Health Systems in Transition


Book Description

This analysis of the United States health care system reviews developments in organization and governance, health financing, health care provision, health reforms, and health system performance. The U.S. system has both considerable strengths and notable weaknesses. It has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program, and, for selected services, among the best medical outcomes in the world. But it also suffers from incomplete coverage of its citizenry, health expenditure levels per person far exceeding all other countries, poor objective and subjective indicators of quality and outcomes, and an unequal distribution of resources and outcomes across the country and among different population groups. Because of the adoption of the Affordable Care Act in 2010, and subsequent revisions to it, the U.S. is facing a period of enormous change. There is a great need to improve coverage and improve equity, better ensure quality outcomes, and find ways to better control expenditures. Health Systems in Transition: USA provides an in-depth discussion of these issues and a thorough review of the U.S. health care system.




Challenging Perspectives on Organizational Change in Health Care


Book Description

Cover -- Title -- Copyright -- Dedication -- Contents -- List of Figures -- Preface -- Acknowledgements -- PART I Theoretical Perspectives on Organizational Change -- 1 Theories of Organizational Change: Transformational Change as a Developed Theory? -- 2 The Diffusion of Innovations: The Translation and Implementation of Evidence-Based Innovations -- 3 Organization Development in Health Care: A Good Fit? -- 4 Contextualizing Organizational Change: The Case of Health Care -- PART II Contemporary Issues in Changing Health Care -- 5 Mandated Top-Down Change and the Restructuring of Commissioning -- 6 Organizational Change and Professionals: System Change and Professionals in Change Processes -- 7 Patient and Provider Perspectives on Safety as a Focus of Change -- 8 System Change-Building Networks of Health and Social Care -- 9 HRM: A Driver and Enabler of Change -- PART III Final Themes -- 10 Changing Perspectives on Change -- Index




The Challenge to Change


Book Description

There is constant pressure on hospitals to improve health care delivery and increase cost effectiveness. New initiatives are the order of the day in the dramatically different health care systems of the United States and Great Britain. Often, as we know all too well, these efforts are not successful. In The Challenge to Change, Rebecca Kolins Givan analyzes the successes and failures of efforts to improve hospitals and explains what factors make it likely that the implementation of reforms will rewarded by positive transformation in a particular institution’s day-to-day operation. Givan’s in-depth qualitative case studies of both top-down initiatives and changes first suggested by staff on the front lines of care point clearly to the importance of all hospital workers in effecting change and even influencing national policy. Givan illuminates the critical role of workers, managers, and unions in enabling or constraining changes in policies and procedures and ensuring their implementation. Givan spotlights an Anglo-American model of hospital care and work organization, even while these countries retain their differences in access and payment. Entrenched professional roles, hierarchical workplace organization, and the sometimes-detached view of policymakers all shape the prospects for change in hospitals. Givan provides important examples of how the dedication and imagination of the people who work in hospitals can make all the difference when it comes to providing quality health care even in a challenging economic environment.




Changing the U.S. Health Care System


Book Description

The third edition of Changing the U.S. Health Care System is a thoroughly revised and updated compendium of the most current thought on three key components of health care policy—improving access, ensuring quality, and controlling costs. Written by a panel of health care policy experts, this third edition highlights the most recent research relevant to health policy and management issues. New chapters address topics such as the disparities in health and in health care, information systems, and performance in the area of nursing. Revisions to chapters from the previous edition emphasize the most recent developments in the field.




Forces of Change


Book Description

American health care has made great strides in the past hundred years. Life expectancy has increased dramatically and advances in medicine and treatments have eradicated many life-threatening diseases. However, in today's health care arena there is divergence between our health needs, the structure of our health care system, and how health care is delivered and funded. In Forces of Change, David A. Shore has collected the leading thinking from experts in the field on how our health care system can benefit from important lessons from other industries and effect transformational change that truly serves all stakeholders well. Contributors include Max Caldwell of Towers Watson; Michael J. Dowling of North Shore Long Island Jewish Medical Health System; John P. Glaser of Siemens Healthcare; Ashish K. Jha of the Harvard School of Public Health; Eric D. Kupferberg of Northeastern University; Lucian Leape of the Harvard School of Public Health; Jeff Margolis of the TriZetto Group, Inc.; and David Shoultz of Philips Electronics.




