A to-do list

AHA of­fers ‘road map’ for hos­pi­tals

Modern Healthcare - - THE WEEK IN HEALTHCARE - Ashok Selvam

In­te­grat­ing in­for­ma­tion sys­tems and en­sur­ing proper align­ment with physi­cians loom as ma­jor pri­or­i­ties for hos­pi­tals pre­par­ing for the fu­ture, ac­cord­ing to an Amer­i­can Hos­pi­tal As­so­ci­a­tion re­port. Among a list of 10 “must-do” strate­gies or pri­or­i­ties, they pose the big­gest con­cerns for hos­pi­tals, said Jeanette Clough, chair­woman of the AHA com­mit­tee that com­piled the re­port, which she de­scribed as a “road map” for hos­pi­tals pre­par­ing for the fu­ture. Clough is pres­i­dent and CEO of 207-bed Mount Auburn Hos­pi­tal in Cam­bridge, Mass.

“The per­for­mance im­prove­ment com­mit­tee of the AHA is look­ing into ask­ing the ques­tion of hos­pi­tals across the field: What’s the fu­ture hos­pi­tal go­ing to look like and how would we rec­og­nize it when we saw it?” Clough said.

The AHA’s 21-mem­ber Board Com­mit­tee on Per­for­mance Im­prove­ment de­liv­ered an an­swer in “Hos­pi­tals and Care Sys­tems of the Fu­ture,” but Clough quickly stressed that there are dif­fer­ent ways to solve chal­lenges. The AHA took a proac­tive stance as hos­pi­tals want­ing to share strate­gic op­tions as fa­cil­i­ties gear up for re­form, she said.

Chang­ing the cul­ture of a hos­pi­tal to ac­cept these changes proves dif­fi­cult, said com­mit­tee mem­ber Dr. Richard Afa­ble. It could take time. “These are changes that must oc­cur to im­prove out­comes,” said Afa­ble, pres­i­dent and CEO at 422-bed Hoag Me­mo­rial Hos­pi­tal Pres­by­te­rian in New­port Beach, Calif. “We can’t wait till 2014.”

The com­mit­tee di­vided its sug­ges­tions into four sec­tions: must-do strate­gies, “sec­ond-curve” met­rics, core or­ga­ni­za­tional com­pe­ten­cies and self as­sess­ments.

Ten must-do strate­gies were listed, in­clud­ing four key ones: en­sur­ing proper align­ment be­tween hos­pi­tals, doc­tors and other stake­hold­ers; us­ing ev­i­dence-based prac­tices to im­prove qual­ity and safety; im­prov­ing ef­fi­ciency through pro­duc­tiv­ity and fi­nan­cial man­age­ment; and de­vel­op­ing in­te­grated in­for­ma­tion sys­tems.

Each strat­egy is il­lus­trated with a case study. Hoag’s cre­ation of its or­tho­pe­dic in­sti­tute in 2010 was one ex­am­ple, show­ing the suc­cess­ful im­pact of prop­erly align­ing doc­tors and de­creas­ing pa­tient vol­ume in op­er­at­ing rooms. For hip and knee re­place­ments, the num­ber of hos­pi­tal-ac­quired in­fec­tions dropped—as did costs.

“For us, joint re­place­ment is not about two days sit­ting in the hos­pi­tal, but 30 days be­fore the surgery and two days af­ter surgery; that en­tire thing is our prod­uct,” Afa­ble said. Gaug­ing the im­pact of im­ple­ment­ing strate­gies has changed, he noted. The old ways in­clude count­ing how many pa­tients suf­fered blood clots dur­ing a pro­ce­dure. Now there’s more fo­cus on af­ter-care and the pa­tient’s qual­ity of life, Afa­ble said.

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