Journal of Healthcare Management - January/February 2014 - (Page 10)

Journal of H ealt H care M anage Ment 59:1 J anuary /f ebruary 2014 medicine" (an implementational value) (Berry & Seltman, 2008). An organization's core values are the ideals and principles that shape the behavior of people in the institution, and Mayo's values lie at the heart of its ability to demonstrate positive results. More than 100 years ago, the Mayo brothers imagined a healthcare environment that was much different from the provision of care in their day. Rather than individual doctors proudly entrenched in their own practices and beholden to no one, the Mayos envisioned physicians of many specialties working together with only their patients' well-being to consider. Teamwork was demanded, not simply encouraged. Sharing knowledge was a requirement, not a hope. Integration around the patient's best interest was uncompromising. The Mayos insisted on a fixed salary for physicians so they would have no incentive to provide any more or any less care than the patient required (Clapesattle, 1941). Patients who come to Mayo Clinic with complex medical conditions benefit from the pooling of knowledge within the organization that is relevant to their care-they get the benefit of an integrated team. Despite its many strengths, Mayo isn't perfect. However, a medical organization that has thrived for 150 years and earned worldwide recognition offers valuable lessons-especially on teamwork. CaN aCos FoStEr GENUiNE tEaMWorK? Many health policy analysts and the Centers for Medicare & Medicaid Services view ACOs as keystones to delivering U.S. healthcare effectively and efficiently by promoting collaborative, coordinated care across multiple providers and organizations (Berwick, 2011). An ACO is a clinical entity made up of one or more organizations that contracts with public or private payers to deliver and coordinate the overall healthcare of a defined patient population, to measure and report on quality performance, and to link reimbursement to the achievement of quality and cost goals (Nichols, 2012). We believe that ACOs can be a force for good if they make teamwork their unshakeable cultural priority (Frolkis, 2013) but recognize the challenge embedded in the resistant nature of established patterns of behavior throughout healthcare (Christensen, Flier, & Vijayaraghavan, 2013; Goldsmith, 2009). To fully achieve improved care, improved service, and reduced cost, ACOs need to acknowledge that integrated care requires, above all else, genuine teamwork; labeling care as "integrated" does not mean that it really is integrated. ACOs must explicitly promote and implement teamwork that is both cultural and structural. Cultural teamwork emerges from the values of team members: People in high-performing teams want to collaborate to be part of something bigger than themselves. Structural tools, such as payment plans, information technology, and organizational charts, facilitate teamwork but do not alone constitute it. The current ACO movement has limited its potential by overemphasizing structural elements, such as incentives, without a simultaneous focus on fostering a values-driven culture of teamwork. An ACO cannot rely solely on incentives to convince 10

Table of Contents for the Digital Edition of Journal of Healthcare Management - January/February 2014

Journal of Healthcare Management - January/February 2014
Contents
Interview With Kenneth R. White, PhD, FACHE, Associate Dean for Strategic Partnerships and Innovation and the University of Virginia Medical Center Professor of Nursing, University of Virginia School of Nursing
Team-Based Care at Mayo Clinic: A Model for ACOs
The Management Springboard: Eight Ways to Launch Your Career as a Healthcare Leader
The Role of a Public–Private Partnership: Translating Science to Improve Cancer Care in the Community Donna M. O’Brien and Arnold D. Kaluzny
The Value of Patients’ Handwritten Comments on HCAHPS Surveys John W. Huppertz and Robert Smith
Can Inbound and Domestic Medical Tourism Improve Your Bottom Line? Identifying the Potential of a U.S. Tourism Market
Success Factors for Strategic Change Initiatives: A Qualitative Study of Healthcare Administrators’ Perspectives

Journal of Healthcare Management - January/February 2014