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Leonard L Berry

Publications and source records attributed to Leonard L Berry.

7 recordsLinked to original sources
PubMed2006

A physicians' agenda for partnering with employers and insurers: fresh ideas.

We report the results of the second phase of a multiphase qualitative investigation of the ways physicians, employers, and insurers can work together more effectively to provide better ambulatory care to employees and their dependents. This article focuses on ways physicians can develop more useful relationships among these groups. We used a grounded theory approach to conduct 71 interviews from August 12, 2004, to December 27, 2005, with 25 practicing physicians in large and small groups, urban and rural areas, private and academic settings, and primary care and specialty practices; 33 hospital administrators, medical association executives, health insurance medical officers, and health policy analysts; and 13 senior executives of large and small companies. The study identifies 2 approaches to the structuring of ambulatory care that can lead to improved health care outcomes and value. In the first approach, direct contracting between physicians and employers transfers tasks previously performed by insurers to employers or other intermediaries who may be able to provide better service or lower cost. In the second approach, insurer-mediated relationships between physicians and employers are restructured, particularly in ways that improve information flow. Such relationships may strengthen physicians' ability to provide quality services while enabling patients to make more informed decisions about physician selection, treatments, and spending. We believe that broader use of these approaches may improve the quality and efficiency of ambulatory care for the large proportion of the population that has work-related health insurance. Although the findings are promising, our intent is not to claim broad external validity but rather to encourage greater experience with these approaches and more formal studies of their effectiveness.

Attitude of Health Personnel↗
PubMed2006

Patients' perspectives on ideal physician behaviors.

We incorporated the views of patients to develop a comprehensive set of ideal physician behaviors. Telephone interviews were conducted in 2001 and 2002 with a random sample of 192 patients who were seen in 14 different medical specialties of Mayo Clinic in Scottsdale, Ariz, and Mayo Clinic in Rochester, Minn. Interviews focused on the physician-patient relationship and lasted between 20 and 50 minutes. Patients were asked to describe their best and worst experiences with a physician in the Mayo Clinic system and to give specifics of the encounter. The interviewers independently generated and validated 7 ideal behavioral themes that emerged from the interview transcripts. The ideal physician is confident, empathetic, humane, personal, forthright, respectful, and thorough. Ways that physicians can incorporate clues to the 7 ideal physician behaviors to create positive relationships with patients are suggested.

Attitude of Health Personnel↗
PubMed2004

The business case for better buildings.

The buildings in which customers receive services are inherently part of the service experience. Given the high stress of illness, healthcare facility designs are especially likely to have a meaningful impact on customers. In the past, a handful of visionary "healing environments" such as the Lucille Packard Children's Hospital at Stanford University in Palo Alto, California; Griffin Hospital in Derby, Connecticut; Woodwinds Health Campus in St. Paul, Minnesota; and San Diego Children's Hospital were built by values-driven chief executive officers and boards and aided by philanthropy when costs per square foot exceeded typical construction costs. Designers theorized that such facilities might have a positive impact on patients' health outcomes and satisfaction. But limited evidence existed to show that such exemplary health facilities were superior to conventional designs in actually improving patient outcomes and experiences and the organization's bottom line. More evidence was needed to assess the impact of innovative health facility designs. Beginning in 2ooo, a research collaborative of progressive healthcare organizations voluntarily came together with The Center for Health Design to evaluate their new buildings. Various "Pebble Projects" are now engaged in three-year programs of evaluation, using comparative research instruments and outcome measures. Pebble Projects include hospital replacements, critical care units, cancer units, nursing stations, and ambulatory care centers. The Pebble experiences are synthesized here in a composite 3oo-bed "Fable Hospital" to present evidence in support of the business case for better buildings as a key component of better, safer, and less wasteful healthcare. The evidence indicates that the one-time incremental costs of designing and building optimal facilities can be quickly repaid through operational savings and increased revenue and result in substantial, measurable, and sustainable financial benefits.

Air Pollution, Indoor↗
PubMed2004

The business case for better buildings.

Beginning in 2000, a research collaborative of progressive healthcare organizations came together with The Center for Health Design to evaluate the impact of their new buildings on patient outcomes. Those organizations are now engaged in three-year programs of evaluation, using comparative research instruments and outcome measures. Their experiences are synthesized here in a composite 300-bed "Fable Hospital" to present evidence in support of the business case for better buildings as a key component of better, safer, and less wasteful health care.

Facility Design and Construction↗
PubMed2003

Innovations in access to care: a patient-centered approach.

To receive health care, patients with nonemergent problems must gain access to a complex, interdependent ambulatory care system currently structured around the conventional office appointment model. The system does not effectively accommodate diverse patient needs and preferences, contributing to both overuse and underuse of health care resources. A patient-centered access model would help patients secure appropriate and preferred medical assistance when and where it is needed. Characteristics of patient-centered access include availability, appropriateness, preference, and timeliness. One or more of these characteristics often is missing in patients' health care experiences. The goal of this paper is to present patient-centered access as an integrated concept and philosophy to provide context for evaluating specific access initiatives. On the basis of an assessment of existing literature, 3 organizing principles of patient-centered access are proposed and discussed: work at the high end of expertise; align care with need and preference; and serve when service is needed. Patient-centered access warrants serious consideration, given the stakes involved for patients, providers, and payers. Few concepts support all 6 of the Institute of Medicine's aims for the 21st century: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equitability. Patient-centered access is such a concept.

Health Services Accessibility↗
PubMed2003

Clueing in customers.

Leonard L. Berry and Neeli Bendapudi When customers lack the expertise to judge a company's offerings, they naturally turn detective, scrutinizing people, facilities, and processes for evidence of quality. The Mayo Clinic understands this and carefully manages that evidence to convey a simple, consistent message: The needs of the patient come first. From the way it hires and trains employees to the way it designs its facilities and approaches its care, the Mayo Clinic provides patients and their families concrete evidence of its strengths and values, an approach that has allowed it to build what is arguably the most powerful brand in health care. Marketing professors Leonard Berry and Neeli Bendapudi conducted a five-month study of evidence management at the Mayo Clinic. They interviewed more than 1,000 patients and employees, observed hundreds of doctor visits, traveled in the Mayo helicopter, and stayed in the organization's many hospitals. Their experiences led them to identify best practices applicable to just about any company, in particular those that sell intangible or technically complex products. Essentially, the authors say, companies need to determine what story they want to tell, then ensure that their employees and facilities consistently show customers evidence of that story. At Mayo, the evidence falls into three categories: people, collaboration, and tangibles. The clinic systematically hires people who espouse its values, and its incentive and reward systems promote collaborative care focused on the patient's needs. The physical environment is explicitly designed for its intended effect on the patient experience. In almost every interaction, an organization's message comes through. "Patients first," the Mayo Clinic's message, is not the only story a medical organization could tell, but the way in which Mayo manages evidence to communicate this message is an example to be followed.

Ambulatory Care Facilities↗