Center for Healthcare Analytics & Improvement

The Center for Healthcare Analytics & Improvement, created in 2024, strives to understand why health systems struggle to improve and develop programs to overcome those struggles.

The American Healthcare System's Current Problem

The American Healthcare System underperforms in both macro-system statistics such as life expectancy and micro-system statistics such as 30-day readmissions, all the while spending 40% + per capita more than every nation in 2021. Healthcare organizations and providers are not solely responsible for the performance in macro-system statistics, but shoulder greater responsibility for poorer results in micro-system statistics. Trends continually show a lack of improvement in financial, operational, quality, safety and patient satisfaction metrics. These data strongly suggest the need for improvement. The hospitals that find the elusive structure and process needed to result in much stronger performance will be the ones that thrive in the future healthcare state. 

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.


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.

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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.

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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.

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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.

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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.

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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.

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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

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Diane O’Connor, M.B.A.

Executive Director for Patient Safety and Quality, Johns Hopkins Medicine

Headshot of Diane O'Connor

Laura Winner, DrPH, R.N., B.S.N., M.B.A.

Senior Director Operational Excellence, Johns Hopkins Medicine

Laura Winner headshot

Jenna Swann

Senior Director of Regulatory Finance and Clinical Analytics, Johns Hopkins Medicine

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Jennifer Bailey, R.N., M.S.

Vice President of Quality and Transformation, Johns Hopkins Medicine

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Steve Meth, J.D., M.S.

Chief Patient Experience Officer, Johns Hopkins Medicine

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Peter Hill, M.D.

Senior Vice President of Medical Affairs, Johns Hopkins Health System

Peter Hill

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

David Christopher Stockwell, M.D., M.B.A.

Get Involved

We invite other health systems to join Johns Hopkins Medicine in all projects realizing that improvement is a team sport. Please contact Steve Meurer at [email protected] to learn more about how to join current projects.

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.