The COVID-19 pandemic has shone a spotlight on the healthcare system like never before — including many of its shortcomings, from health disparities to capacity strains to employee turnover. But even before this crisis, it was clear that we needed a better model for sharing high-quality, cost-effective care in more places so patients can access these services close to home.
At UPMC, we've been on this journey long before the pandemic — building strong and integrated clinical service lines not just in the U.S. but across our international facilities in Italy, Ireland, and soon, Chengdu, China, which is 7,531 miles away from Pittsburgh. This unique focus on consistent quality standards, training and culturally competent services across facilities benefits all stakeholders. Most importantly, it means better care for patients with more opportunities for novel and effective therapies throughout the communities we serve.
UPMC Hillman Cancer Center is one of the best examples of our international service line model. UPMC and University of Pittsburgh researchers developed and shared specialized cancer treatments and protocols first across our network in Pennsylvania, Ohio, Maryland and New York — and then with our physicians in Italy and Ireland, allowing patients to receive UPMC Hillman-style care worldwide.
But creating this service line approach — whether in oncology, orthopedic care and sports medicine, or heart and vascular treatments — requires concerted effort and investment. Here are four key steps that have proven effective for us at UPMC:
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The first step is to gain support from all stakeholders and develop a consistent process of sharing information and education. It is important to connect staff across all sites and provide opportunities to learn and collaborate through a variety of educational opportunities, exposing staff to best practices in their specialty and fostering a sense of community.
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Next, once the education and camaraderie have been established, create clinical care practices that accommodate cultural differences. Physicians must collaborate to make sure any policies and procedures work for their local patients, while still delivering on the promise of world-class care close to home. The standard of care may differ based on the availability and cost of resources in each location, as well as the preferences of patients. For example, while round-the-clock cardiac catheterization labs are common in hospitals throughout western Pennsylvania, that's not the case in all global locations, necessitating different treatment protocols.
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After establishing the standards of care, create multidisciplinary committees from across all your locations to regularly measure the quality of care. This includes developing organizational structures focused on meeting accreditation criteria from trusted organizations. These groups should also assess each site and establish general guidelines to provide a consistent patient experience, with a focus on developing programs to engage and empower staff.
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It is key to establish regular leadership and physician meetings for each service line to build shared goals and values. The service line must have strong administrative and clinical leadership in each region or country, with an overarching leadership committee. For our international and U.S. teams, the sharing of ideas and best practices is a two-way street. In fact, since Europe often approves new devices and medicines before the U.S., we've sometimes been able to get a head start on understanding and preparing for new technologies.
When implementing a service line across your system, you will inevitably run into challenges — whether regulatory barriers, insurance hurdles, staffing or culture. Clear communication and collaboration will help you overcome them. The result will be better care for patients and higher satisfaction for physicians and staff — and a healthcare system that is better prepared to serve our communities in the next pandemic.
Charles Bogosta is executive vice president of UPMC and president of UPMC International. Dr. Matthew Harinstein is senior vice president, COO and associate CMO of UPMC International.