Honoring 5 years of lab-enabled healthcare excellence

Now in its sixth year, the UNIVANTS of Healthcare Excellence awards spotlight transformations in which clinical laboratories play an integral role. After reviewing more than 75 best practices that received program recognition through year 5, two experts involved with UNIVANTS have gleaned important insights, which they will share at ADLM 2025 (formerly the AACC Annual Scientific Meeting & Clinical Lab Expo) in Chicago on July 29.

The UNIVANTS of Healthcare Excellence program is a partnership among eight organizations: the Association for Diagnostics & Laboratory Medicine (ADLM, formerly AACC), Abbott, Modern Healthcare, the International Federation of Clinical Chemistry, the European Health Management Association, Modern Healthcare, the National Association for Healthcare Quality, and the Institute of Health Economics. With a name that combines the terms “unify” and “avant-garde,” UNIVANTS recognizes health-centered teams that collaborate across disciplines, transforming healthcare delivery and improving patients’ lives.

Applications to the program must describe laboratory-enabled best practices that have been implemented into clinical care. They also must include at least one key performance indicator (KPI) supporting improvement for each of the following stakeholder groups: patients, clinicians, health systems and administrations, and payers. While UNIVANTS requires applicants to involve a minimum of three disciplines in their best practice, the program often gives its highest ratings to initiatives that incorporate at least five disciplines, including laboratory medicine and pathology. Each application is reviewed by at least seven judges, and all judges are selected by the partnering organizations.

This article captures insights from Christine Schmotzer, MD, pathologist-in-chief and executive vice chair at University Hospitals in Cleveland, and Tricia Ravalico, executive lead for UNIVANTS and global director of scientific leadership and education at Abbott. Schmotzer is a member of a recognized care team and has independently also served as a judge.

Enhanced quality

The quality of metrics has improved since UNIVANTS began in 2020, according to Schmotzer and Ravalico. Being able to measure the impact that a best practice has on patient care, clinicians, health systems, and payers is a key component of truly transformational best practices, they noted.

“It’s not enough to have good ideas. The program requires implementation and assessment of impact,” said Schmotzer. “It’s often a challenge for labs to measure impact on out-of-laboratory stakeholders. One of the things we will share in our session at ADLM 2025 are examples of how people have designed and implemented collaborative work and determined measurable outcomes that they can share.”

Schmotzer also noted that the number of applications — and the diversity of the teams they reflect — has increased since the awards program began. Recent best practices have addressed a variety of healthcare challenges, from improving access to testing for sexually transmitted diseases to enhancing screening for liver disease.

Initiatives that are recognized by UNIVANTS aren’t necessarily complicated or “lofty,” said Schmotzer, adding that there is important work to be done on what some might consider basic lab testing, such as testing for glucose or sodium.

“Often people underestimate the significance of what they do because it seems simplistic,” she said. “A winning best practice doesn’t have to involve creating or implementing fancy new tests. Rather, it might involve improving the way that testing is currently done.”

Ravalico agrees. “You don't necessarily need 'sexy' or 'new' things to drive transformational change,” she added.

In fact, only about 25% of the best practices recognized by UNIVANTS involve a new test. Process changes — which optimize the tools currently available — represent about 50% of the award-winning initiatives. Algorithms account for less than a fifth of the best practices recognized.

Enhanced KPIs

Just as teams have improved over the last 5 years, so too have KPIs, according to Ravalico. In particular, the number of KPIs associated with patients — both quantitative and qualitative — has significantly surpassed the total number of KPIs associated with clinicians, health systems, or payers. In addition, KPIs associated with patients were notably diverse, falling into 29 unique categories.

“This highlights the fact that laboratory medicine has a true and powerful connection to patient care,” said Ravalico.

While KPIs associated with patients have been robust in award-winning best practices, benefits that link lab medicine to payers appear to be the most difficult to quantify, said Ravalico.

The absence of a valid payer metric is consistently among the most prevalent reasons for program ineligibility. In year 5 alone, 72% of the submitted applications that did not receive subsequent recognition failed to fulfill the minimum criterion of a quantitative or qualitative measure of change for the payer stakeholders.

“A consistent trend across all 15 best practices with top elite honors associated with UNIVANTS shows that downstream payer benefits far exceed the cost of laboratory testing, particularly when core laboratories are proactively involved as an integrated discipline for problem solving around an unmet need,” said Ravalico.

Another challenge is measuring improvement in KPIs related to clinicians. Providers’ appreciation of laboratory medicine may be caught in a chicken-and-egg conundrum: Laboratory results are not directly correlated with health outcomes despite being integral components of the clinical decision-making process that drives diagnosis and treatment, said Ravalico.

“If clinicians are the hardest stakeholder for quantifying the value of lab-enabled best practices and they are the direct recipients of insights from the lab, how do we change that paradigm?” asked Ravalico. “More can be done in this area.”

Evolving areas of focus

In the first 5 years of UNIVANTS, clinical care initiatives that focused on cardiology and infectious disease, including COVID-19, represented almost half of the award winners. Also represented, although to a lesser extent, were best practices related to women’s health, oncology, diabetes, kidney disease, liver disease, prenatal care, trauma, sepsis, endocrine disorders, neurology, and substance use disorder.

The absence of best practices across other disease areas is not necessarily indicative of a lack of value or excellence in laboratory-enabled best practices. It is more likely attributable to gaps in program awareness, said Ravalico.

For future applicants, opportunities abound for best practices in transfusion medicine, respiratory medicine, and anatomic pathology, added Schmotzer. Both Schmotzer and Ravalico would like to see more best practices involving algorithms and digital health solutions.

Setting up for success

To improve a team’s chances of having a successful initiative, project leaders should be sure to choose the right stakeholder partners, advised Schmotzer. For example, initiatives trying to track financial outcomes should involve someone from the finance department in their organization.

“I have seen initiatives fail in the real world because they didn’t have the right people involved,” she said. “Choose your partners well and choose them early.”

While laboratory medicine must be a part of the interdisciplinary team to qualify for UNIVANTS, labs do not have to initiate the projects, added Ravalico. Of course, when clinical laboratory professionals strategically collaborate with physicians and other stakeholders in proactive and crossdisciplinary ways, healthcare teams tend to have exceptional outcomes; this, in turn, makes them more likely to achieve high levels of recognition through the program, she explained.

“By contrast, clinical care initiatives derived within the laboratory, without substantial out-of-laboratory collaboration, tend to achieve lower levels of award recognition,” said Ravalico. Physician-led, integrated clinical care initiatives account for a relatively small amount of the total recognized best practices, but they constitute more than 73% of the top winners.

To learn more lessons from the first 5 years of UNIVANTS, attend the July 29 session presented by Schmotzer and Ravalico. Their session, which will be held from 4:30-6 p.m. U.S. Central Daylight Time in the Grand Ballroom of McCormick Place Convention Center, is designed to maximize insights learned from the program. They hope to inspire and empower lab-enabled healthcare teams to lead best practices, measure outcomes, and, ideally, achieve global recognition for their exceptional efforts. More information about UNIVANTS can be found at www.univantshce.com.

Kimberly Scott is a freelance writer who lives in Lewes, Delaware. +Email: [email protected]