© 2010 university of southern california session v, panel i integrated health care delivery systems...
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© 2010 University of Southern California
Session V, Panel IIntegrated Health Care Delivery Systems in Action II
Organizing for Sustainable Quality Health Care
Delivery
A Time for Change: Restructuring America’s Health Care Delivery System
Cornell University, Wednesday, May 12, 2010
© 2010 University of Southern California
Susan Mohrman, Center for Effective Organizations, University of Southern California
Michael Kanter, Southern California Permanente Medical Group, Kaiser Permanente
Patti Harvey, RN, MPH, CPHQ, Kaiser Permanente Southern California Region
Walter Allen, Coalition of Kaiser Permanente Unions
Guido Bergomi, Director, Quality & Patient Safety, Cleveland Clinic
Linda McHugh, Executive Administrator , Cleveland Clinic
© 2010 University of Southern California SM102T
• Demographic trends• Escalating costs• National economic adjustments
in healthcare resources• Powerful, expensive, and
disruptive medical care technologies for treatment, prevention, and cure• Skill shortages• Active government
stakeholders• Relentless degradation of the
environment
© 2010 University of Southern California SM26U
Definitions of Sustainability
• Development that "meets the needs of the present without compromising the ability of future generations to meet their own needs”
(Brundtland Commission, 1983)
• Our working definition of the sustainable provision of health care outcomes: the complex healthcare system operates to continually deliver high quality health, societal, and ecological value and operates with a viable economic model.
© 2010 University of Southern California SM20U
The Health Care Eco-System May Look Quite Different in the Future
• The Cleveland Clinic and Kaiser Permanente are among those leading the way
• They are making headway with multi-faceted approaches involving integrated health care delivery and system optimization
© 2010 University of Southern California SM22U
Principles of Health Care Sustainability
• Increase Value: Quality and impact of the health care services that are delivered and the benefits derived from health care resources
• Decrease consumption of resources that does not contribute value
• Optimize the system• Build effective work systems• Empower patients to take responsibility for
their health
© 2010 University of Southern California SM23U
A Tale of Two Systems – Institutional Contexts
Not-for-Profit• Kaiser Permanente – Capitation and Member
Model• Cleveland Clinic—Fee for Service
Values Based
Integrated Care Focus• KP—Prevention and Life-Cycle Care;
Integration across primary and specialty care• CC—Multi-specialty care brought to bear on
patient
© 2010 University of Southern California SM23U
Institutional Context, Continued
Knowledge Leverage and Growth Strategies• KP—increase market penetration; raise bar
for health status and outcomes of entire membership; build on deep longitudinal knowledge from millions of members
• CC—leverage cutting edge health care knowledge into new markets and services
Research and Evidence-Based Approaches
© 2010 University of Southern California SM24U
Common Elements of Emerging Healthcare Delivery System• Comprehensive electronic medical records provide
ease of integration of care• Organizational and process integration across multi-
specialty medical system• Resource leverage through the
rationalization/system-wide integration of multi-facility system
• Work system and organizational redesign• Developing shared, evidence-based standards,
protocols, methodologies and technologies• New care modalities enabled by I.T. and other
technological advances• System regulation• Learning, innovating, and improving• Beyond “Traditional Health Care” focuses:
– Ecological impact– Health community
© 2010 University of Southern California SM25U
Conclusion
• The major elements of the sustainability transformation of the two systems are the same
• The particular manifestations are impacted by the institution contexts and business model
The journey to sustainable health care is:SystemicMulti-OrganizationalMulti-Level
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