• Leadership E-Bulletin: March 2012

    Mar 19, 2012

    This March e-bulletin highlights the Spring 2012 Leadership magazine, which includes numerous examples of how hospitals and other providers are transforming healthcare delivery to improve coordination and efficiency. The latest issue of the Leadership magazine also features a refreshed layout, new departments and columns, leader profiles, and more.

    Medication Handoffs: Mending the Gaps

    Early each morning, every patient being treated in one of Memorial Healthcare System's six Florida hospitals receives a patient- and family-friendly daily medication schedule. The list includes the names and doses of each medicine that the patient is scheduled to receive and the time the medicine will be given.

    By sharing that information, Memorial encourages patients and families to help ensure that the right medications are administered to the right patient in the right dose. "We have had some amazing catches, such as 'I'm not a diabetic, so why would insulin be on this list?'" says Rebecca Caschette, RN, MS, Memorial's administrator of quality and patient safety.

    Like Memorial, many leading health systems are trying to improve medication management using technology, process improvement techniques, and care coordination. For the most part, these providers are focusing on two serious and expensive problems: a high rate of medication errors in hospitals and poor compliance with medication orders after patients are discharged. 

    Coordinating Care Across Sites

    Michael Richter, MD, a pediatrician and internist in Queens, is one of 2,500 independent physicians participating in an electronic health record (EHR) initiative that is creating a "virtual" healthcare system in medically underserved areas of New York City. Collectively, participants in the Primary Care Information Project (PCIP) serve nearly 2 million patients.

    The virtual PCIP network enables physicians to communicate easily and coordinate care- either by automatically faxing medical summaries, laboratory values, and progress notes to one another or by sending structured data directly into another physician's progress notes when a referral is made. The PCIP initiative is just one example of how providers are working to coordinate care across sites. 

    The Quest to Accomplish More with Less

    At Appleton Medical Center in Wisconsin, nurses no longer waste time retrieving supplies because most items are stocked within easy reach of patient rooms. In New York, Mount Sinai Medical Center has connected a wireless communication system to ventilator and cardiac-monitoring alarms-and increased caregiver response times. And in Ohio, The Arthur G. James Cancer Hospital is increasing cancer volumes by pairing nurse practitioners with oncologists.

    These types of output-boosting strategies are essential to solving one of the healthcare industry's fundamental problems: lagging labor productivity. 

    Q&A: Scripps' Restructure Unleashes Dramatic Results  

    In late 2010, San Diego-based Scripps Health restructured, overlaying a horizontal management structure on the vertical arrangement that was already in place at its hospital campuses and outpatient centers. The goal is to improve care and cut costs by reducing the variation in clinical and administrative functions-without eliminating jobs.

    Scripps' radical new matrix management structure led to $48 million in cost cuts and $29 million in revenue increases-in just one year. "Each one of our hospitals was doing very well, says president and CEO Chris Van Gorder. "But all of them were operating very differently based on the desires of a vertical management team…It struck me that if we looked at our organization horizontally…we would probably see a very different picture." 

    More Inside Leadership

    The Spring 2012 Leadership magazine also contains profiles of three prominent healthcare leaders-Intermountain Healthcare's Brent James, MD, MStat; care coordination expert Gerri Lamb, PhD; and the Veterans Affairs CIO Roger Baker.

    Also, access the following columns from Leadership contributors: