Table Of ContentHealthcare
Transformation
A Guide for the
Hospital Board Member
Healthcare
Transformation
A Guide for the
Hospital Board Member
Maulik S. Joshi, DrPH
Bernard J. Horak, PhD
Foreword by John R. Combes, MD
Health Forum, Inc.
An American Hospital Association Company
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Library of Congress Cataloging‑in‑Publication Data
Joshi, Maulik.
Healthcare transformation : a guide for the hospital board member / Maulik S. Joshi
and Bernard J. Horak.
p. ; cm.
Includes bibliographical references and index.
ISBN 978‑1‑4398‑0506‑0 (pbk. : alk. paper)
1. Hospital trustees‑‑Handbooks, manuals, etc. I. Horak, Bernard J. II. Title.
[DNLM: 1. Delivery of Health Care‑‑organization & administration‑‑Handbooks.
2. Quality of Health Care‑‑organization & administration‑‑Handbooks. 3. Governing
Board‑‑Handbooks. 4. Hospital Administration‑‑methods‑‑Handbooks. 5. Hospital
Administrators‑‑Handbooks. WX 39 J83h 2009]
RA971.J67 2009
362.11068‑‑dc22 2009003730
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Dedication
To our colleagues who provide us constant learning, opportunity, and
energy to work toward better healthcare
To our families for all the support and love—Emilie, Ella, and Lucas;
Nancy, Rachel, David, Molly, and Willie
Table of Contents
Foreword ................................................................................................xi
Preface ................................................................................................... xv
Chapter 1 Introduction ....................................................................... 1
Current Challenges in Healthcare Quality ...............................1
Your Duty. .....................................................................................3
Need for Transformational Change and Leadership ...............4
Te Top Ten Healthcare Transformers .....................................4
Transformer 10: Reliably Implement the Tried
and True (Chapter 2) ...........................................4
Transformer 9: Disseminate Best Practices
(Chapter 3) ............................................................6
Transformer 8: Build Organizational Quality
Improvement Capability (Chapter 4) ................6
Transformer 7: Patient-Centeredness (Chapter 5) .......6
Transformer 6: Care Coordination (Chapter 6). ...........7
Transformer 5: Health Information Technology
(Chapter 7) ............................................................7
Transformer 4: Transparency (Chapter 8) .....................7
Transformer 3: Payment Reform (Chapter 9) ...............8
Transformer 2: Culture (Chapter 10) .............................8
Transformer 1: Leadership (Chapter 11) .......................9
Organization of the Book ...........................................................9
References ...................................................................................10
Chapter 2 Healthcare Transformer 10: Reliably Implement the
Tried and True .................................................................. 11
Problem .......................................................................................12
Transformer ................................................................................14
Best Practices ..............................................................................15
Board Questions ........................................................................18
References ...................................................................................19
vii
viii • Table of Contents
Chapter 3 Healthcare Transformer 9: Disseminate Best
Practices ............................................................................ 21
Problem .......................................................................................21
Transformer ................................................................................23
Best Practices ..............................................................................26
Board Questions ....................................................................... 28
References .................................................................................. 28
Chapter 4 Healthcare Transformer 8: Build Organizational
Quality Improvement Capability .................................... 29
Problem ...................................................................................... 30
Transformer ............................................................................... 30
Best Practices ..............................................................................31
Board Questions ....................................................................... 34
References .................................................................................. 34
Chapter 5 Healthcare Transformer 7: Patient-Centeredness .......... 35
Problem .......................................................................................36
Transformer ................................................................................38
Best Practices ............................................................................. 40
Board Questions ....................................................................... 42
References .................................................................................. 42
Chapter 6 Healthcare Transformer 6: Care Coordination. ............. 45
Problem ...................................................................................... 46
Transformer ................................................................................47
Best Practices ............................................................................. 48
Board Questions ........................................................................51
References ...................................................................................51
Chapter 7 Healthcare Transformer 5: Health Information
Technology ........................................................................ 53
Problem .......................................................................................53
Transformer ................................................................................55
Best Practices ..............................................................................57
Table of Contents • ix
Board Questions ........................................................................58
References ...................................................................................59
Chapter 8 Healthcare Transformer 4: Transparency ...................... 61
Problem .......................................................................................62
Transformer ............................................................................... 64
Best Practices ..............................................................................65
Board Questions ........................................................................67
References .................................................................................. 68
Chapter 9 Healthcare Transformer 3: Payment Reform ................. 69
Problem .......................................................................................70
Transformer ................................................................................73
Best Practices ..............................................................................73
Board Questions ........................................................................75
References ...................................................................................76
Chapter 10 Healthcare Transformer 2: Culture ................................ 77
Problem .......................................................................................78
Transformer ................................................................................78
Best Practices ............................................................................. 80
Board Questions ........................................................................82
References ...................................................................................83
Chapter 11 Healthcare Transformer 1: Leadership ........................... 85
Problem ...................................................................................... 86
Transformer ............................................................................... 86
Best Practices ............................................................................. 88
Board Questions ....................................................................... 90
References .................................................................................. 90
Chapter 12 Conclusion: The Governance Engagement Checklist .... 93
Quality Literacy .........................................................................94
Agenda and Alignment .............................................................94
Patient-Centeredness ................................................................94
References .................................................................................. 96
