Jennifer Kozakowski serves as the Executive Director for the Institute for Human Caring at Providence St. Joseph Health.
On May 11th, Ms. Kozakowski will serve as a speaker at Becker's Health IT + Clinical Leadership 2018. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place May 10-11th 2018 in Chicago.
To learn more about the conference and Ms. Kozakowski's session, click here.
Question: How is your organization moving toward a value-based rather than fee-for-service model?
Jennifer Kozakowski: Whole person care is one of the areas of strategic focus at [Renton, Wash.-based] Providence St. Joseph Health. Whole person care borrows from the tenets of palliative care, but it's for people of all ages and stages of life. Whole person care involves a series of conversations among patients, their loved ones and members of the care team, with the aim of delivering medical care that's aligned with the patient's lifestyle, values and priorities. It emphasizes shared-decision making models and requires goal-aligned care. The Institute for Human Caring is responsible for driving transformative change in culture to one of whole person care across Providence St. Joseph Health. We do this by training doctors, nurses, social workers, chaplains and other care professionals how to have goals-of-care conversations with patients and families. We provide education materials, including role play and videos, to help with patient/caregiver engagement. We have customized the EHR to capture goals-of-care conversations and advance directives, to make "the right way, the easy way." We have developed success metrics and online dashboards to measure outcomes, so whole person care is quantifiable. We host community cultural events and workshops to help educate the public about value-based, whole person care. And we regularly communicate our activities through system-wide newsletters and engagement with outside media. There are a lot of moving parts to implementing culture change, and they're all mutually reinforcing. I'm happy to say that in the three years since our founding, we have increased patient engagement and reduced costs in the pilot hospitals with which we've worked. We look forward to showing equally positive findings with caregiver engagement and well-being.
Q: What advice would you give other health systems interested in moving to a more person-centered care model?
JK: Implementation doesn't happen by accident — it needs to be intentional, customized, flexible and persistent. You need the usual suspects, of course — a clearly articulated vision of what your ideal operation would look like. You have to tailor your game plan around a needs assessment that includes determination of "cultural readiness" — buy-in from executives, managers and front-line service professionals. Particularly nurses — not only because of their role in patient care, but also because we know how important their role is in leading the way for other interdisciplinary team members. Beyond those basics, you can't just stand up a program and hope that is self-sustaining, nor does providing the education, tools and resources alone work in changing culture. You need boots on the ground to provide day-to-day support for the changes in practice, education, tools and resources — personable and professional project managers who know how to gently disrupt the microsystems that provide the behavioral cues to do things the way they always have and reinforce new ways of doing things. They provide a visible presence and support to front-line caregivers and staff in changing practice. These are the people who identify and nurture clinical champions up and down the value chain. They reinforce the goals of your program, assist folks with the use of the new tools or education, and hand deliver tools and information to help ease the way for clinical staff.
Q: All healthcare is local. What about your market influences your organization's business or operations most?
JK: Our markets are spread across seven states, from Anchorage, Ala., to Lubbock, Texas, creating challenges and opportunities. As a mission-driven Catholic healthcare organization, we are called in particular to serve the poor and vulnerable. Many of our hospitals — we call them ministries — are in underserved communities and in areas with high concentrations of elderly. So, for instance, when we designed the first patient advance directive toolkit for the entire Providence St. Joseph Health system, we made sure the size of the typeface was big and easy to read for our elderly audience, and the reading level was lower to enhance healthcare literacy. We also surveyed our regional markets to prioritize the appropriate language translations. This approach is in keeping with our promise: "Together, we answer the call of every person we serve: Know me, care for me, ease my way."