Healthcare News & Insights

Patient-centered care: Healthcare CEOs share what works

Running a hospital nowadays isn’t easy, especially when payments are tied to performance measures and patient satisfaction scores. That’s why patient-centered care has taken center stage in many of the top-performing healthcare entities.

In 2012, executives of 11 leading healthcare delivery institutions collaborated on A CEO Checklist for High-Value Health Care in which they shared 10 key strategies for reducing costs and waste while improving care.

Now, in the article Ten Strategies to Lower Costs, Improve Quality and Engage patients: The View From Leading Health System CEOs, which was published in the February issue of Health Affairs, these 11 CEOs are offering insight into how using these strategies benefits healthcare organizations and patients.

Patient centeredness

Each patient is unique.

That statement isn’t as much of a no-brainer as you might think.

With the unrelenting pressure on hospitals to cut costs, patients often are overlooked when the focus is put on the process — finding the fastest, most inexpensive way to treat diabetic patients or patients with heart disease.

When hospitals and their physicians focus solely on the process of providing care, medical errors and mistakes are made, and unnecessary test and procedures are performed raising the cost of health care. However, when patient-centered care is delivered, patients get the right care for them, the highest quality care and the most cost-effective care.

That’s why patient centeredness,  which according to the authors of the article is “the idea that care should be designed around patients’ needs, preferences, circumstances and well-being,” is a core principle of healthcare delivery today.

Patient-engaged care = high-value care

The important thing about patient engagement is it empowers patients, which leads to better outcomes at a lower cost. While it was overlooked in the past, it’s quickly becoming the norm thanks to all the new telehealth options that allow patients to keep in direct contact with their providers.

But in order to engage patients, healthcare systems have to create a role in the organization’s processes for patients and their families.

When the CEOs were creating their checklist for high-value care, one theme came through in all 10 key points they identified as necessary for improving care and lowering costs: “Patient-engaged care is also high-value care.” And when they were looking over the changes they made within their organizations to increase patient engagement, they fell into the following five categories:

  • delivering evidence-based care
  • developing team-based approaches and shared decision making
  • making care delivery more efficient
  • providing care in new ways, and
  • targeting care to patient and community needs.

Real life examples

Kaiser Permanente’s Healthy Bones Program identifies and proactively treats patients at risk for osteoporosis and hip fractures. To improve patient experiences while providing safe, efficient and consistent care, Kaiser implemented evidenced-based protocols in its Healthy Bones program. Practice guidelines for osteoporosis were standardized according to the latest clinical evidence. Patient education was also added to the program, as was a home health component.

This program has been in operation for five years and has experienced great success. By allowing its patients to become proponents of their own health, the program has seen a 30% reduction in hip fracture rates for at-risk patients.

Hospital Corporation of America (HCA) has about 18 million patient encounters annually. So when it changed the way clinical rounds were done, it affected a lot of patients. Before the change, conversation among a patients’ caregivers were private. Now, the conversations are open and include the patient, and take place at the patient’s bedside.

This change, which gave patients ample opportunities to take an active role in their care, improved communication scores on the Hospital Consumer Assessment of Health Plans Survey (HCAHPS) and improved nursing efficiency and better end-of-shift handoffs.

Virginia Mason Health System, a Seattle-based integrated health services system, had its nurses re-evaluate their workflow and make any changes that improve the efficiency of their care. One major change that took place was reorganizing nurses’ care patterns on the hospital floor. Now nurses care for patients who are in groups of rooms instead of spread out across their units.

This singular change allows Virginia Mason nurses to spend 90% of their time on direct patient care, giving them more opportunities to attend to patients’ needs quickly and effectively.

Partners HealthCare in Massachusetts, a nonprofit, integrated health system that includes hospitals, community health centers and other health related entities, has a self-management and telemonitoring program called Connected Cardiac Care. This program allows patients with heart failure to manage their health in the comfort of their own homes.

Advance care coordination, patient education and technology give patients the ability to check and report their weight, blood pressure, heart rate and symptoms to telemonitoring nurses. Not only does this program take some of the pressure off patients by not requiring them to come to the office as often, it also frees up providers to treat patients who need to be seen face-to-face.

Other benefits of the program that have been experience during its 10 years of operation:

  • it’s saved about $10 million, and
  • it’s reduced hospital readmissions for patients with heart failure by 51%.

Denver Health’s community health centers help identify people who are considered “high risk” because they suffer from one or more chronic conditions. Once identified through its registries, patients are assigned a medical home and primary care provider, who is responsible for working with patients to improve their management of their care between clinic visits.

The effects of this program:

  • increased breast cancer screening rates by 20%
  • increased colorectal cancer screening rates by 50%, and
  • increased hypertension control among its patient by 12% over three years.

 

 

 

 

 

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