Real work of health reform begins now
With health care reform now a reality through recently passed legislation, the real work of continuous improvement must begin. That's the message of Glenn Steele, MD, President and CEO of the Geisinger Health System in Danville, PA.
Steele highlighted the third annual Silverman Symposium, a day devoted to quality and safety at BIDMC, including the display of posters highlighting more than 90 process improvements undertaken by BIDMC staff.
"The health care system as it is today will be unsustainable unless we change," said Steele, noting that studies have shown as much as 40 percent of current patient care is either unhelpful or potentially harmful for patients.
Steele walked the audience of staff and physicians through a series of improvements Geisinger staff had made in areas such as coronary bypass surgery and diabetes care. In the case of bypass surgery, the work involved identifying multiple small but ideal indicators and treatments that allowed them to greatly reduce mortality and multiple complications. These included careful monitoring of blood sugar and body temperature, and precise timing of antibiotics and other medications.
"We are talking nitty gritty actions that were engineered into care, not big, monumental changes," noted Steele, "but together these changes make a measureable difference.
A devotion to continuously examining and improving care is key for hospitals to differentiate themselves and thrive in the new system of health care, said Steele. He noted that BIDMC - with its environment of transparency and multiple improvement efforts - is positioned to do well.
Geisinger is somewhat unique in that its system includes both inpatient and outpatient facilities, staff physicians and an insurance entity as well as relationships with independent providers and insurers. The buy-in and control of their "owned" entities helped expedite change, but Steele noted that independent entities were also interested in benefitting from and adapting their work.