Hospitals seek clinical partners who will integrate into the fabric of their organizations as they make key transformations in anesthesia,
hospital medicine, and the ED.
Two years ago Saint Agnes Hospital set a new course for its emergency department: It was time to take patient satisfaction scores to the next level, as well as make critical changes to improve patient throughput. Admission and discharge times were too high, and too many patients were leaving without being seen. While the hospital had outsourced its ED for two decades with varying degrees of success, a strategic plan called for bringing on a brand-new national clinical partner to help revamp the department. "Our ED accounts for about 70% of our admissions," says Adrian Long, MD, CMO for the 276-bed teaching hospital in Baltimore. "The ED was the front door to the hospital, and it was important for us that we had providers who were going to improve these scores and our performance."
Workforce management and the pursuit of productivity have formed a consistent pain point for hospitals for several years. The Affordable Care Act has only exacerbated the problem, increasing the demand on providers as the number of insured grows and the bar continues to rise on quality of care. According to a recent HealthLeaders Media Council survey, workforce productivity and acuity-based staffing will continue to be top priorities this year. Karlene Kerfoot, PhD, chief clinical integration officer at API Healthcare, says the survey results indicate a shift taking place as workforce management initiatives are expected to deliver more than reduced labor costs.
From the cloud and mobile devices to the latest in robotics, healthcare’s renegades are riding a new wave of transformational technologies.
The University of California, San Francisco (UCSF) Medical Center, which sits on a steep hill in one of the city’s foggiest neighborhoods, may be only 30 miles north of Silicon Valley, but for its researchers and clinicians, technology disruption starts on the home turf. Unwilling to wait for others to develop the same slick apps and technologies that consumers have come to expect, UCSF is finding success forging its own innovative path. “When you are on your computer doing your work and you get a FaceTime message on your iPhone from your kid who’s 3,000 miles away, you ask, ‘Why can’t we do this in healthcare?’ ” says Robert Wachter, MD, chief of the division of hospital medicine and chief of medical service. “Here, when we see gaps like that, we have the inclination to develop a tool to fix it.”
For telemedicine trailblazer Robert Groves, MD, his first recollection of the technology is an illustration in a 1950s magazine article showing a little boy interacting with a physician over a video screen. Most of telemedicine's history, says Groves, "has been that model, that on-demand, limited time-frame interaction that facilitates both trust between the parties and the ability of the provider to assess the patient more than they would be able to by a telephone conversation." Today, however, Groves oversees a telemedicine program that is a "radical departure" from this early vision. As vice president of health management at Banner Health, a nonprofit healthcare delivery system based in Phoenix, Groves runs a teleICU program that enables physicians and other clinicians to remotely monitor critical care units hundreds of miles away. Introduced nine years ago, the technology has done more than just provide telemedicine consults between board-certified intensivists and providers in far-flung outposts: It has changed the way the system delivers critical care services.
The ripple effect of healthcare reform is beginning to impact care delivery strategies as care management now falls increasingly to providers.
According to a recent HealthLeaders Intelligence survey, hospital leaders are making progress with care management efforts, but more robust tools will be needed if hospitals want to scale up.
Courtesy of McKesson Corporation.
Eight years ago, executive and board leaders at Sentara Healthcare in Norfolk, Virginia, threw down a strategic gauntlet: It was time to make a big shift and focus on new growth. Since then, the nonprofit health system has been ramping up its presence in its home state of Virginia and continues to evaluate opportunities for partnerships in other states. ?Sentara?s evolution as an IDN is similar to many other health systems nationally in that our delivery system was largely centered in one geographic region,? says Megan Perry, corporate vice president of mergers and acquisitions. ?In 2006, as we looked at the national landscape, we realized that in order to meet the needs of the current communities we served, as well as make the necessary investments in technology and innovation, that we needed to continue to grow.? Between 2010 and 2014, Sentara merged with five hospitals and has entered into new partnerships with Ohio Health, in Columbus, Ohio, as well as with Huntsville Hospital Health System in Alabama. Today, Sentara encompasses more than 100 sites of care, including 12 acute care hospitals, five medical groups, and a health plan; it offers postacute, outpatient, and urgent care services, among others.