Frontiers of Health Services Management - Spring 2013 - (Page 29)

The Present Unsustainable Healthcare Environment The Key Question and Key Answers Both authors ask this critical question: What must we do to ignite the enthusiasm and will in our organization—at the front lines, in the leadership and management teams, and in the board and governance processes—to create not only a sustainable but a thriving healthcare industry for all who enter our doors? not surprisingly, toussaint and Kaplan provide similar answers. each repeatedly stresses that transformational change throughout all levels of the delivery system is essential, noting that changing the way the people in the organization think and perform is the most important step toward ensuring success in the future marketplace. they agree that this change in approach must be driven by lean thinking— studying how to perform tasks and provide services more efficiently than in the past with fewer resources. this thinking is embedded in toussaint’s management-byprocess model and exemplified by virginia Mason’s adoption of the toyota Production System (tPS) almost a decade ago. Both authors also indicate that change is a journey and not a destination. that journey requires an organization to focus on continuous improvement, lifelong learning, and an intense commitment to reporting metrics related to outcomes in Thomas C. Royer • 29 c o m m e n t A r y Both toussaint and Kaplan define in their opening paragraphs the operational characteristics of most healthcare delivery today, which industry leaders generally accept as valid. i attribute the poor performance outcomes they note to four drivers of the need for transformational change, a critical factor for future success that both authors mention in their articles. the first driver is the lack of consistency and coordination of services among providers that results in much of the poor quality of care delivered today. toussaint highlights this problem by noting the excessive levels of medical errors, readmissions within 30 days of discharge, and unnecessary deaths. the second driver is the high cost of care in the United States, where prices and charges bear no relationship to actual cost structures. exacerbating the high cost of poor outcomes is the unnecessary duplication of services and tests caused by the aforementioned absence of care coordination among providers. the third driver is increased physician dissatisfaction, often triggered by physicians’ realization that they are being asked to relinquish their independent practice style. although toussaint knows firsthand that doctors in training are taught that individual judgment is more important than best-practice protocols and independence is more important than group critical thinking, he understands that this mind-set no longer has a place in today’s healthcare marketplace. the fourth driver is a misaligned vision of leadership teams that results in a focus on illness rather than wellness and on volume rather than value. Kaplan and the leadership team at virginia Mason Medi- cal center confront this driver by working “to avoid the mentality that bigger is inherently better” (page 24). When considering these four drivers of change, it appears that the only health systems that will survive in the future are those that can prove by their outcome metrics that they are providing consistent, high-quality, and safe services at accessible sites and times and at affordable costs.

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Spring 2013

Frontiers of Health Services Management - Spring 2013
Contents
Frontiers of Health Services Management - Spring 2013
A Management, Leadership, and Board Road Map to Transforming Care for Patients
Pursuing the Perfect Patient Experience
Adapting to the New Healthcare Market
High Reliability: Truly Achieving Healthcare Quality and Safety
Making Lean Progress Last: Why Sustaining Excellence Requires the Right Leadership Framework

Frontiers of Health Services Management - Spring 2013