Is the Relationship Between Your Hospital and Your Medical Staff Sustainable? Greg Carlson and Hugh Greeley
Issues in the macroenvironment are affecting the historic relationships that have existed between hospitals and their medical staffs over the last half century. Rising healthcare costs, deteriorating relationships, unexplained variations in clinical outcomes, transparency in healthcare outcomes, medical tourism, competition between hospitals and physicians, and reluctance by hospitals and physicians to change are among the issues challenging the sustainability of the current business model. This article highlights barriers to maintaining traditional relationships and concludes with strategies to preserve and strengthen relationships between physicians and hospitals.
Hospital IT Adoption Strategies Associated with Implementation Success: Implications for Achieving Meaningful Use, Eric W. Ford, Nir Menachemi, Timothy R. Huerta, and Feliciano Yu
Health systems are facing significant pressure to either implement health information technology (HIT) systems that have “certified” electronic health record applications and that fulfill the federal government’s definition of “meaningful use” or risk substantial financial penalties in the near future. To this end, hospitals have adopted one of three strategies, described as “best of breed,” “best of suite,” and “single vendor,” to meet organizational and regulatory demands. The single-vendor strategy is used by the simple majority of U.S. hospitals, but is it the most effective mode for achieving full implementation? Moreover, what are the implications of adopting this strategy for achieving meaningful use?
The simple answer to the first question is that the hospitals using the hybrid best of suite strategy had fully implemented HIT systems in significantly greater proportions than did hospitals employing either of the other strategies. Nonprofit and system-affiliated hospitals were more likely to have fully implemented their HIT systems. In addition, increased health maintenance organization market penetration rates were positively correlated with complete implementation rates. These results have ongoing implications for achieving meaningful use in the near term.
The federal government’s rewards and incentives program related to the meaningful use of HIT in hospitals has created an organizational imperative to implement such systems. For hospitals that have not begun systemwide implementation, pursuing a best of suite strategy may provide the greatest chance for achieving all or some of the meaningful use targets in the near term or at least avoiding future penalties scheduled to begin in 2015.
Developing a Culturally Competent Health Network: A Planning Framework and Guide, Eric J. Gertner, Judith N. Sabino, Erica Mahady, Lynn M. Deitrick, Jarret Patton, Mary Kay Grim, James F. Geiger, and Debbie Salas-Lopez
The number of cultural competency initiatives in healthcare is increasing due to many factors, including changing demographics, quality improvement and regulatory requirements, equitable care missions, and accreditation standards. To facilitate organization-wide transformation, a hospital or healthcare system must establish strategic goals, objectives, and implementation tasks for culturally competent provision of care. This article reports the largely successful results of a cultural competency program instituted at a large health system in eastern Pennsylvania.
Prior to the development of its cultural competency initiative, Lehigh Valley Health Network, Allentown, Pennsylvania, saw isolated activities producing innovative solutions to diversity and culture issues in the provision of equitable care. But it took a transformational event to support an organization-wide program in cultural competency by strengthening leadership buy-in and providing a sense of urgency, excitement, and shared vision among multiple stakeholders. A multidisciplinary task force, including senior leaders and a diverse group of employees, was created with both the authority and responsibility to enact changes. Through a well-organized strategic planning process, existing patient and community demographic data were reviewed to describe existing disparities, a baseline assessment was completed, a mission statement was created, and clear metrics were developed. The strategic plan, which focused on five key areas (demographics, language-appropriate services, employees, training, and education/communication), was approved by the network’s chief executive officer and senior managers to demonstrate commitment prior to implementation.
Executive Leadership Development in U.S. Health Systems, Ann Scheck McAlearney
The healthcare industry is known for constant and rapid change, highlighting the need for strong executive leadership. Within this industry, multihospital healthcare systems present particular executive leadership challenges due to their size and complexity, yet our understanding of how these executive-level health system leaders are developed has been extremely limited. The objective of this research was to study the establishment, organization, content, process, evaluation, and evolution of executive leadership development (ELD) programs in U.S. healthcare systems. Results of a national survey of health system CEOs, supplemented by interviews with multiple health system key informants, showed that ELD programs existed in around half of responding U.S. health systems and were especially prevalent among smaller systems. On average the programs were fairly new, with most having been established since 2003. ELD programs were reportedly valued by the health systems, as reflected by respondents’ perceptions of program payoffs and sustained budgetary commitment. Specifically, ELD programs are believed to help further healthcare systems’ strategic goals, initiate succession planning, and provide local development opportunities. In addition, the majority of program elements were reportedly worth the investment in improving executives’ leadership skills and capabilities. Given the imperative to improve leadership capabilities in healthcare, ELD programs provide important opportunities to enable health systems to meet the challenges of a changing health services industry.