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PubMed1995

Meeting patients' needs: quality care in a changing environment.

Recent surveys of patients in New York and Cleveland, among other cities, indicate that there is substantial room for improvement in meeting patients' needs and preferences, particularly in the areas of emotional support, coordination of care, discharge preparation, and the involvement of family and friends. Hospitals are using a variety of techniques to improve patient care and organizational efficiency in this challenging environment. One prominent approach, reengineering, offers a means by which hospitals can integrate highly specialized departmental structures and functions by focusing on interdisciplinary teamwork and organizing the delivery of care around patients. Key elements of successful hospital reengineering efforts have included: - the involvement and commitment of senior management and other key stakeholders, particularly physicians, nurses, and union representatives; - investment in staff training and retraining, and the redesign of staff evaluation and compensation systems; - timely, unit-specific measures of patient satisfaction and the clinical quality of care; - consistent and frequent internal communication between staff and leadership; and - treatment that emphasizes communication among caregivers, patients, and their family members. Several basic issues need to be addressed if hospitals are to offer technically sophisticated medical care that is also responsive to their patients' personal needs, including: - variations among patients regarding the amount of information they want and need, and the amount of involvement they want in their care; - the means by which patients will get information about their medical care, and who will provide any additional support that may be needed by non-English-speaking or socioeconomically disadvantaged patients; and - the specific changes in medical practice and hospital processes that will promote the involvement of patients in their care.

Chicago↗
PubMedDate not supplied

Finding new strength in unity. Four Cincinnati-area Mercy hospitals form an integrated regional system.

In early 1993 the leaders of the Sisters of Mercy in Cincinnati decided to form their four area hospitals into a new integrated regional system, The creation of this system--Mercy Regional Health System Greater Cincinnati--was made difficult by the fact that each of its four facilities had its own culture. Change, moreover, can be threatening to even the boldest. As a result of these factors, formation of the new system did not proceed as smoothly as we had planned. Things improved after we began to acquaint ourselves with the histories and cultures of the four hospitals. After that, we created a new regional leadership structure that enabled us to form administrators and employees into teams, breaking down the compartmentalization traditional in healthcare. We showed our employees that the system would open opportunities for them. We also created a new regional board of trustees to develop the system's strategic plan, manage its business infrastructure, and draw up its budget. We established a holistic health and wellness center to encourage focus on the connections between body, mind, and spirit. Through new corporate publications, newspaper advertisements, and lobby displays, we have explained our evolution both to our employees and the residents of the region. As a result, we are now in virtually all of greater Cincinnati's managed care plans.

Catholicism↗
PubMedDate not supplied

Cost reduction in cardiopulmonary and neurology services.

A plan was developed and implemented to reduce costs per unit of service in three departments (pulmonary, cardiology, and neurology services), which resulted in a 19% reduction in cost per RVU over two years. These savings were attained primarily by a reduction of supplies and the redesign of work practices, which resulted in a reduction of both personnel and purchased service expenses. The departments have continued to improved the quality of services provided while reducing the costs of these services through this proactive approach to cost-containment.

Cardiology Service, Hospital↗
PubMed1997

Changing course. Columbia the buyer becomes Columbia the builder as the company seeks to overcome market impediments.

In an attempt to overcome market roadblocks, Columbia/HCA Healthcare Corp is revising its strategy from buying existing hospitals to constructing new ones. In this issue we take a look at the investor-owned giant's changing tactics as well as its sometimes rocky relations with the media. We also examine Columbia's performance in its former headquarters city, Louisville, Ky.

Catchment Area, Health↗
PubMed1997

A circular organization chart promotes a hospital-wide focus on teams.

Our Lady of the Way Hospital, like most hospitals in the late 1980s and early 1990s, exemplified the bureaucratic organization represented by the traditional "line and box organization chart." Additionally, as in most small hospitals, the CEO of Our Lady of the Way Hospital--a 39-bed, JCAHO accredited, general, acute care hospital in Martin, Kentucky--had direct management responsibility for several functional departments. In 1992, administration replaced the traditional, hierarchical organization chart with a circular structure that reflected its increased reliance on team processes throughout the organization. The new structure also significantly reduced the number of reporting assignments to the CEO. This article describes the hospital's transition to a team-based organization, illustrates the application of a circular organization chart, and assesses its value and limitations.

Community-Institutional Relations↗