Time to Trash Your Org Chart?

Philip Betbeze, for HealthLeaders Media , August 15, 2011
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That group of people is responsible for identifying variations in practice from a quality, cost, and service point of view from hospital to hospital, as well as the system’s 23 ambulatory sites.

“Just in our early analysis, we have identified $150 million in practice variation, and that does not even get into medical management,” he says. He also says that within six months, the new management structure
has saved more than $30 million by reducing variation.

All well and good, but physicians hated the previous experience with centralized management. What’s different this time?

James LaBelle, MD, longtime medical director of emergency services and clinical quality at Scripps Memorial Hospital Encinitas, is still transitioning to his new role as corporate vice president of quality, medical management, and physician comanagement. Previously, there was no real coordination of efforts. It’s now LaBelle’s job to build a focused and coordinated program of medical management that will ultimately link to Scripps’ clinical service lines and population health management. LaBelle is responsible for building out Scripps’ new inpatient and ambulatory medical management system and coordinating the physician comanagement component, which is a major departure from the first attempt at centralization. 

He says Van Gorder’s announcement last fall really wasn’t a shock.

“A lot of what Chris has done in horizontal management is consistent with his messaging to the medical staff,” he says. “The horizontal piece with the medical staff started 10 years ago when Chris created his physician leadership cabinet to guide policy. Over the years it has become a trusted conduit of communication between medical staff and CEO. So the transition hasn’t disrupted the medical staff at all.”

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