Harvard Business School Case Study - Intermountain Essay

The reasoning to Intermountain Health Care’s approach to the management of health services can be related back to a ‘crazy’ idea James was introduced to in a Lecture he attended conducted by Dr. W. Edwards Deming. This idea argues that higher quality could lead to lower cost. As we identified previously, IHCs business goals relate to the optimization of processes and services in order to minimize the quality of waste in terms of cost. This sort of business model will produce a high quality business, reflecting optimisation of processes and resources which will aid positive services to patients - whilst maintaining the financial stability of the business in the most effective way possible.

In 1997 University of California, San Francisco (UCSF) merged its two public hospitals with Stanford’s two private hospitals. The two separate entities merged together to create a not-for-profit organization titled UCSF Stanford Health Care. The merger between the health systems at UCSF and Stanford seemed like a good idea due to the similar missions, proximity of institutions, increased financial pressure with cutbacks in Medicare reimbursements followed by a dramatic increase in managed care organizations. The first year UCSF Stanford Health Care produced a profit of $22 million, however three years later the health system had lost a total of $176 million (“UCSF-Stanford Merger,” n.d.). The first part of this paper will address reasons

To understand this process better, a case study will be referenced as a basis of the discussion of the paper. The study that will be utilized follows a multi-phase implementation of a program to change how to increase the Triple Aims within healthcare systems to deliver services within the community. The 2007 study was designed to evaluate how organizations could improve the quality, access, and reliability of care while being cost effective in providing healthcare services to the community (McCarthy & Klein, 2010). By identifying issues that impede providing these three elements, healthcare providers and organizations can utilize resources to address the issues and improve the patient’s health (McCarthy & Klein, 2010). Organizations can make a positive

Western Connecticut Health Network (WCHN) is a fairly large regional network, with a scope encompassing the vast majority of specialties and services as would be expected between several hospitals and a plethora of outpatient facilities. A well-organized executive leadership model helps ensure quality, through the core values WCHN has established, whilst keeping themselves in check through third party surveys and analysis. WCHN’s quality improvements have simply built onto an already strong foundation of health care quality, with a focus on the patients.

Such a structure revolves around clinical leadership dyads, or pairs of part-time physician-leaders teamed with full-time nurse administrators, based within geographic regions. The majority of the physicians involved in care delivery were independent, community-based practitioners motivated by shared professional values emphasizing high quality service and satisfying patients' needs. Their dyads regularly reviewed data on delivery costs and service outcomes, and they collaborated with one another throughout the IHC system to indentify improvement opportunities and share best practices. Equipped with sound evidence and empowered by management, the dyads formed shared baselines and drove initiatives that dramatically lowered healthcare costs by reducing the incidence of overused procedures, such as elective inductions and unplanned surgical deliveries.

I have chosen to analyze an organization that has helped millions of individuals in Utah and Idaho with their healthcare needs, Intermountain Healthcare, (IHC). For the specific purposes of this paper I will be representing the homecare department of IHC, located in Ogden, Utah. The individual I have selected to analyze is the branch manager who is over the Ogden branch. I have selected this organization and leader as I had the opportunity to work for this company for over 3 years. I have a high level of insight and personal experience that I can bring to this paper which I feel is very advantageous. I hope to learn how to improve the organizational performance of this branch by analyzing previous management and leadership methods.

Transitioning to this model is not as easy as it seems. Businesses such as hospitals will have to educate all health care workers on the foundations of a value based care system so that the highest quality of care is obtained for each patient and a satisfactory rate of patient outcomes are optimized. Health care providers may have trouble transitioning because there not used to being rewarded off patients outcomes, but rather off increasing revenue by preforming as many procedures as possible, some not even under the scope of evidenced based practice and medicine. Smaller

(Hill Physicians Medical Group, 2013, para. 2). The Hill Physicians Medical Group case study reveals several innovations which led to their success in delivering quality care and improving patient health outcomes. An analysis of their approach and process reveals success in quality and care management innovations, financial incentives, and lessons learned from their experiences.

