The healthcare industry is evolving rapidly, and the move from fee-for-service to value-based care has begun. Healthcare leaders must start implementing changes today for their organizations to survive and thrive tomorrow.
Peter Doerner, executive vice president and chief development officer at North American Partners in Anesthesia, a provider of single specialty anesthesia services, discusses how leaders need to motivate their teams to embrace and implement changes, particularly in terms of managing the perioperative service line which can be challenging to do in the midst of transitioning from one reimbursement model to another.
Question: What are some of the biggest challenges facing hospital administrators during this period of transition from the fee-for-service model to value-based purchasing model?
Peter Doerner: The transition is happening, and the key for hospital administrative leaders is to adapt and drive the cultural change within their organizations accordingly. It's much like driving down the highway when suddenly the destination changes. You need to map out the new route — but you still need keep moving. You wish you had the luxury to pull over for a while to map out all the details, but the need to maintain speed and work within time pressures makes that impossible. So in many ways, you need to hang out the window to rotate the tires, change the oil, etc. while the vehicle is swiftly rolling down the road. This is analogous to hospital operations moving from fee to value. Hospital leaders have to keep moving forward, but they still need to make changes today to deal with tomorrow's issues and opportunities.
When implementing changes across a hospital system to aid the movement to value, the need for effective change management gets magnified even further. Administrators have to be very strategic about engaging stakeholders and over communicate. They need to know how to help each hospital in the system that has its own unique culture undergo this change effectively and emerge stronger.
Q: In terms of perioperative management, what are some specific challenges facing administrators in this period?
PD: In the OR, the challenge lies in becoming more efficient with fewer resources. We need to leverage data and outcomes when making decisions regarding care. For example, at NAPA, we serve around 900,000 patients a year and know which types of sedation will result in better patient outcomes, such as a lower incidence of nausea and vomiting. At the same time, we use outcome data to drive improved OR throughput.
The better access to real-time data hospital administrators have, the easier it will be for them to change cultures and transition to a value-based environment.
Q. What are some ways in which hospital administrators can ensure OR productivity and efficiency during this transition period?
PD: It's all in the data. Collect the best intel available and use it as a management tool in a proactive way. Previously, those involved in change management used data to figure out what wasn't working well. But today, the use of data helps to provide feedback to change culture and develop high-functioning clinical teams and individuals. Using independent data as a coaching tool improves efficiency.
Q. What are some ways to engage OR staff and surgeons while managing fluctuating procedure numbers while implementing the new value-based model?
PD: It starts with having really good communication with all stakeholders. One can never over-communicate. Things are moving so rapidly that all stakeholders really need to be engaged throughout what is likely to be a long-term process. This kind of fundamental shift doesn't happen overnight.
Such communication supports teamwork and flexibility. Great communication with surgeons fosters an environment with hospital administrators to ensure efficiency and the proper utilization of hospital resources.
Q. What are some common aspects of change management that hospital administrators tend to overlook when trying to keep the OR functioning effectively during this transition period? What do they need to keep in mind?
PD: There are two mistakes that some hospital administrators tend to make. The first is moving faster than organizational culture allows. The kiss of death comes when hospital administration moves faster or slower than the organization can tolerate, resulting in lost or disengaged stakeholders along the way. Administrators need to take the temperature of the organization’s culture and implement change accordingly.
The second is leadership by mandate rather than by stakeholder engagement. It's easy for administrators to implement new processes, but doing so without previously engaging stakeholders is a recipe for failure for any organization. Administrators need to inform all stakeholders that the move to value is happening, explain the benefits of change and make sure they are on board.
Q. Should hospital administration look into using technology in the OR to help during this transition? If so, what kind of technologies?
PD: Absolutely. Gathering good data and having the data available for the stakeholders who are in charge of making the shift to value is key. At NAPA, we are using Peak Performance², a proprietary remote video auditing system for the OR. This system provides for regular team feedback and makes the surgeon's day more predictable. It also improves efficiencies by supporting faster room turnover times. We are also looking at technologies like Google Glass and are in the process of testing it for anesthesia-related applications in the OR and perioperative space. It has been used in the surgical suite and we are evaluating its use in the anesthesia space as well.
Come hear more about change management and organizational culture change in the movement from fee to value at the Becker's Hospital Review Annual Chief Executive Officer Strategy Roundtable in Chicago, Nov. 4 & 5.