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Systemness: Leading Healthcare Systems from Theory to Reality. 系统性:引领医疗保健系统从理论到现实。
Q4 Medicine Pub Date : 2021-07-01 DOI: 10.1097/HAP.0000000000000112
David A Rubenstein
DOI: 10.1097/HAP.0000000000000112 David A. Rubenstein, FACHE, is an executive consultant to the US Army Medical Command in San Antonio, Texas. He served as Commanding General of the US Army Medical Department Center and School and Chief in the US Army Medical Service Corps, retiring in 2012 as major general. He also served as 2008–2009 chair of the Board of Governors of the American College of Healthcare Executives. The feature article authors in this issue of Frontiers of Health Services Management perform an important service for leaders at all levels of health and healthcare organizations. Let’s applaud them for that. Retired Memorial Hermann Health System leaders Charles D. Stokes, FACHE, and Rod Brace provide research and a description of what needs to be done to reach systemness; Aimee Daily, FACHE, chief transformation officer at Memorial Health System in Illinois, provides a useful description of her organization’s road to systemness. We should take lessons, tools, and challenges from both feature articles and add them to our professional toolboxes. Then, we owe it to our teammates, patients, and many other stakeholders to develop the mindset to go beyond systems in name only to systems that exhibit true systemness, ones that successfully move from theory to practice. Achieving systemness is a journey. Christopher D. Van Gorder, FACHE, whom I will introduce later, has been on that journey as CEO of a system for more than 20 years. Others I will introduce have been on their current CEO journeys for shorter, but just as impactful, times. Drawing from their stories, I will discuss the mindset of executive leadership that describes the goal and moves the system from theory to reality.
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引用次数: 0
How to Lead an Organization Toward Systemic Transformation. 如何领导一个组织走向系统性转型。
Q4 Medicine Pub Date : 2021-07-01 DOI: 10.1097/HAP.0000000000000115
Abi Sriharan
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引用次数: 0
How One Healthcare Organization Is Creating a True System. 一家医疗机构如何创建一个真正的系统。
Q4 Medicine Pub Date : 2021-07-01 DOI: 10.1097/HAP.0000000000000114
Aimee Daily

Summary: Founded in 1897 as a 12-bed hospital and training school in Springfield, Illinois, Memorial Health System (MHS) today serves communities throughout central Illinois with five affiliated hospitals, ambulatory care services, and behavioral health programs. The system includes Memorial Medical Center in Springfield, Abraham Lincoln Memorial Hospital in Lincoln, Taylorville Memorial Hospital in Taylorville, Passavant Area Hospital in Jacksonville, Decatur Memorial Hospital in Decatur, and the Memorial Physician Services, Memorial Home Services, and Memorial Behavioral Health network across central Illinois. The evolution of MHS from a system in name only-lacking full integration of organizational functions-to its current status as an optimized health system has been marked by challenges, from the initial doubts of employees and the community to the upheaval caused by the COVID-19 pandemic. Systemness requires visionary and sure-handed leadership to identify and realize economies of scale, share best practices for operational improvements, and reduce unwanted variation to improve quality of care. As the MHS story illustrates, that all starts, grows, and endures with strategic planning.

摘要:纪念健康系统(MHS)成立于1897年,是伊利诺斯州斯普林菲尔德的一家拥有12个床位的医院和培训学校,今天通过五家附属医院、门诊护理服务和行为健康项目为伊利诺斯州中部的社区提供服务。该系统包括斯普林菲尔德的纪念医疗中心、林肯的亚伯拉罕·林肯纪念医院、泰勒维尔的泰勒维尔纪念医院、杰克逊维尔的Passavant地区医院、迪凯特的迪凯特纪念医院,以及横跨伊利诺伊州中部的纪念医生服务、纪念家庭服务和纪念行为健康网络。MHS从一个名义上的系统(缺乏组织功能的充分整合)发展到目前作为一个优化的卫生系统,这一过程充满了挑战,从员工和社区最初的怀疑到COVID-19大流行造成的动荡。系统化需要有远见和稳健的领导来识别和实现规模经济,分享操作改进的最佳实践,并减少不必要的变化以提高护理质量。正如MHS的故事所说明的那样,这一切都始于战略规划,成长并持续下去。
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引用次数: 0
The Power of Systemness: Adding Value to Healthcare. 系统性的力量:为医疗保健增加价值。
Q4 Medicine Pub Date : 2021-07-01 DOI: 10.1097/HAP.0000000000000116
Trudy Land
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引用次数: 0
The Pursuit of Systemness Calls for an Intentional Approach. 追求系统性需要一种有意识的方法。
Q4 Medicine Pub Date : 2021-07-01 DOI: 10.1097/HAP.0000000000000113
Kira M Carter-Robertson
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引用次数: 0
Implementing a New Service Line Model to Support Growth and Serve Patients. 实施新的服务线模式,以支持增长和服务患者。
Q4 Medicine Pub Date : 2021-04-01 DOI: 10.1097/HAP.0000000000000104
Peter S Fine, Kathy Kuhlenbeck

