Atul Gawande, MD, a surgeon at Boston-based Brigham and Women's Hospital and writer for The New Yorker, along with two other researchers, discussed the potential safety risks patients may encounter as hospitals and health systems across the industry engage in consolidation in a study published in JAMA April 6.
The research team comprised Dr. Gawande; Susan Haas, MD, an OB-GYN physician and visiting scientist at the Boston-based Harvard T.H. Chan School of Public Health; and Mark Reynolds, president and CEO of the Controlled Risk Insurance Company of Vermont, which aims to provide primary and excess insurance coverage to professionals within the Harvard community. The study was fostered through a research partnership between CRICO and Ariadne Labs, of which Dr. Gawande is executive director.
The team determined hospital merger and acquisitions activity may expose patients to significant, unintended harm if clinical leadership does not take steps to manage potential risks. Researchers identified three major ways M&A can affect patients:
1. As physicians are integrated into a new system, they must learn to navigate new infrastructure, processes, teams and clinical cultures while treating patients.
2. Consolidation will inevitably introduce new populations into a hospital or health system's payer mix, which may lead to gaps in care if facilities are unprepared for the influx of patients.
3. M&A may also result in a shortage of supplies, or the use of different or unfamiliar medical equipment and information systems, which may make routine tasks more challenging for providers, slowing care and introducing potential risk errors.
To help hospitals and health systems mitigate patient risk during M&A, the research team developed a framework to guide hospitals during consolidation or expansion. The toolkit includes a user's manual and discussion guides, among other tools, to help executive leadership foster relationship building and teamwork, uncover potential risk factors and address areas of potential harm after affiliation begins.
"When airlines merge, they follow a systematic process for putting pilots in unfamiliar planes," said Dr. Haas. "In healthcare M&A, however, we have been much less deliberate. And the danger from that is significant."
To view the toolkit, click here.