How will you ensure that the target audience sees, hears, or feels your advocacy piece? (You can assume you have a small budget for this purpose.)

Delivering excellent care for health maintenance and acute illness, which meets quality, safety and patient experience standards, while reducing costs is the focus of health care organizations across the country (Kara, Johnson, Nicley, & Niemeier, 2015; IHI, 2016). Healthcare organizations are under deep scrutiny by public and government sectors to meet the IHI Triple Aim to improve patient experience, improve the health of populations and reduce cost of health care (IHI, 2016). However, these sectors use different measures to evaluate the effectiveness of healthcare organizations. Carolinas Healthcare System, which consists of over 900 care locations, including thirty-three hospitals within North and South Carolina, works to meet the Triple Aim and be viewed by the public and governmental sectors as a healthy organization. The question is how does one measure the health of an organization? Is Carolinas Healthcare System an example of a healthy organization, one that integrates leadership principles and concepts, utilizing fiscal responsibility within the organization’s climate, culture and behaviors? Or, is Carolinas Healthcare System an organization without a mission, vision, goals or strategic plan, on the brink of failure and without public and governmental approval?

The healthcare field is constantly changing and frequent practices and procedures are reviewed and updated based on evidence-based practice (EBP). Research and EBP guides us in identifying areas that need improvement or revision. Whether it be new practices, procedures, protocols, or equipment, nurses are expected to be able to adapt to change. At Sacred Heart hospital, a new intravenous pump (IVP) will be introduced hospital-wide. The purpose of this paper is to describe what leadership style, change theory, and collaborative practice will be utilized in implementing the new IVP and how healthcare economics plays a role in its implementation.

In fact, in a recent survey of health care leaders, 90% indicated they have intentions to pursue a population health strategy (Gamble & Sachs, 2015). While there is evidence that ACO’s are saving money, most of the cost savings are coming from physician run ACO’s (Steckler, Feldman, & Watts, 2015). In comparison, ACO’s run by integrated health systems are saving relatively little money (Williams, 2016). Even the Federal Trade Commission (FTC) is wary of the intentions of healthcare leaders who claim the pursuit of population health management as a goal of consolidation. The FTC’s skepticism of population health management was demonstrated when they blocked an acquisition of a 43-physician practice by St. Luke’s Health System in Boise, Idaho. Regulators stated that the acquisition was anticompetitive and would lead to higher prices (Galewltz,

The first step was to evaluate their current operations in each region. This was accomplished by determining data components from different functions of the current information system. The data was then evaluated on the benefits of combining the inpatient and outpatient systems. The next step was to look at the cost of implementation. Research was gathered from literature, interviews from experts, site visits, data analysis of Kaiser Permanente’s data, and focus group interviews. This research was reviewed and the project team enhanced their validation process. The third step was to examine the long term investment of the project. The project team determined one-time expenses and recurring expenses. Then the team developed different examples that would demonstrate financial approaches toward implementation for a ten year period. These approaches ranged from conservative to aggressive. The last step was to determine the net value by looking at the implementation lag and benefit realization. (Garrido) During the “go live” stage the team monitored and evaluated pre-implementation data compared to post-implementation data. Adjustments were made so that processes could be improved and benefits were greater.

Kaiser Permanente offers a holistic health care system by combining a nonprofit insurance plan with its own hospitals and clinics. Additionally, since the plan pays a fixed amount for medical care per member, there is a considerable financial incentive to keep people healthy and out of the hospital. Kaiser oversees, administers and provides a comprehensive care for patients, ranging from providing screening and diagnosis to filling a prescription to running a hospital where the patients undergo surgery. This strategy of integration is at least 10 percent less expensive than other providers’ services (Abelson, 2013).

The only way sure way to increase our sales is to increase our client base. We currently provide coffee to