Healthcare Organizations – Improving The Affordability

According to an article published in H.B.R in the year 1990,

“Within four years of introducing on, the Malcolm Baldrige framework became the most important catalyst for transforming American Business. More than any other initiative, public or private, it has reshaped leaders’ and managers’ thinking and behavior. The Baldrige Award not only codifies the principles of quality management in clear and accessible language, but it also goes further: it provides companies with a  comprehensive framework for assessing their progress toward the new paradigm of management and such commonly acknowledged goals as customer satisfaction and increased employee involvement.”

 

An organization that commits itself to the journey of implementation of the Baldrige framework is practicing enlightened self-interest. If it does a beer job of understanding its stakeholder requirements, it will do an excellent job of fulfilling it. Understanding the stakeholder requirements is simply the most reliable source of long-term profitability and sustainable growth. In the world of business, every idea – however noble must survive the test of the bottom line. 

A case in point is the Readmission rate, ‘A hospital readmission is an episode when a patient who had been discharged from a hospital is admitted again within a specified me interval.’ 

Re admissions are already one of the costliest episodes to treat, with hospital costs reaching $41.3 billion for patients readmitted within 30 days of discharge, the Agency for Healthcare training & Research and Quality (A.H.R.Q) reported.

This is a case study of a mid-size organization that was struggling with the challenge of shrinking market size and reducing community confidence. Inspired by the success
stories of other organizations, the organization decided to implement the Baldrige framework. The framework requires asking a lot of questions that help the organization in channelizing the already scarce resources in the right direction.

It mandates that the applicant organization needs to define its key stakeholders and
their requirements. And as a part of this exercise, two main healthcare segments were identified. As an outcome of this activity ‘Affordability’ and ‘Quality of Care’ were identified as the key requirements by both the key stakeholders – Patients and the Community.

Key customer / stakeholder requirements and expectations

This Become one of the Strategic Objectiveof Organization

Strategic ObjectiveKey Measure
Enhance the continuum of care for all patients (Quality, growth)30 days Readmission rate

It Was Then Aligned With The Strategic Planning Process And Short Term And Long Term Goals And Process Changes Were Idenfied.

Strategic ObjectiveRelevant Strategic challenge & Strategic AdvantageShort (S) & Long (L) term goalsKey Short (S) & Long (L) term HR goals
1. Enhance the connuum of care for all paents (Quality, Growth)1. Well-deployed interdisciplinary care teams

2. Strategic partnership with affiliated medical group

3. Integraon of physicians and staff on process improvement and innovaon

4. Collaboraon with community clinics

Strategic Challenges

1. Maintain affordable prices in environment of increasing labour and technology costs.

2. Financial resources in environment of increasingly low reimbursements and Regulatory changes
S:

1. Collaborate with case management, physician offices, community clinics, SNF’s, and PHP to enhance the connuum of care

L:

1. Develop and pilot a model for comprehensive care delivery
S:

1. Recruit and hire one case management supervisor and two case management staff members

L:

1. Recruit specialists in partnership with medical group
2. Staffing adjustments to be determined aer inial needs assessment is performed

The organization then designed and implemented its Work System (a broad and high level end-to-end process depiction the enre value chain) by drawing a critical link to the core competency to meet the customer and stakeholder requirements, and deliver customer and stakeholder value. This was achieved by continuous and rigorous monitoring of DASHBOARD results.

The following steps were taken to reduce the readmission rate in Healthcare Organizations :

  1. Patient and family education (Coaching) – Patient-directed education or coaching to diagnosis or treatment rationale to increase patient / family’s knowledge and enhance their involvement in care and compliance of the medications and other treatment requirements.
  2. Discharge Planning – Formalizing an approach to prepare for discharge; Establishing a transitional care plan before discharge; Ensuring  communication between the medical team members and / or evaluating the patient’s support network and post-discharge services; Evaluating patients’ abilities of self-care and household environments.
  3. Scheduled physician appointment at the me of discharge – every patient that is discharged , leaves with a scheduled physician office appointment. Patients requiring a follow-up appointment from the emergency department also have scheduled physician appointments.
  4. Palliative Care Nurse – resources were approved to add a Palliative care nurse and team to address end-of-life patient needs and reoccurring patient re-admissions. The Palliative Care team provides resources and support for patients and families confronted with chronic diseases and end-of-life care.

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