Culture Shift in Healthcare
A healthcare organization’s success relies heavily on the implementation and execution of organizational culture and clinical performance improvement initiatives.
More than ever health systems are seeking leaders that can lead through culture and who are prepared for these changes.
As healthcare organizations begin to move further into Value-Based Purchasing (VBP) Programs, leadership roles grow in complexity in relation to the change.
In an article published August of 2017 by HIT Consultant, contributing writer and researcher Julianna Davis discusses the nature of organizational culture stating,
“An ambiance of positivity, support, and innovation typically leads to better job satisfaction, which in turn often translates into greater profits, happier clients, and improved overall workplace rankings.”
A corporate culture model can be effective for healthcare organizations, but it also must continue to be shaped by industry changes, and endeavor to keep costs down without negatively impacting patient outcomes.
Leadership in Value Based Environments
Understanding how leadership culture and clinical performance are related, it is important to acknowledge the positive organizational effects of transitioning to Value-Based Healthcare.
As opposed to a traditional fee-for-service (FFS) model, in which all services are to be paid or reimbursed encouraging greater spending, Value Based Care models reward better outcomes and lower spending.
This model drives home the idea of a “patient first” mindset, and has proven to be successful over a broad range of health organizations. By pairing corporate culture models with value based care, organizations strive to improve staff communication, customer service, and above all create a better patient experience and save lives.
HIT Consultant continues the discussion on the complexity of culture in healthcare organizations stating,
“The healthcare industry has a number of unique attributes that can make culture-planning something of a challenge. The focus on patients, the frequently odd working hours, and the often pervasive shifts in team composition necessitate a certain flexibility not always found in more traditional office set-ups.”
With this evolving model, it has become evermore important to appoint organizational leaders that are prepared for transformative change, as well as hire employees willing to adapt to a healthy corporate culture.
Determine your Healthcare Leadership Style
Leading The Way
The best way to develop you're own culture improvement initiative is to learn from the exceptional leaders at the forefront of change.
San Francisco General Hospital and Trauma Center
Catalyst.org discusses 5 changes leaders can make to develop an improvement culture. One of which is “willingness” on the part of leadership and staff.
Catalyst.org states,
“Positive transformation requires a state of readiness for making the personal changes that allow leaders to improve their interactions with others”, and that “change is required, which then lends to the willingness to do so.”
As seen in a case study of Zuckerburg San Francisco General Hospital and Trauma Center, CEO Susan Ehrlich has seen positive improvements since the implementation of a culture improvement pilot program in 2011. ZSFGH has reported,
“shorter cycle times for lower-acuity patients in the ED, a greater capacity to see patients in the urgent care clinic, and reduced wait times for prescriptions in the outpatient pharmacy”
Organizations lacking cultural leadership are more prone to breakdowns in communication, especially in a period of organization-wide transition like ZSFGH.
To lead a successful executive healthcare career, executives must acknowledge all of the difficulties and complexities in order to execute a healthy change, and the importance of appointing a prepared leader who inspires confidence in both staff and patients is immeasurable.
According to the San Francisco Health Network, Health Director Barbara Garcia states,
“Dr. Ehrlich joins us at a moment of unprecedented activity and excitement, as the entire environment of healthcare is changing, as the needs of our community continue to grow, and as we prepare to move into our new state-of-the-art acute care and trauma center in spring of this year. We know our hospital will be in great hands.”
Horizon Healthcare Services
In a case study published in February of 2015, Horizon Healthcare Services (HHS) demonstrates how they began their own journey into culture improvement. Beginning in 2010, HHS partnered with the Healthcare Incentives Improvement Institute (HCI3) to implement a model that tackled the challenge of moving from fee-based to value based care models to improve quality, and increase patient satisfaction and cost reduction.
Lili Brillstein, Director of Episodes of Care at Horizon Healthcare Services stated,
“Of all the triple-aim models that focus on quality, improving patient experience and total cost of care, the bundled payment or episode of care model really is the most manageable. Instead of focusing on a single provider and what that provider can achieve, it puts the patient at the center and focuses on everything that actually happens to that patient related to a particular medical condition, illness or procedure.”
Using the episodes of care model, HHS kicked of the new initiative in 2010 beginning with the tracking of total hip and total knee replacement episodes only. Since then they have applied the model to knee arthroscopy, pregnancy and delivery, colonoscopy, breast cancer, heart failure, lung cancer, and colon cancer.
According to the case study, as of 2015, Horizon’s Episodes of Care program had over 900 physicians. As 2015 drew to a close, the company completed over 12,000 care episodesand had several thousand episodes in-flight – making it the largest commercial bundled payment program in the country.
Results of the study concluded that significant improvements were made in the areas of patient safety and cost of care delivery which the new model was applied.
Quality Improvements
- 3% higher rate in cholesterol management in 2014
- 3% higher rate in breast cancer screenings in 2014
- 8% higher rate in colorectal cancer screenings in 2014
Cost Reduction Improvements
- 5% lower rate in emergency room visits in 2014
- 8% lower rate in hospital admissions in 2014
- 4% percent lower cost of care for diabetic patients
- 9% lower total cost of care in 2014
Culture and Leadership
Maintaining a healthy culture while juggling frequent policy changes and initiatives can benefit an organization in every respect. Patient satisfaction can often be linked to employee satisfaction, and in a patient first environment this is critical.
Dr. Amita Rastogi of HHS describes Lili Brillstein’s leadership qualities throughout the initiative:
“Lili’s collaborative spirit is infectious as she describes how episodes of care can change the way healthcare is delivered and reimbursed. Through her leadership we see providers and payers working in close collaboration with mutual trust, and with a common goal – to have the patient’s medical and financial wellbeing as their true success factors.”
Effective communication can help prevent errors, leading to more positive patient outcomes and thus a greater sense of job satisfaction amongst managers and staff.
In both cases, a strong, conscious, and adaptable leader was required to keep up with the demands of an ever changing industry.
Each executive acknowledged and understood the complexity of new initiatives, and with the trust of their staff were able to build a culture capable of successfully implementing new policy changes.
Determine your Healthcare Leadership Style
Leaders of every background and professional can become agents of transformative change within their healthcare organization.
Discover six different leadership styles and learn how you can apply them to lead organization-wide culture improvement initiatives like the San Francisco General Hospital and Trauma Center and Horizon Healthcare Services.
Determine your Healthcare Leadership Style