Summary: Many healthcare organizations are reinvesting in clinical service lines to differentiate themselves, standardize evidence-based care, and add value. Typically, service line structures are built around hospital-based procedures and are accountable solely to local operations. That can be a blueprint for missed growth and lost value.Banner Health, based in Phoenix, Arizona, with operations in six southwestern states, has pivoted to a systemwide service line strategy to foster growth and support value-based care. Service lines are now organized to maximize both revenue and quality across the continuum of care, to the benefit of both the system and its patients. The new, team-based structure allows Banner Health to respond nimbly to changes in the healthcare environment because it is based on the ways patients access the system. In 2021, just two years into this complex transition, the results have demonstrated that this service line model can achieve measurable benefits that include growth; improved financial performance, safety, and clinical outcomes; and increased collaboration in value-based payment models-all helping the system to realize its mission of making healthcare easier so that life can be better for our patients.

总结:许多医疗保健组织正在对临床服务进行再投资,以使自己与众不同,使循证护理标准化,并增加价值。通常,服务线结构是围绕以医院为基础的程序建立的,只对当地业务负责。这可能是错过增长和失去价值的蓝图。总部设在亚利桑那州凤凰城的班纳保健公司在西南六个州开展业务,已转向全系统服务线战略,以促进增长和支持基于价值的护理。现在,服务线路的组织是为了在整个连续护理过程中最大限度地提高收入和质量,使系统和患者都受益。基于团队的新结构使Banner Health能够灵活地响应医疗环境的变化,因为它是基于患者访问系统的方式。到2021年,也就是这一复杂转型的两年后,结果表明,这种服务线模式可以实现可衡量的效益,包括增长;改善财务绩效、安全性和临床结果;并在基于价值的支付模式中加强合作——所有这些都有助于系统实现其使命,即使医疗保健更容易,从而使患者的生活更美好。
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引用次数: 2
Service Line Development Serves to Support the Entire System. 服务线开发服务于支持整个系统。
Q4 Medicine Pub Date : 2021-04-01 DOI: 10.1097/HAP.0000000000000107
Sarah Roberts
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引用次数: 0
Changing Times Point to New Directions in Clinical Service Line Leadership. 时代变迁为临床服务领导指明新方向。
Q4 Medicine Pub Date : 2021-04-01 DOI: 10.1097/HAP.0000000000000109
Richard J Priore
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引用次数: 0
Service Lines: Working Toward a Value-Based Future. 服务宗旨:迈向价值导向的未来。
Q4 Medicine Pub Date : 2021-04-01 DOI: 10.1097/HAP.0000000000000105
John A Lutz, Paula M Zalucki, Maria Finarelli

Summary: The primary drivers for service line development have historically been market differentiation and profitable growth. In the current transition to value-based care, however, several other factors are now driving service line strategy. Specifically, in a value-based world, service lines must be patient centric, not provider centric; they must focus on more than hospitals; and they must be market facing.To build the operating model of the future and succeed in a value-based world, health systems need to reimagine the clinical, operational, and financial features of today's service lines. In working toward this future state, a coordinated, evidence-based care model with a multidisciplinary care team must replace today's episodic care. Easy access to prompt solutions and a seamless, low-stress experience for both patients and providers will be new competitive differentiators, along with cost transparency. Outcomes, patient convenience, and the total cost of care will drive future service line relationships between health systems and physicians. The criteria for selecting physician partners will be materially different, too.In implementing this future-state model, healthcare organizations will need to reconcile several opposing forces and tear down structural and operational silos. Health systems that can navigate through these challenges can realize numerous benefits.

总结:从历史上看,服务线发展的主要驱动力是市场差异化和盈利增长。然而,在目前向基于价值的护理过渡的过程中,其他几个因素正在推动服务线战略。具体来说,在一个以价值为基础的世界里,服务线路必须以患者为中心,而不是以提供者为中心;他们必须关注的不仅仅是医院;它们必须面向市场。为了建立未来的运营模式并在以价值为基础的世界中取得成功,卫生系统需要重新构想当今服务项目的临床、运营和财务特征。为了实现这一未来状态,一个协调的、基于证据的、多学科护理团队的护理模式必须取代今天的偶发性护理。方便地获得及时的解决方案,为患者和提供者提供无缝、低压力的体验,以及成本透明度,将成为新的竞争优势。结果、患者便利性和护理总成本将推动卫生系统和医生之间未来的服务线关系。选择医生合作伙伴的标准也会有很大的不同。在实现这种未来状态模型时,医疗保健组织将需要协调几个对立的力量,并拆除结构和操作孤岛。能够应对这些挑战的卫生系统可以实现许多好处。
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引用次数: 1
Service Lines: An Organizing Framework for a Value-Based World. 服务线:价值世界的组织框架。
Q4 Medicine Pub Date : 2021-04-01 DOI: 10.1097/HAP.0000000000000108
Trudy Land
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引用次数: 1
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