27 ways to positively affect healthcare

Amid industry changes and an uncertain political climate, people seek to make positive changes in healthcare. However, they may not always know how to do so. Fortunately, there are many ways to make a difference.

Becker's tapped 13 industry leaders for 27 ideas on how hospital and health system leaders, physicians, medical schools, patients and policymakers can take action and positively contribute to healthcare today.

Note: Comments are in leaders' own words, lightly edited for length and clarity.

Things hospital and health system leaders, medical schools, physicians and policymakers can do today.

Thomas Bauer, MD, Clinical Medical Director of Oncology Services, Hackensack Meridian Health (Edison N.J.).

1. Keep in mind potential for waste or unnecessary spending. I think patients are starting to pay closer attention to the necessity of care rendered now because as more patients have high-deductible insurance plans, how they spend their money becomes critically relevant to them. The patient is much more cautious about getting unnecessary testing when they have to pay for it. So, the patients are starting to be critical of what physicians are doing to make sure care really is necessary. Hospital administrators have always been concerned about that because they have a bottom line and they need to not spend more than they need to provide the care that they need to. But now I think that everyone else is catching up to those sentiments. Being cognizant of what we order and why we order is important, be it lab tests, or radiographic studies and procedures.

Robyn Begley, DNP, RN, CEO, American Organization of Nurse Executives and Senior Vice President and CNO, American Hospital Association. 

2. As healthcare professionals, it is important we lead by example and focus on our personal health. We need to care for ourselves so we can care for our patients, healthcare team and community.

Jay Bhatt, DO, CMO, American Hospital Association.

3. Each day across our country, patients, physicians, hospital leaders and policymakers are taking a range of actions that make a positive contribution to the healthcare field. While these actions can take many forms, most start with simply having the awareness that you do have the ability to move the needle in a positive direction when it comes to providing care and advancing health. Second, realizing that we must all be good stewards of health. And third, the importance of sharing a positive message should not be underestimated. Positive messages can be crucial in helping to build inner strength and getting people through trying times. We should also consider what matters to patients.

Sam Flanders, MD, Senior Vice President and Chief Quality and Safety Officer, Beaumont Health (Southfield, Mich.).

4. Measure safety culture frequently and act on results. Measuring must be done at the unit level for local change to occur, rather than an aggregate result. Strong safety culture means that healthcare team members have what they need to do their jobs, have supportive and engaged leadership and are comfortable speaking up about problems, even small ones. No one can anticipate and engineer out every possible failure, but if everyone on the team is comfortable speaking up, we can make healthcare safer.

5. Teach performance improvement methods that engage the front-lines and encourage continuous improvements every day, everywhere. Avoid "tool based" methods that rely on performance improvement experts; there will never be enough experts to be everywhere. Instead, educate and empower your front-line team members to detect and correct problems "in the moment," even if they are small. Discourage work-arounds that can lead to safety and quality problems. This creates an atmosphere of sustainable, continuous daily improvement.

Matthew A. Gibson, PhD, Senior Vice President and Chief Strategy Officer, Erlanger Health System (Chattanooga, Tenn.).

6. What can I do today to support our front-line staff in raising the personalized geriatric care in our system to a level that I would want for my 71-year-old mother?  Is there a partnership with a health plan or nontraditional, new healthcare entrant that we can consummate that would improve access and compel conscientiousness in my 60-year-old neighbors with chronic hypertension and diabetes? Are we being intentional enough with our general pediatricians in helping them materially impact health disparities among the underserved children in the hundreds of rural miles across our service area?

Numerous healthcare organizations across the country are adept at delivering trauma treatment down to quality clinic based primary care. As leaders we should shepherd the continued delivery of this quality care, but also challenge ourselves to facilitate investment of our resources to solve questions such as those above. No one is in a better position than a senior leader to affect far reaching, positive change among those their organizations are privileged to serve. It is incumbent on us as leaders in healthcare to leverage our platforms to make decisions that yield meaningful, scalable, positive change.

Alan Goldsmith, Executive Vice President and CFO, Broward Health (Fort Lauderdale, Fla.).

7. Leaders and policymakers must subscribe to an agreed upon healthcare delivery model. Quality care must be patient centric and consistent.

Achieving a high standard of care is best achieved through the leveraging of technology and removal of system-wide silos.

When you leverage technology, you obtain more real time data that can be used to drive results. Technology also enables us to simplify processes, which can result in expense reductions while improving patient outcomes.

Technology is most viable when hospitals are working as a cohesive system. Hospitals that are part of larger systems, such as Broward Health, must cease acting as independent silos and instead marry their objectives with enterprise and national health initiatives. We win as a team and lose as a silo.

Darrell Kirch, MD, President and CEO, Association of American Medical Colleges.

8. Medical schools and teaching hospitals are very concerned about the growing problem of student and physician stress, burnout and depression. Organizational leaders must continue to help students and residents maintain their resilience as they encounter the challenges of a rapidly changing healthcare environment. Physicians should be trained at every stage to assess and address their own stress and burnout. AAMC member institutions are training students and clinicians to know when to ask for help.

9. Health system leaders can act at multiple levels. Interventions to address learner well-being, such as counseling programs, mind-body skills training, curricular changes, and group-based faculty mentoring, are being created at medical schools and in residency training programs. These programs also help reduce the fear of stigma and professional consequences, increasing the chance that students and residents seek the help they need. Most importantly, institutions can establish a program led by a chief wellness officer to help make well-being a priority, identifying workplace issues that contribute to burnout, and then working toward solutions and changing the culture.

