What Do High Performing Hospitals Have in Common? Creative Partnerships

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In a session at the Becker’s Hospital Review 4th Annual Meeting in Chicago on May 9, Pamela Stoyanoff, executive vice president and COO of Methodist Health System in Dallas, Chris Jones, vice president of strategy and business development for Catholic Health Initiatives, and Robert Garrett, president and CEO of Hackensack (N.J.) University Health Network discussed the best ideas to transform hospitals into high performing organizations in a panel session moderated by Chuck Lauer, former publisher of Modern Healthcare.
Improving quality, lowering costs

Mr. Lauer began the session by asking, "How do we get to high quality, low cost?" It's an important question, but a difficult one to answer in regard to the provision of healthcare.

While there is, of course, no easy answer, Ms. Stoyanoff explained the first step is reducing administrative and operating costs. "You've got to be willing to make large changes," she said. At Methodist, the system contracted with a new food service vendor, opting to part ways with the vendor that had served it for 30 years.  The move is expected to result in $8 million in savings over next five years. The system also brought in a new emergency medicine group, which resulted in savings and a doubling of ED patient satisfaction in the first month.

Mr. Garrett said his system's focus on cutting costs has now shifted to clinical care delivery. "We're redesigning our care processes, disease entity by disease entity." A group of multidisciplinary clinicians within HUMC examine each care process "from start to finish," implementing best practices. The move – which began in cancer care and is now taking place in cardiovascular – is expected to result in efficiencies and better outcomes.

Mr. Jones added that innovative leadership is a key element of successfully bringing down costs while preserving or improving quality. "All of us have switched to a matrix environment, but we don't know how to operate in one," he said, adding that ad-hoc cost cutting efforts will not be sustained unless the culture is changed to support the triple aim of better quality, lower costs and better population health.

What one thing should health system leaders do now?
Mr. Lauer then asked the panelists what one thing they think is most important for hospitals to do now in order to ensure success in the future.

Mr. Garrett urged leaders to explore creative partnerships. For example, HUMC has a joint venture with LHP hospital group, which has enabled HUMC to "preserve capital at the flagship hospital to reinvest it and expand, and be able to get into new market," he said. He also mentioned HUMC's partnership with CVS' MinuteClinic; HUMC provides medical directors to the clinics as part of the collaboration. He called the deal "an opportunity for us to bring healthcare closer to people's homes," while potentially expanding the health system's footprint. "Sixty percent [of patients visiting] retail clinics are not associated with a PCP," he said.

Ms. Stoyanoff said her system has similar partnerships. For example, Methodist has partnered with Walgreens for bedside medication delivery to patients by a Walgreens pharmacist to ensure prescriptions are filled and instructions are understood before discharge. Methodist is also partnering with an insurer on a narrow-network insurance product.

Competitors should also be viewed as potential partners. Mr. Garrett said his system has a partnership with North Shore-Long Island Jewish in Manhasset, N.Y., that facilitates the sharing of quality data. While the partnership is not a business relationship, the chief quality officers share best practices and comb through data to inform improvement initiatives.

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