ABSTRACT
The United States falls far short of its potential for delivering care that is effective, efficient, safe, timely, patient-centered, and equitable. We put forward the Better Care Plan, an overarching blueprint to address the flaws in our current system. The plan calls for continuously improving care, moving all payers to risk-adjusted prospective payment, and creating national entities for collecting, analyzing, and reporting patient safety and quality-of-care outcomes data. A number of recommendations are made to achieve these goals.
Subject(s)
Access to Information , Fee-for-Service Plans/statistics & numerical data , Insurance Claim Review/statistics & numerical data , Medicare/statistics & numerical data , Patient Protection and Affordable Care Act , Centers for Medicare and Medicaid Services, U.S. , Cost Control , Delivery of Health Care/economics , Delivery of Health Care/standards , Delivery of Health Care/trends , Disclosure , Health Services Research , Medicare/legislation & jurisprudence , Public Policy , Quality of Health Care , United StatesABSTRACT
Patient-centeredness--the idea that care should be designed around patients' needs, preferences, circumstances, and well-being--is a central tenet of health care delivery. For CEOs of health care organizations, patient-centered care is also quickly becoming a business imperative, with payments tied to performance on measures of patient satisfaction and engagement. In A CEO Checklist for High-Value Health Care, we, as executives of eleven leading health care delivery institutions, outlined ten key strategies for reducing costs and waste while improving outcomes. In this article we describe how implementation of these strategies benefits both health care organizations and patients. For example, Kaiser Permanente's Healthy Bones Program resulted in a 30 percent reduction in hip fracture rates for at-risk patients. And at Virginia Mason Health System in Seattle, nurses reorganized care patterns and increased the time they spent on direct patient care to 90 percent. Our experiences show that patient-engaged care can be delivered in ways that simultaneously improve quality and reduce costs.
Subject(s)
Cost Control/methods , Delivery of Health Care/organization & administration , Patient Participation/methods , Quality Improvement/organization & administration , Checklist , Decision Making , Delivery of Health Care/economics , Delivery of Health Care/methods , Delivery of Health Care/standards , Efficiency, Organizational , Evidence-Based Medicine/methods , Health Services Needs and Demand , Humans , Quality of Health Care/standardsABSTRACT
An urgent need in American health care is improving quality and efficiency while controlling costs. One promising management approach implemented by some leading health care institutions is Lean, a quality improvement philosophy and set of principles originated by the Toyota Motor Company. Health care cases reveal that Lean is as applicable in complex knowledge work as it is in assembly-line manufacturing. When well executed, Lean transforms how an organization works and creates an insatiable quest for improvement. In this article, we define Lean and present 6 principles that constitute the essential dynamic of Lean management: attitude of continuous improvement, value creation, unity of purpose, respect for front-line workers, visual tracking, and flexible regimentation. Health care case studies illustrate each principle. The goal of this article is to provide a template for health care leaders to use in considering the implementation of the Lean management system or in assessing the current state of implementation in their organizations.
Subject(s)
Delivery of Health Care/organization & administration , Efficiency, Organizational , Total Quality Management/organization & administration , Cost Control , Health Care Reform , Humans , Organizational Innovation , Process Assessment, Health Care , Quality Improvement , United StatesABSTRACT
Inspired by nearby manufacturing plants, ThedaCare adopted Lean to standardize quality.
Subject(s)
Leadership , Total Quality Management , Humans , Quality Assurance, Health CareABSTRACT
OBJECTIVE: To develop an effective way to link statewide healthcare information technology strategy to payment reform. STUDY DESIGN: Investigation of what Wisconsin did to develop and publicly share provider performance data and then use those data to drive payment reform. METHODS: We examine 2 statewide organizations (Wisconsin Collaborative for Healthcare Quality and Wisconsin Health Information Organization) and 1 integrated health system (ThedaCare) to evaluate how they pool data and use those data to measure provider performance. RESULTS: When aggregated data regarding health outcomes are shared, a clearer picture emerges of provider performance baselines and improvements with which payment models can be developed. CONCLUSIONS: Aggregating commercial and Medicare claims data will help states to better measure provider performance and to compare providers on quality and cost. The ability to compare performance using broad databases is necessary if the current payment system in the United States is to be reformed.