Launching and Leading Change Initiatives in Health Care Organizations


Book Description

Implement change that fosters sustainable growth and better patient care Health care projects depend on astute management of change. But more than anything else, they depend on leaders who pay attention, who understand the importance of starting right, and who know how to launch projects that succeed. If leaders can increase the percentage of successful projects, patients, and practitioners everywhere will be better off and so will the organizations that depend on these projects for innovation. In Launching and Leading Change Initiatives in Health Care Organizations: Managing Successful Projects. Author David A. Shore of the Harvard School of Public Health speaks directly to the health care leaders and managers who see the need for change, but keep encountering nearly insurmountable challenges. Through his research, Shore discovered that most implementation failures occur because of a poor launch, and that strengthening processes and operations during the early weeks of a new project is a key to continued success. The book covers issues like: The preliminary groundwork that cultivates a stronger launch Systematic and selective project selection Building the team that accomplishes change Skill-building and record-keeping systems that foster sustainable growth Launching and Leading Change Initiatives in Health Care Organizations gives leaders and managers the practical, easy-to-implement ideas and methodologies to start and manage projects successfully.




Healthcare at a Turning Point


Book Description

If the furious debate around the state of healthcare in the US has led to any consensus, it’s that the system should be delivering better quality for less cost than it does. The truth is that our healthcare system is a sprawling mix of competing interests in which those of the patient are valued least. Too much discussion has devolved to simplistic scapegoating, and too few comprehensive, constructive solutions have been offered. It’s time for a fresh vision. In straightforward language, Healthcare at a Turning Point: A Roadmap for Change outlines a new market-based business model that aligns industry financing mechanisms with the goals of prevention, improved quality, and reduced costs. Drawing on more than 25 years of cross-industry consulting experience, the authors: Articulate a market-based vision of the industry Examine past efforts to reduce costs, their failures and their unanticipated consequences Spotlight perverse incentives that distort the way the healthcare system operates and make it less than it could be Present concrete recommendations for change within the healthcare delivery, insurance, pharmaceutical, device and diagnostics sectors Explain the changes that employers, consumers and policy makers can make to create a more customer-responsive system that delivers more value For all the uncertainty in the current environment, there is also a rare opportunity to fundamentally redefine who wins in this market. Healthcare at a Turning Point provides guidance to executives ready for that contest as well as a roadmap for change.




