Performance Principles that Transcend Politics

Added on Jan 4, 2017

By Dr. Thomas H. Lee, Chief Medical Officer 

congress-healthcareThe 2016 Presidential election is behind us, and there is much uncertainty surrounding the future of health care financing. Yet, the imperative to meet patients’ needs and to do so efficiently remains the same. These objectives transcend contract models, and we can expect them to transcend Presidency terms as well. Health care providers must understand their patients’ needs and organize to address them if they are to retain their market share of patients and good personnel. 

The following principles of performance are not likely to be influenced by decisions in Washington over the next several years, and should therefore be top-of-mind for clinicians and managers. 

  1. The re-organization of care delivery around patients’ needs will continue. The change in Administration does not alter the steady increase in medical knowledge, which inevitably requires more personnel to deliver state-of-the-science of care. Most patients need coordination more than new miracle drugs, so improving teamwork and the focus on patients’ overall picture should be a major focus for all providers.
  2. By segmenting patients into groups with similar needs, teams of caregivers can organize to respond to those needs. Organizations can only accomplish so much with across-the-board interventions. Creating teams around groups of patients with shared needs, such as those with similar chronic conditions, can lead to innovations and interventions that are not possible with heterogeneous populations. The ability to segment populations and deliver integrated team-based care will be an important competitive differentiator for health care organizations in the years ahead.
  3. Measure what matters to patients. The goal of performance measurement is to improve care for patients, not classify clinicians as reliable or not. So performance should be defined in terms of the clinical and experience-of-care outcomes that matter to patients, even if these measures are not fully under the control of clinicians. 
  4. The reduction of suffering should be the overarching goal of improvement initiatives. Clinicians should believe that their organization is trying to get better at something noble, and they should believe that the organization wants to help them as individuals improve, too. For both organizations and individuals, the reduction of suffering constitutes a goal that all embrace.
  5. Transparency is a driver of improvement.  Public reporting of data unnerves clinicians, who worry about any implication that their care is imperfect, or that they may be below average. But the fact is that transparency has its most potent impact not upon consumers, but rather on those who are being measured. Transparency causes clinicians to see every encounter as important, and deliver their best. In short, transparency makes quality reporting about “the next patient you see” more than what has happened in the past.
  6. Commit to Zero Harm. Patient safety is the cornerstone of high-quality health care. Organizations that deliver safer care also tend to deliver more patient-centered care. The unifying force comes from personnel engaged in creating a High Reliability culture by delivering care the way it should be delivered every time.  To move down the High Reliability road, the first critical and uncontroversial step is to set Zero Harm as an explicit goal at the governing board level and commit to it across every level of organizational leadership.

Regardless of what happens to the Affordable Care Act over the coming months and years, value-based care will likely remain a guiding force in the industry. Organizations that have embarked on their value-based journey should continue to stay the course.