Hospital and health system service lines can help align operations to build growth and volume, but as the industry transitions to a value-based model, the dynamics of those service lines will need to change dramatically and quickly, according to Brian Sweeney, RN.
Mr. Sweeney, who serves as vice president for clinical and support services at Thomas Jefferson University Hospitals in Philadelphia, presented 11 service line transformation tools at the Becker's Hospital Review 6th Annual Meeting on May 9 in Chicago.
"Historically, service lines have been used as framework to create structure and ensure a hospital's business perspective is aligning with everything that needs to be done," said Mr. Sweeney. "There is a lot that has not been done in terms of clinical integration, which is one of the shortfalls we see in service line structures across the country today."
To transform a hospital or health system's service lines, executives should:
- Make sure you have the right team. The right team may include population health experts, quality experts, administrators, physician champions, nurses, financial analysts and executive sponsors, to name a few.
- Embed performance and quality improvement leaders in the model. Doing so at the beginning of the strategic process, instead of later when there is a quality crisis, can help drive change.
- Recognize you may need to enhance the skills of team members. Sending team members to attend local and national seminars can help them gain skill sets that will make the whole hospital stronger.
- Invest in physician leadership development and coaching. Physicians with advanced training or MBAs can be very influential and provide a useful perspective in transforming service lines.
- Engage physicians. Physicians who take part in strategic planning, performance improvement projects and creating budgets and profit and loss statements may feel more empowered to enact change and take ownership over service line transformation.
- Assure strategic plans extend beyond just growth. Organizational struggles should also be discussed when creating the strategic plan to address and solve core problems the hospital faces.
- Minimize clinical variation. Clinical variation can be very costly for hospitals. To help standardize care, hospitals can implement pathways and checklists for different conditions and procedures.
- Adjust marketing campaigns to include outcomes. Increasingly, physicians are going to be incentivized to refer patients not to their friends, but to the highest quality, lowest cost provider. Making sure marketing campaigns highlight these areas is crucial.
- Clinically integrate and align. For employed physicians, incentive compensation is a great way to connect a hospital's strategy to the results. Other ways to bring together physicians and physician groups include clinically integrated networks, co-management agreements and network agreements.
- Change dashboard metrics from fee-for-service measures to value measures. Going forward, scorecards might include outmigration rates, episode expenses, evidence-based care compliance rates and patient access.
- Assure accountability and results. Creating a structure that ties accountability and results is crucial and can be achieved by holding meetings to track the status of different initiatives as related to performance measures and linking progress to compensation.
Ultimately, the biggest service line-related challenge hospitals will face will be ensuring the service lines align with the triple aim, according to Mr. Sweeney.