Measurement and Analysis in Transforming Healthcare Delivery: Volume 2: Practical Applications to Engage and Align Providers and Consumers

129 Pages·2017·3.89 MB·English

by  Harry C. Sax (eds.)

Measurement and
Analysis in Transforming
Healthcare Delivery
Volume 2:
Practical Applications to
Engage and Align Providers
and Consumers
Harry C. Sax
123
Measurement and Analysis in Transforming
Healthcare Delivery
Harry C. Sax
Editor
Measurement and Analysis
in Transforming Healthcare
Delivery
Volume 2: Practical Applications
to Engage and Align Providers
and Consumers
Editor
Harry C. Sax
Department of Surgery
Cedars Sinai Medical Center
Los Angeles , CA , USA
ISBN 978-3-319-46220-2 ISBN 978-3-319-46222-6 (eBook)
DOI 10.1007/978-3-319-46222-6
Library of Congress Control Number: 2016943088
© Springer International Publishing Switzerland 2017
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To my children, Ben, Adam and Rachel; it is
for their generation, and those that follow,
that we have to get healthcare right
Pref ace
To say there is uncertainty in healthcare is an understatement. To suggest that
change is needed is obvious. How we do it, and how we measure the effectiveness
of those interventions is where the real challenge lies.
In my own career as an academic surgeon, I have at times been frustrated by
multiple forces working at crossed purposes. Incentives are misaligned, outcomes
measures do not fully refl ect the complexity of the process, and patients are often
overwhelmed with options. Healthcare executives and clinicians try to provide
patient-centric care in a heavily regulated and litigious environment. Yet despite
these challenges, organizations have emerged that are achieving the Institute of
Healthcare Improvement “Triple Aim” of improving the patient experience of care,
improving the health of populations, and reducing the per capita cost of healthcare.
This book hopes to capture the lessons learned by those successes and give the
reader tools and ideas relevant for their own situation.
A lthough this volume has an emphasis on American healthcare delivery, we have
drawn from experts familiar with alternative models, including single payer systems.
We strove to provide the reader with clear defi nitions of quality, effi ciency, fi nancial,
and appropriateness measures. Chapters focusing on leading change and motivating
others may provide ideas that are applicable in one’s own organization. We hope to
capture lessons learned from the past to reduce the uncertainty of the future.
Los Angeles, CA Harry C. Sax
vii
Acknowledgments
I have been fortunate to have had mentors who helped organize my thinking and
taught by example. Some were supervisors, and many were colleagues. During
residency at the University of Cincinnati, my Chairman, Dr. Josef Fischer, insisted
that excellence was expected and everything else needed an explanation. He pro-
vided me my fi rst understanding of the business concepts of medical delivery and
research. Dr. Seymour Schwartz, at the University of Rochester, gave me my fi rst
job in 1989. He was the ultimate Renaissance man and emphasized the humanistic
aspects of leadership. My colleagues at The Miriam Hospital and Brown University
helped me round out my understanding of medical staff functioning, collaboration
with the community, and how to interface with governmental agencies. We took
risks with data transparency, individual practitioner report cards, and integration of
new technology. The chance to go back to school at age 52 at the Harvard Masters
in Health Care Management Program was energizing and gave me new tools and
insights. As good as the professors were, the 17 other physicians from around the
world were my everyday teachers. We spent more than a few nights in the hotel
lobby, fi guring out solutions to case studies…. and our lives. My current Chair at
Cedars-Sinai, Dr. Bruce Gewertz, exemplifi es leadership in all he does, with a com-
bination of pragmatism, humor, and a deep understanding of people. He and the
former Chair of Medicine, Dr. Glenn Braunstein, were gracious in creating a new
position for me when I was transitioning my career to focus on healthcare manage-
ment, quality, and safety.
Barbara Lopez-Lucio and her colleagues at Springer gently pushed to keep me
on track with this book and provided alternatives when we hit roadblocks. It has
been a pleasure to work with them.
ix
Contents
1 Healthcare Transformation: What Are the Challenges? ....................... 1
Harry C. Sax
2 Terminology and Applications: Hospital Performance Measures ........ 7
Brett McCone
3 Measurements and Analysis in Transforming Healthcare Delivery:
Terminology and Applications—Physician Performance .................... 25
David Norris
4 Assuring Appropriate Care ...................................................................... 41
Charles E. Coffey Jr. and Teryl K. Nuckols
5 Aligning Medical Staff Within the Academic Medical Center ............. 59
Victoria G. Hines and Michael F. Rotondo
6 Aligning Healthcare Systems ................................................................... 71
Thomas R. Graf and Glenn D. Steele Jr.
7 Influencing with Integrity ........................................................................ 83
Michael R. Williams and Steven R. Sosland
8 Perspectives from Single Payer Systems ................................................. 99
Eyal Zimlichman and Yishay Falick
9 Leadership to Encourage and Sustain Performance ............................. 113
Monica Jain and Bruce L. Gewertz
Index ................................................................................................................. 123
xi
Contributors
Charles E. Coffey Jr. , M.D., M.S., F.H.M., F.A.C.P. Los Angeles County +
University of Southern California Medical Center , Los Angeles , CA , USA
Yishay Falick , M.D., M.B.A. Department of Medical Affairs , Ministry of Health ,
Jerusalem , Israel
Bruce L. Gewertz , M.D. Department of Surgery , Cedars-Sinai Medical Center ,
Los Angeles , CA , USA
Thomas R. Graf , M.D. The Chartis Group , Pine Grove , PA , USA
Victoria G. Hines , M.H.A. U niversity of Rochester Medical Faculty Group,
University of Rochester Medical Center , Rochester , NY , USA
Monica Jain , M.D. Department of Surgery , Cedars-Sinai Medical Center , Los
Angeles , CA , USA
Brett McCone , B.A., M.H.A. Department of Rate Setting , Maryland Hospital
Association , Elkridge , MD , USA
David Norris , B.S-.C.S. MD Insider , Santa Monica , CA , USA
Teryl K. Nuckols , M.D., M.S.H.S. Department of Medicine , Cedars Sinai Medical
Center , Los Angeles , CA , USA
Michael F. Rotondo , M.D., F.A.C.S. University of Rochester Medical Faculty
Group, University of Rochester Medical Center , Rochester , NY , USA
Harry C. Sax , M.D., F.A.C.S., F.A.C.H.E. Department of Surgery , Cedars Sinai
Medical Center , Los Angeles , CA , USA
Steven R. Sosland , M.B.A., B.S. Offi ce of People Development, University of
North Texas Health Science Center , Fort Worth , TX , USA
Glenn D. Steele Jr. , M.D., Ph.D. xG Health Solutions , Danville , PA , USA
xiii
xiv Contributors
Michael R. Williams , D.O., M.D., M.B.A. U niversity of North Texas Health
Science Center , Fort Worth , TX , USA
Eyal Zimlichman , M.D., M.Sc. Central Management , Sheba Medical Center ,
Ramat Gan , Israel