Reengineering Health Care


Book Description

"""Reengineering Health Care" gets to the core of transforming our current system by advocating the widespread use of IT, eliminating inefficient practices, and keeping the system focused on a healthy individual and not on a broken process.""--Newt Gingrich, Founder of the Center for Health Transformation, and former Speaker of the U.S. House of Representatives ""This book is a prescription for streamlining health care. Using the techniques that have successfully transformed business into customer-focused and efficient organizations, the authors provide a step-by-step approach to improving health care processes, guiding health care into the next generation of Lean delivery systems.""--Dr. John Halamka, Chief Information Officer, Beth Israel Deaconess Medical Center ""In health care, we tend to inundate our people with information, rather than enabling them to have insights. This concise guide will resonate with both senior and front-line managers who know they're engaged in unproductive work. They will see that reengineering is not overly difficult and can enable them to improve patient care and efficiency.""--Trevor Fetter, President and CEO, Tenet Health Corporation, and Trustee, Federation of American Hospitals ""It isn't reform that will fix our ailing health care system, its reengineering. Champy and Greenspun highlight organizations that have transformed, and reinvented, themselves by reengineering care delivery-they've lowered costs, improved care quality and patient safety, and increased the satisfaction of those giving and receiving care. Every clinician, hospital executive, and politician should read this book.""--Bill Crounse, M.D., Senior Director, Worldwide Health, Microsoft Corporation ""Implement health care technology, and you have better health care tools; reengineer with a focus on technology, process, and people, and you have a better health care system. This straightforward guide shows how to transform health care to maximize quality, safety, convenience, and impact the cost of delivery. No one can read this book and not feel a profound call to action.""--H. Stephen Lieber, CAE, President & CEO, HIMSS In their legendary book, "Reengineering the Corporation", Jim Champy and Michael Hammer introduced businesspeople to the enormous power of a revolutionary methodology called "reengineering". Using reengineering, businesses around the world have systematically retooled their processes--achieving dramatic cost savings, greater customer satisfaction, and more value. Now, Jim Champy and Dr. Harry Greenspun show how to apply the proven reengineering methodology in health care: throughout physician practices, hospitals, and even entire health systems. You'll meet innovative and visionary leaders who've been successfully reengineering organizations across the entire delivery spectrum and learn powerful lessons for improving quality, reducing costs, and expanding access. This book doesn't just demonstrate the immense potential of health care reengineering to revolutionize health care delivery: "it offers a clear roadmap for realizing that potential in your own organization""." Deliver Better Care to More People, at Lower Cost How reengineering can lead to more efficient, safer delivery--and sharply reduced costs How to focus on prevention and wellness, as well as chronic disease and hospital care How to earn the trust, contributions, and passion of skeptical physicians and health care professionals How to harness technology to create more seamless, accessible, valued, and sustainable health care systems--and avoid technology's pitfalls How Zeev Neuwirth transformed the Lenox Hill Hospital ER and the 700-doctor Harvard Vanguard Medical Associates practice How Tom Knight is revolutionizing patient safety at Methodist Hospital System, one of America's largest private, nonprofit medical complexes How to start today in your own organization!




Breaking out of the Health Care Abyss


Book Description

It has become routine to see in various health care magazines, e-mails to leaders, and executive discussions on social media internet outlets, a listing of the ten top challenges that CEOs believe they are facing in the health care industry today. They often call this list the “what is keeping me up at night” list. Although the recognition of their current challenges is important for health system leadership teams and board members, just knowing them is not enough. To be successful in this extremely challenging and complex health care environment today, implementation of action plans is key. The recognition of this critical need to implement a successful road map to the future in order to address the disconnect between knowing and doing has driven the content of this book. Based on the less than positive performance, both clinically and financially, of many health care providers, it seems obvious that the implementation of successful action plans is sorely missing in many boards’ and leadership teams’ processes. The proof that such is the case lies in the fact that the yearly challenge list provided by a wide array of CEOs from small, medium as well as large complex health systems and across the broad health care sector has changed very little over the last decade. We hear and read over and over again about the lack of primary care providers, the declining inpatient volumes, the decrease in profitability, the variability in clinical outcomes, the lack of strong clinical integration and collaboration, and the fragmented care due to a lack of case coordination across the continuum. The authors of this book worked together since 1999 in leadership/governance/management challenges domestically and internationally. They predicted, decades ago, what most would never have dreamed could become reality in the health care world. It is their intent to help readers successfully lead their organizations through a transformational journey in the current turmoil in the health care industry.




The Changing U.S. Health Care System


Book Description

The "managed care backlash" arguably topped the list of media and policy concerns in 1998. Yet, against the background of the highly charged environment in which the future of our health care system continues to be debated, there is a dearth of concrete, "objective" facts on the nature of the changes, the reasons for them, and their meaning. An analysis of five important themes that emerged from a review of the recent literature on health system change concludes that an inherent tension exists between the interest in rapidly driving down health care costs through organizational change and the long time frames that are required to make fundamental changes in structure, process, and orientation. Unfortunately, in an environment in which purchasers are driven to seek cost savings and the political will supports a pluralistic and mixed public/private system, the health system may chart an alternative course, with the result that purchasers may rely increasingly on individual cost sharing and continue to cut back the amount of coverage they are willing to offer. The real challenge for public policy makers is to confront the issues directly, avoiding political incentives to adopt easy and fast solutions for these complex matters.