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It's not often you come across an executive of a $2.6 billion integrated health system with 14,000 employees who takes the time each morning to exchange pleasantries via email with a unit secretary who works at one of his hospitals.
But then there aren't many CEOs like Chris Van Gorder. I recently interviewed him to learn more about his frontline approach to leadership, which helped bring Scripps Health back from the brink of financial disaster and cut staff turnover in half.
As he talked about the importance of his Friday leadership rounds, when he visits and interacts with employees at one of the system's five hospitals or 28 outpatient clinics, he mentioned how one unit secretary from the 11th floor of Scripps Mercy Hospital in San Diego emails him every day.
And he responds every time.
She begins each email the same way, "Hi Boss." On the day we had our scheduled interview, Van Gorder says Arby Bautista had asked over email about his weekend and what was on his schedule for the day. Knowing that she worked over the weekend, he replied, saying he hoped she could take a couple of days off during the week.
"It only takes a couple of seconds" to respond, Van Gorder says.
As the national movement away from fee-for-service healthcare--the seismic transformation from volume to value--gains steam, hospitals are beginning to understand on a deeper level that keeping entire communities healthy is an effort that (almost literally) takes a village.
While many hospitals are forming organic relationships with community partners like primary care physicians, skilled nursing facilities, health departments, social service agencies and others, here in Maryland, hospitals have found a another dedicated partner in the state government.
A little more than a year ago, Maryland's health secretary designated five Health Enterprise Zones (HEZs)--areas throughout the state with traditionally poor health outcomes that needed a boost.
I am writing this on a plane with my seatbelt strapped tightly around my waist. We have just experienced what the pilot casually referred to as "slight turbulence." It dawned on me that slight turbulence to him was not the same to me. My gut was in a knot and by the expression on the faces of my fellow passengers, they didn't think it was "slight," either.
I was reading an article on value-based care as I bounced about in my seat, and thought about all the healthcare policy changes that have occurred over the past 18 months. Those of us in healthcare know and understand that commotion in this industry is expected and eventually passes with time, but the turbulence we have undergone and continue to face does not have an end in sight.
There were many presentations at the March conference of the American College of Healthcare Executives regarding population health management. With value-based purchasing heating up, accountable care organizations forming fast, and readmissions a big hot button, it's only natural that keeping people well and out of the hospital would be a part of the conversation.
I am not a clinician, but I know enough to understand that population health management has been focused on the chronic conditions that eat up cost, challenge access and could be controlled--heart disease, diabetes or cancer, for example.
But is dementia, including Alzheimer's, really being addressed in current population health management models? I would contend no.
by Raymond Hino
In January, the American Hospital Association (AHA) came out with its most recent report for the healthcare field, "Leadership Toolkit for Redefining the H: Engaging Trustees and Communities." I like to call this report the third in a series of major landmark reports by the AHA that deal with the road that our nation's hospitals are embarking on to reinvent themselves for a new future payment system based upon the Triple Aim of patient experience, patient care at an affordable cost and population health.
All three reports are valuable to our field. The first was "Hospitals and Care Systems of the Future," released in late 2011. The second report was "Your Hospital's Path to the Second Curve: Integration and Transformation," which arrived in January 2014. All hospital executives and hospital board members would be well served, if you have not already done so, to read all three reports. They are all easy to read and available on the web. Be sure to choose the version of each report with all appendices. They are the most important parts of each report.
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