We wouldn't have gotten there without a group of people with the vision, skill and commitment to achieve something that at times seemed impossible. Your skin will glow and people will notice. This is where leadership will meet its test: Are we willing to forge ahead, confront difficult situations, even consider losing people who have been with the organization for decades, to execute the new playbook required of truly integrated delivery systems? Even though there may be a perfectly fine strategic plan for the system, does each business unit have a clear mandate for how it will help to achieve it? While geographic and service expansion may occur, too often the resulting organization is a potpourri of entities — yielding neither integration nor efficient operations. To avoid being a system in name only, health care organization leaders should undergo some intensive self-evaluation, and then take concrete steps to ensure that their organizations are, in fact, integrated. Leaders at many health systems are hoping their organizations will become integrated delivery systems, but they struggle to achieve the desired goals.
A patient is desperate to get well and will not be bothered about what happens to the payment made at that point. Care management, physician recruitment, risk management, patient safety, and staff education and training are just a few functions that can benefit from integration within the system, and they are often not coordinated effectively. Does the physician recruitment plan for the hospitals support the needs of a physician network for population health management? Consolidating resources for efficiency, expanding access points and market presence, adding resources to assist population health management, acquiring facilities for expansion or diversification, creating a means to recruit and retain physicians … the list goes on. Population health initiatives have not been integrated or may even compete with traditional operations (e.g., discharge planning, care management, hospitalist programs). The skills and experience necessary at the system level may be different from that of the past, if the organization has grown from a one- or two-hospital institution to a multidimensional system that spans the continuum of care. While many traditional functions — finance, human resources, marketing, information technology, purchasing — already may be centralized into system functions, others may be proliferating around the system in different silos.
Then hold on and stay focused — and don't be afraid to disassemble some parts to be sure those you retain fit together to create the vehicle that will propel you to your desired destination. What will the hospitals' payer strategy be? Are payer and pricing strategies integrated for each of these business units? Making sure that systemwide goals and incentives are just as powerful as local or business unit incentives is key if system strategies are to be achieved with any speed. Likewise, do physicians' incentives reach beyond individual productivity and include measures related to systemwide performance (e.g., population health metrics)? For example, if the system seeks to evolve into a population health management enterprise, how will the employed physicians be engaged to lead the redesign of care models? Inertia is a powerful thing and, left to its own devices, each hospital within a system, each physician practice, and each post-acute or other business unit will pursue activities that have produced success in the past. One of the most critical ways to integrate clinical performance is to establish a clinical leadership governance model that oversees the physician enterprise, employed physicians, clinical standards and recruitment throughout the system.
Set the vision, structure the enterprise, assemble the team and measure performance to ensure that you're on the right path. No matter which method is chosen, home remedies for stretch marks can be found right in the kitchen or bathroom cupboard. As you rightly said it's not an easy issue to solve, but turning the head around until it's late isn't the right answer. My poor 12 year old daughter does so much for me and I am so sad that I have to depend on her. Thank you so much for your interest and support in this and other DIY skin care articles of mine. There are many reasons health care organizations are extending their reach horizontally and vertically. Is there a systemwide information technology plan that considers all business units (hospitals, medical groups, post-acute care, system needs, etc.)? The same can be said for system management positions: Make sure that the roles necessary for systemwide leadership are a match for the capabilities of the individuals assigned.
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