Rick van Pelt, M.D., M.B.A., chief clinical transformation officer at UAB Hospital in Alabama, is launching a startup company, PreciPS, based on his work helping front-line care teams take an active role in identifying and resolving operational challenges. He recently spoke with Healthcare Innovation about the concept behind PreciPS. 

Before working at UAB, van Pelt was Associate Clinical Principal with consulting firm The Chartis Group, where he led performance improvement initiatives with hospital systems in clinical system assessment and redesign. PreciPS was built on a methodology he has refined over years of working with care teams to improve performance, morale and patient care.

The program takes its name from the Precision Problem Solving methodology, an evolution of van Pelt’s original “3D Prioritization” approach, which focused on helping teams identify and prioritize challenges through a structured process of discovery, distillation and definition.

“It is based on an understanding that for most engagements, it doesn't matter if you have the perfect solution. If teams don't own it, when they're in conflict, they will not do it. This becomes an invitation for teams and organizations to really have profound shifts in how they problem-solve.”

PreciPS will commercialize the Precision Problem Solving methodology by developing a scalable web-based tool and training platform, which will enable health system teams to solve complex problems and create sustained, high-impact change.

Unlike traditional improvement models that begin with metrics or predefined standards, PreciPS starts by identifying front-line frustrations, issues and concerns related to their care environment. Teams share what matters most to them and what barriers they experience in delivering care. Then, the methodology guides participants toward identifying common themes, clarifying and prioritizing root causes and developing system-based solutions.

One example is a redesign of the UAB Acute Care Surgery and Trauma operations. The division’s 95-bed inpatient service, where a patient’s care was handed off to new teams every time they transferred from one unit to the next, disrupted continuity of care. Using Precision Problem Solving, the team shifted to an integrated coverage model, which enabled patients to be followed by the same care team from admission through discharge. “We were able to differentiate and solidify roles and responsibilities, so that when you were in a particular area or role, that was your role for the day, and you didn't have all these distractions,” explained van Pelt, who is a board-certified anesthesiologist.

The change reduced the average length of stay by 1.4 days and cut trauma diversion days by 79 percent to virtually zero, with continued gains in quality outcomes. “With all the redesign that we did, and with the leadership saying, yes, we want to do this, basically all of the metrics that one would say matter shifted dramatically,” van Pelt said. “They increased their throughput by almost 60 patients a month and I think it's even higher now. So they are seeing 4,000 more patients per year than they were before we started on the same footprint, with no additional beds.”

Besides fixing clinical care issues, this work has an impact on clinician well-being, van Pelt said. “We have statistically significant data to support that the inclusivity and the ‘team-ness’ that comes from the process of solving problems collaboratively” has an impact on well-being, he said. “It’s not to diminish the support services that help with burnout, but this is an approach that says you can identify the problems that are bothering you and then be part of the solution.”

Van Pelt had help on developing the business model from the Harbert Institute for Innovation and Entrepreneurship at UAB. The company has completed licensing, formed an LLC and is focused on developing the core technology application.

Now van Pelt is looking for investors. “The team that I need for PreciPS to be successful needs to be trained. I have my clinical transformation office at UAB, which is a great resource. I look at UAB as a phenomenal laboratory that I want to try to stay connected with, but I have to get funding to be able to hire that initial consulting and advisory team."

He spoke about how he envisions other health systems using the platform. Healthcare is a conservative environment, and there are a lot of people out there saying they can help you solve your problems, he noted. “We’ve got to come in and do a pilot with with an organization in an area that has a high return, show what we do, and have the tools available that they can see impact with.”

Based on that, a percentage of them will want to train teams, he said. “Then we have a platform that is simple, user-friendly and accessible.” 

He said it will help if the health systems create a clinical transformation office structure within their organization similar to the one he built at UAB. “Based on that, it becomes progressively less engagement on our part — moving from co-management to advisory to support. What we want to have is this AI-enabled platform that has not just the 3D prioritization tools, but other tools that are not overly complicated and a teaching methodology for facilitation and other elements that ultimately become a sustainable resource platform for organizations to continue to do the work.”