Integrating Research and Practice Health System Leaders Working Toward High-Value Care: Workshop Summary (2015) / Chapter Skim
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8 Fostering the Well-Prepared Stakeholder Culture
8 Fostering the Well-Prepared Stakeholder Culture
Pages 97-108
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From page 97... ...
effective leadership, which builds shared responsibility for improving outcomes, making transparent measurements, and sharing data in a way that engages all participants in the sys tem in collaboration to produce continuous learning, and (2) effective resources, such as tools, training, and financial sup port that enable all of the different constituencies to participate with reduced transactional barriers.
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From page 98... ...
Peter Margolis, codirector of the Center for Health Care Quality at Cincinnati Children's Hospital Medical Center, addressed the topic of physician engagement, and Bray Patrick-Lake, director of stakeholder engagement for the Clinical Trials Transformation Initiative and a member of the PCORnet Executive Leadership Committee, talked about the importance of patient engagement in a learning health system. A discussion moderated by Slutsky followed the three presentations.
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From page 99... ...
Bellin worked with its physicians to improve its production system so that it could make a guarantee in the market that it would give individual patients diagnosis-to-treatment options within 3 days. The first five dimensions, Knox said, are all wrapped up in the final dimension, which is a high-performance culture that supports creating value at speed.
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From page 100... ...
Addressing the concept of managing energy, Knox said that the entire organization runs on a rhythm of 120-day cycles, with the leaders in the organization getting together every 120 days to redefine and recalibrate the organization's priorities. In addition, a select group of executives, including the CEO, chief information officer, the chief medical officer, and the chief financial officer, get together weekly to talk about how they are managing organizational energy and the breakthrough and operational priorities as well as how to continuously foster the development of a culture to support the organization's goals.
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From page 101... ...
Despite the widely accepted findings of a 1993 study (Diabetes Control and Complications Trial Research Group, 1993) showing that intensive therapy delays the onset and slows the progression of diabetic retinopathy, nephropathy, and neuropathy in patients with diabetes and that clinicians can help patients prevent the development of these complications by helping patients maintain glycemic control, the Type 1 Diabetes Exchange showed that there is a wide variation in the degree of glycemic control that patients are achieving today.
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From page 102... ...
When this works, it produces a culture where everyone is working together and where, as Margolis put it, "our networks steal and share shamelessly." PATIENT ENGAGEMENT In the session's final presentation, Bray Patrick-Lake said that patients dream of a high-quality health care system that is patient-centered and efficient and that enables reliable and timely access to evidence-based prevention and treatment options that are responsive to individual patient needs. Moreover, she said, while the current health care system is not operating optimally for anyone, she believes that it is possible to create just such a system if everyone can come together to work on the issues that this workshop has identified: inefficient use of resources, siloed data that could be used to improve care on a daily basis, research that never filters back to patients, and lack of transparency when it comes to value and outcomes.
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From page 103... ...
They are creating forums for real-world populations of patients to compare medication regimens and exchange other relevant information that they feel they are not getting from the clinical community. "Patients are coming together to create these user-designed systems that actually meet the triple aim and that have been shown to reduce spending," Patrick-Lake said, adding that these networks need to think more about metrics and that she hoped that the PCORnet community would help with that task.
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From page 104... ...
Jon White from AHRQ asked Knox to comment on the resources that a system needs to invest in, in an information system. Knox replied that he and his colleagues are building what they are calling a knowledge brain that has to operate at three levels: a strategic level that can look at populations, understand populations at a macro-level, and help devise strategies to improve population health; the mezzanine or registry level that operates outside of the boundaries of the Bellin Health system to help accomplish the triple aim; and a point-of-care level that helps clinicians when they are in front of patients.
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From page 105... ...
"I think that's the paradigm shift that we can see where we can partner and study things in a much broader capacity," she said. This remark prompted Richard Platt of the Harvard Pilgrim Health Care Institute and director of the PCORnet Coordinating Center to note that he would be meeting with the various NIH institute directors to discuss how they might engage with PCORnet to take advantage of the opportunities created by working at the scale that PCORnet will create when it is fully implemented.
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From page 106... ...
The results showed that care being delivered by neurologists varied significantly across the country, with the greatest departure from best practices seen in patients treated by neurologists who were not epilepsy specialists. There were two particularly disturbing findings: Neurologists did not discuss contraceptive control with patients on antiseizure drugs or the potential for surgical intervention.
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From page 107... ...
As examples, he cited the Cleveland Clinic's effort to market its cardiac surgery model to states and Geisinger's partnering with XG Health Solutions, a venture capital firm in which it is a minority owner, to get its solutions to the market. Knox noted that Bellin is the fourth-largest vendor of retail clinics through its FastCare brand and that it is about to launch a franchise licensing model.
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From page 108... ...
(3) organization, Margolis replied, "We do it in the context of a network that includes multiple medical centers and a 501(c)
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