10. Medical schools, health systems and other organizations can join the National Academy of Medicine's Action Collaborative on Clinician Well-Being and Resilience, a network dedicated to promoting well-being across all career stages and specialties.

Fred Kniffin, MD, President of University of Vermont Health Network Porter Medical Center (Middlebury).

11. To advance healthcare reform and new/innovative population health initiatives, hospital leaders need to focus on aligning our interests with our patients. For too long, our fee-for-service reimbursement system has provided incentives for providers to develop services that generate revenue based on more utilization (caring for people who are sick), when our patients obviously would prefer less utilization (to be healthy). There will always be a role for hospitals to care for the sick and injured, but if we are going to truly bend the cost curve and be successful in the world of population health, we must find new ways to align our incentives with our patients' incentives, so that "improving the health of our community" is not only a clinical goal for providers, but a financial goal as well.

Steve Roach, President and CEO of UMass Memorial-Marlborough (Mass.) Hospital.

12. Be more aggressive in adapting to industry changes. Healthcare has been a constant for many years. We do change and adjust to all the issues and the challenges we face through reimbursement or cost or anything around that, but we're extremely slow at predicting what the future's going to hold and being willing to change our business models to reflect that. So we have to be much more aggressive around that.

13. Provide more opportunities for new talent. Because healthcare has been relatively solid and stagnant in what it does, we're losing out on some of the new talent that comes out — who are developing artificial intelligence, who are working at high-tech firms — and those firms can pay significantly higher than hospitals for those talents. We have to find a way to provide some opportunities for that and apply those technologies to make improvements in healthcare.

David Strong, President and CEO of Orlando (Fla.) Health.

14. Create an environment that people can thrive and enjoy their work. Fear and uncertainty lead to poor outcomes.

15. Be present with each person you see today. It's a gift to them and you.

16. Soak in — and be thankful for each moment you are given.

Bernard J. Tyson, Chairman and CEO, Kaiser Permanente (Oakland, Calif.).

17. Stigma associated with mental health conditions can stop people from speaking up about their struggles. We must continue to make asking for support for mental health conditions as accepted as asking for treatment of diabetes or high blood pressure. Only then will we create a culture of acceptance, so people can feel comfortable to seek the care they need.

18. Today, mental health is considered separate from physical health, yet to achieve total health, we must reconnect the mind to the body and treat people holistically — mind, body and spirit.

Brett Oliver, MD, Practicing Family Physician and CMIO, Baptist Health (Louisville, Ky.).

19. From a clinician's perspective — try to remember why you went into medicine in the first place and although the climate or situation changes over time, it is still a blessing and a privilege to be allowed into people's life where they are often most vulnerable to serve them. There is still great joy in that and joy is infectious. You can positively change the environment you find yourself in for the better!

20. Send a handwritten note to a patient or colleague once a week. It does not need to be long or verbose but the positive impact on that person in this age of computers is powerful. I've had patients and colleagues that remember the gesture years later and remark on the impact it had on them.

21. Refuse to fall into a victimization mindset and think the best of people and change. If the government places new requirements on the practice of medicine, insist that your default thought is "someone smart believed this would help patients," and try to understand why.

22. Get more sleep — we are way too sleep deprived!

Things patients can do.

Robyn Begley, DNP, RN, CEO, American Organization of Nurse Executives and Senior Vice President and CNO, American Hospital Association.

23. Talk to your nurses. Studies routinely identify nursing as the profession most trusted by the public. People feel comfortable talking to nurses. Do not hesitate to ask nurses questions about your health or treatment plan. Nurses are patient advocates. They are adept at interpreting people's questions and responding using easily understood terms. Every day, nurses help patients, families and the community navigate the complex health system.

Matt Eyles, President and CEO, America's Health Insurance Plans.

24. Whether you get your coverage through your employer, on the individual marketplaces, or if you're eligible for a federal program like Medicare, it is important to review your coverage options, know what your plan will and will not cover, and actively shop when possible. Make sure you understand how your coverage fits with your medical priorities for the year — for example, is your preferred physician and hospital in-network, what options exist for telehealth services, and what is the coverage for the medications you need?

25. Right now, drug prices continue to rise at rates that are out of control, and we need real policy solutions to bring prices down. That's why it's more important than ever to be a smart consumer of medications. Make sure to ask your doctor about all the treatment options available. Check different pharmacies for the best deal — including mail order services your insurance provider may offer. Also, ask your pharmacist if you're getting the best price at the counter.

26. Unfortunately, some patients receive "surprise doctor bills" when treated at an in-network facility (e.g., hospital) but not all the physicians who practice at that facility participate in their health plan's network. If you need to go to the hospital for a procedure that's not an emergency, ask whether every provider is in your health plan's network. Review your options beforehand to see if there's an urgent care clinic that's close by or a telehealth option you can use for a more convenient, more timely venue of care. If it's a true emergency, don't hesitate to call 911 or go the emergency room immediately. If you need help, call your health plan — they can answer any billing, coverage or network question you have to make sure you're getting the right care for you at the right time.

27. Last but certainly not least, take care of yourself and make time to focus on your health. Prevention is key — allot enough hours for sleep, make smart food choices, exercise, track and manage your chronic conditions, and adhere to your medication regimen, if you have one. When you prioritize your health, you're establishing a pathway to long-term wellness and fewer medical complications.


More articles on leadership:
Federal officials to inspect 2 DMC hospitals after ex-cardiology leaders cite patient safety issues
Living like a leader: A day with AHA chair elect and Atlantic Health System CEO Brian Gragnolati
Public outrage prompts Montana hospital to fire nurse with felony child porn record

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