By Matt Kuhrt
The move toward value-based care provision models in healthcare has led to an increased focus on both the cost and quality of care patients receive. Many of the efforts to date have dealt with primary care practices, leading to a relatively untapped opportunity to improve value among specialists, according to an article in the Harvard Business Review.
Tests and procedures controlled by specialists generate enough costs within the healthcare system to spawn major initiatives such as Choosing Wisely to get them under control. The difficulty hospitals and healthcare organizations have had in getting physicians involved in cost-control efforts suggest the need for a culture change, and has led some organizations to add an administrative layer to centralize efforts through "value management offices."
The Brigham and Women's Physicians Organization takes a slightly different tack by enlisting "Directors of Performance Improvement" (DPIs) from among their specialist physicians to work directly with their peers to improve the value of the services they provide, according to the article. To do this, the DPIs first become familiar with efforts being made to improve value at an organizational level, and then work with fellow physicians to help translate those efforts into practical changes to care provision within their departments.
At the same time, the hospital encourages DPIs to enroll in a Harvard Business School leadership program in order to build, refine and round out their management skills, the article noted.This two-pronged approach generates a new set of physician leaders focused on the overarching cultural shift toward value-based care while they remain grounded in the realities of day-to-day care provision.
The article attributes the program's success to this careful positioning of its change agents, allowing for communication up and down the leadership chain. "The culture change and engagement required for success can't be either top down or bottom up," advise Jeffrey O. Greenberg, M.D., and Jessica Dudley, M.D., the article's authors. "It must be both."
To learn more:
- read the article