Welcome to the Future

Elyas Bakhtiari, for HealthLeaders Magazine , November 12, 2009
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Design is about more than bricks and mortar, though. Hospitals are increasingly rethinking space to go green, right-size spaces, and incorporate digital care. As clinical care changes, so does the look and feel of the hospital.

A positive patient experience first requires a good outcome, and four healthcare leaders explored how to move beyond just measuring data, to acting on the data collected. "Quality has to become the foundation on which all initiatives are built upon," said Jay Srini, chief innovation officer for UPMC Health Plan.

The future they painted sounds promising: Quality will extend beyond hospital walls into patient communities; prevention will get more attention; quality will be ingrained into hospital culture; and technology will support, but not drive, quality improvement. Although there is a long road ahead, particularly under the current reimbursement model, each panelist offered examples of how hospitals could move closer to the goals today.

One key step is to simplify and seek the right outcomes. St. Joseph Health System boils down nearly 300 indicators that are measured in its quality report to about 15 work processes to keep improvement achievable. "If we can't design reliable clinical work then the [outcome measurement] experience is moot," said Dan Varga, MD, chief medical officer for the system.

The hospital of the future can't be built through policies and procedures alone. Overreliance on rules can muddy already-complex systems and burn out middle managers. What really drives organizational change is culture.

Memorial Health System, for instance, gradually increased the intensity of culture change over a five-year period, said Matthew Krathwohl, MSN, CPA, executive director of performance excellence.

Memorial started with ad-hoc projects lasting only a few months but progressed systematically by using rankings on metrics and employee feedback to drive change; the final result was a full implementation of Lean management principles.

Elyas Bakhtiari is senior editor for physicians and service lines for HealthLeaders Media. He may be contacted at ebakhtiari@healthleadersmedia.com.

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