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Recently, I attended an interdisciplinary team meeting. There was a knock on the door to the conference room. Before I could rise to open the door, it swung open and one of our attending physicians scanned the room, made eye contact with me and beckoned me to step outside.
The two of us made our way to my office, where this physician, visibly upset, explained to me her interaction with the wife of one of her patients. She described the spouse (whom I'll call as Mrs. Jones), as aggressive, unrelenting, and dare I say, hostile. I was taken aback, as the patient was admitted the day before. What could possibly have gone so wrong in such a short period of time?
The physician asked me to accompany her to the patient's room, as she wanted me to witness the interaction between the patient, Mrs. Jones and the staff. After quickly reviewing the patient's admission notes, I accompanied the physician to the patient care unit, where we came upon Mrs. Jones standing at the nurses station. She was visibly upset, evidenced by her raised voice and demand to see someone in charge. As I approached the desk, I reach out my hand to introduce myself with a calm, low voice. The staff stood wide-eyed waiting to see what would happen next. The physician gave me the, I told you so look, but I stayed focused on the family member.
In boardrooms, at universities and in executive offices throughout the U.S., top healthcare leaders have worked feverishly for years to combat escalating healthcare costs and middling, if not downright poor, health outcomes when compared to other nations.
The efforts resulted in a number of innovative experiments in different states. The outcomes remain to be seen, but one of the early findings suggests that healthcare providers have failed to engage patients and, in effect, make them full partners in their own healthcare.
Patient engagement at its heart is a simple concept--empowering the people in our care to take more control of their individual health. But for hospitals, putting that concept into action took a back seat under traditional fee-for-service models. The new experiments throughout the nation exploded those models and patient engagement has come to the forefront.
by Kent Bottles
The implementation of the Affordable Care Act (ACA), with its payment reform components that champion the transition from fee-for-service to global, value-based payments, continues to stir up the healthcare insurance industry. Insurers, recognizing that the ACA outlaws traditional industry practices, attempt to reinvent their business models.
Three recent news articles highlight the difficulty of this reinvention process. Emphasizing the national nature of this challenge, two of the developments came out of the Pittsburgh region and one out of Los Angeles.
The bitter battle between the University of Pittsburgh Medical Center (UPMC) and Highmark has captured the attention of health policy analysts from all over the country. Both organizations have their own insurance products, and the decision by Highmark to create a competing health system, Allegheny Health Network, resulted in UPMC failing to renew contracts with Highmark. Many Pittsburgh citizens with Highmark insurance want to be able to visit specialists at UPMC and complained about the inability of the two large organizations to cooperate.
Why do people fear failure in business? I mean, what's the worst they could happen? You get fired.
It was around 1999 when my boss Sue called me into her office. Someone brought a concern to her and she wanted me to know. She let me know there were a few people in my department who felt I was out to get them. These were all employees who were out on a performance improvement plan for their work. She was aware of these plans. We spoke some more and she saw I was clearly shaken up. Here I was, holding people accountable, staying focused on our organizations goals, my intentions in the right place and wham--I was suddenly the bad guy.
My boss provided a good lesson: She asked if I was out to get these employees and I immediately said no. She asked if she's ever accused me or expressed concern that I wasn't treating people fairly while holding the department team accountable. I said no.
She said, what's the worst thing that could happen to you? I shared the fact that she could fire me. She agreed and went on to ask, "Don't you think you would have some warning if this was going to happen, or if I had concern with your performance?" Yes, that certainly made sense.
Patient-centered care, patient engagement, patient activation--all terms many of us healthcare leaders use to describe a key output of improving the healthcare system.
I write a lot about these topics and recently made note of misconceptions and lessons learned specific to these very important focal points:
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