As described in Part I, the theme of the 2013 ACHE Congress was “Changing Healthcare Design.” My reason for writing What I Learned from ACHE Congress, Part II is to share insights with those who did not attend this year’s session.
I. Innovation: Hot Topic Session with Dr. Molly J. Coye,
Chief Innovation Officer, UCLA Health System
Using a 7-step framework, Dr. Coye pointed out the importance of tying innovation to strategy:
- Define the opportunity to accelerate what strategy?
- Design the innovation to answer how would it function?
- Charter the innovation to obtain commitment from the executive ranks
- Pilot the innovation and build a prototype
- Deploy the innovation
- Evaluate the innovation and test its impact
- Disseminate the innovation and exchange learning
III. Physician Employment and Compensation Models:
Mickey Bilbrey, James Daniel
The authors described the guiding principles based on realistic, business conditions, including:
- clear definition of requirements and expectations
- terms, calculations, and methodologies that are transparent and understandable to physicians
- financial sustainability
- favorable recruitment and retention
An ideal compensation model, aligns strategic incentives for providers to care for patients in a way that optimizes quality, improves patient and provider satisfaction, and rewards mission-based activities, such as teaching, research, outreach, and citizenship (defined as timely medical record completion, coding accuracy, committee participation, electronic medical record usage, continuing education, and compliance with the code of conduct).
They feel that pay for performance will undergo three iterations:
- Pay for reporting
- Pay for improved performance, as defined above
- Pay for delivering value that reduces errors, costs less, and coordinates care, which CMS will require by 2017
This intriguing presentation described the journey of a midwest faith-based hospital to break out of the confining silos of the past. Using the model of a life raft and the Fleetwood Mac song, “Don’t Stop Thinking about Tomorrow,” they made a series of hospital videos (the nuns did a great job) that took people from a risk-averse culture to one that was more humanistic, supportive, participative, self-actualizing, and joyful.
They enlisted physician champions like Dr. Stockhausen and created physician-administrator dyads to redesign care and provide exceptional experiences. They started with Why: “HFM was founded in 1899 by the Franciscan Sisters of Christian Charity to create a human ministry to help our community lead healthier lives.” They developed a compass to hardwire improvement and innovation into the HFM culture, sharpen leadership focus, raise the bar for success (“We are what we tolerate… we become what we reward”), and accelerate transformation through multidisciplinary teams.
Since 2008, employee pride has risen from 71% to 87% and the number of people who recommend HFM’s care to friends and family increased from 58% to 82%. Accountants have tracked the savings resulting from improvement at over $10,000,000 since 2009. They are a Solucient 100 Top Performance Improvement Leader and in the Top 25 Most Wired Small and Rural Hospitals, at HIMSS Stage 6, which involves physicians using structured templates and electronic tracking of clinical variation. They feel that their success resulted from:
- Asking the question regarding the impact of culture on strategy and clinical outcomes
- Engaging employees and providers in their strategic plan
- Explaining the rationale for what they do during the process of shaping the culture
As always, I welcome your input to improve healthcare collaboration where you work. Please send me your comments and suggestions for improvement.
Kenneth H. Cohn
© 2013, all rights reserved
I have not received any compensation for writing this content. I have no material connection to the brands, topics and/or products that are mentioned herein.