and key stakeholders who determine interventions to implement and monitor the metrics' performance.
Leadership
Leadership can help drive improvement through their most important role; strengthening their organization's financial, operational, quality and safety performance, and making these improvements visible to the organization.
Insight
Insights in healthcare are defined as the specific reasons why one hospital’s performance differs from another's. To find these, dashboards and key data metrics should be analyzed, interpreted and discussed with leadership to help drive improvement interventions.
Change
Change needs time and resources to be effectively implemented. Once interventions are created to improve key measures, the teams in charge of leading these interventions need the support to successfully follow through.
Engagement
Creating sustainable change requires your team to be engaged with the improvement interventions. If leadership understands and embodies their role in improvement, then clinicians’ interest and engagement in improvement efforts grows.
Meet the Team
Angela Green, Ph.D., R.N.
Vice President of Quality and Safety, Johns Hopkins Health System
Joint Appointment with the Johns Hopkins University School of Nursing
Joint Appointment with the Johns Hopkins University School of Nursing
Diane O’Connor, M.B.A., C.P.H.Q.
Executive Director for Patient Safety and Quality, Johns Hopkins Medicine
Laura Winner, DrPH, R.N., B.S.N., M.B.A.
Senior Director Operational Excellence, Johns Hopkins Medicine
Jenna Swann
Senior Director of Regulatory Finance and Clinical Analytics, Johns Hopkins Medicine
Jennifer Bailey, R.N., M.S.
Vice President of Quality and Transformation, Johns Hopkins Medicine
Steve Meth, J.D., M.S.
Chief Patient Experience Officer, Johns Hopkins Medicine
Peter Hill, M.D.
Senior Vice President of Medical Affairs, Johns Hopkins Health System
David C. Stockwell, M.D., M.B.A.
Chief Medical Officer, Johns Hopkins Children's Center
Associate Professor of Anesthesiology and Critical Care Medicine and Pediatrics, The Johns Hopkins University School of Medicine
Cited Sources
Nelson EC, Batalden PB, Godfrey MM.. Quality by Design: A Clinical Microsystems Approach. Lebanon, NH: Center for the Evaluative Clinical Sciences at Dartmouth; Jossey-Bass/Wiley; 2007.
Donabedian A. The Definition of Quality and Approaches to its Assessment. Ann Arbor, MI: Health Administration Press; 1980.