3 top CEO strategies for improved care

Eleven top healthcare executives agreed that engaging patients was vital to reducing costs and waste while improving outcomes. In a Health Affairs article, executives from Hospital Corporation of America, Geisinger Health System, Intermountain Healthcare and Cleveland Clinic, among others, revealed that empowering patients at their institutions helped improve care at a better value.

"For CEOs of healthcare organizations, the move toward engaging patients in their own care is not simply the right thing to do. It is quickly becoming the norm," they wrote.

They noted that patient-engaged care can be high-value care. Among the strategies, the hospital CEOs pointed to team-based care and shared decision making.

1. Evidence-based care
At Intermountain, an evidence-based approach to labor and delivery resulted in savings of up $50 million and improved patient satisfaction. Patients in labor and delivery facilities spend 750 fewer hours in delivery per year. The Salt Lake City-based system also saw inappropriate elective labor inductions drop 26 percentage points since 2001.

2. Shared decision making
ThedaCare advocates for shared decision making, in which collaborative units organize care delivery around the patient's experience. Upon admission, a interdisciplinary  team coordinates with the patient on a mutually agreed-upon care plan. The Wisconsin community health system says the program reduced hospital lengths-of-stay, errors and inpatient costs by 25 percent. In addition, patients rated their care a five out of five 95 percent of the time.

ThedaCare has also attributed high patient satisfaction to Lean management, FierceHealthcare previously reported. After applying the Toyota's Lean strategies, the number of "excellent" patient satisfaction ratings jumped from 68 percent in 2006 to 95 percent in 2010. The health system added new roles, responsibilities and care processes, which involved a clinician team visiting a patient within 90 minutes of admission.

3. Targeted care for patients, community
The health leaders also pointed to patient registries as a way to improve care for individual patients and the community. Denver Health further engages patients with patient navigators, particularly, to help low-income Latinos access medical care, FierceHealthcare previously reported. These navigators accompany patients on doctor's visits, remind them about upcoming appointments, and help patients explore options to pay for costly procedures.

On a community level, Denver Health's community health centers use registries of chronic condition patients identify high-risk patients with multiple conditions. Each identified patient is assigned to a medical home and a primary care provider. Though such targeted approaches, Denver Health increased breast cancer screening rates by 20 percent and colorectal cancer screening rates by 50 percent.

The authors noted that not all the strategies will work at every institution, taking into account differences in organizational culture and resources.

"Our experiences show that even among high-performing health systems, the definition and measurement of patient-engaged care differs based on context," they wrote.

Nevertheless, their experiences offer examples of how the leading institutions have implemented patient engagement.

For more information:
- read the Health Affairs study abstract and checklist

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