An accountable healthcare organization – it is possible!

I was excited to read recently that the Cleveland Clinic took the radical step of eliminating their departments of medicine and surgery! In the article Cleveland Clinic’s 4 radical approaches to care integration, patient satisfaction, by Karen Cheung-Larivee, December 7, 2012, published on FierceHealthcare, Karen states that they were "rethinking the organization based on patient needs." Radical!?

In my recent whitepaper on accountability in health care, I make the point that physician leaders are not empowered to run a Service Line, not in the sense that they have full accountability for all 5 critical goals:
"Triple Aim"
• Excellence in clinical outcomes
• Value
• Patient Satisfaction
Institutional success
• Revenue growth
• Culture that attracts and retains the very best clinicians, leaders and staff.

Most service line chiefs do not have full authority and consequent accountability for everything that happens to their patients, including inpatient services and nursing. Also, frequently, they must fight political battles with the Chief of Medicine or Chief of Surgery who manage a function rather than a cohort of patients. So the old model of a Department of Surgery and a Department of Medicine are one of the many confounding elements that make service line accountability difficult. Yet, here we have one of the most renowned healthcare institutions tearing away the old assumptions and operating under a new model.

This type of fundamental restructuring of organizations can be a game changer. It genuinely empowers leadership in the service lines to drive improved outcomes, process improvement, staff development and more, all while being able to look at the full financial impact of their decision, whether inpatient or outpatient, surgical or noninvasive.

Once organizations truly begin to rethink how they serve their patients, from the patient’s point of view, I truly believe that improving value (better outcomes at best cost) will truly be within reach. What do you think?

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