几乎所有的儿童医院都将其愿景和使命表述为提供高质量护理的某种变体, conducting innovative 研究, training the next generation of healthcare providers, and improving the health and well-being of children in their community. While branding and promoting themselves as “children’s hospitals,他们的愿景和使命需要在医院和更广泛的医疗保健云顶集团系统中工作的云顶集团40011官网和医疗保健专业人员的努力.
通常,儿童医院和儿科云顶集团40011官网组织(PO)雇用的专家作为独立的业务单位进行管理, often leading to functional “silos,” even though they depend on each other for mutual success (i.e., 增长, 护理质量, operational performance) and financial stability, and ultimately their ability to carry out their collective mission.[1]这在一定程度上是由公司结构和按云顶集团收费的报销模式指导收入的方式造成的.
这些操作筒仓可能导致事务性关系,给管理团队带来过多的管理负担, exclude physician leaders from hospital decision-making, and fail to align the strategic and financial interests of the hospital and PO.
Children’s hospitals that have partnered with POs to function effectively as integrated children’s health systems have a number of advantages, as they:
- Create strategic advantages.
- Foster physician engagement.
- Reduce fragmentation.
- Lower infrastructure costs and duplication.
- Are best positioned to jointly set and achieve performance goals.
Five Core Characteristics of a Children’s Health System
An integrated children’s health system is characterized by these features.
Empowered Physician Leadership and Shared Accountability
Integrated children’s health systems include senior physician executives (e.g., 实践CEO, the pediatrician-in-chief, the surgeon-in-chief) on the health system’s executive leadership team, and typically in a matrixed reporting structure. 执行团队推动集体系统的共同愿景和战略的开发和采用.
Hospital and physician leadership jointly develop and pursue strategies for regional expansion, 招聘, capital investment, 教育, 研究, and the development of programs, 云顶集团线, 和研究机构. Physician leaders are empowered and share accountability for the 增长 and performance of services across ambulatory and hospital settings; they are not limited to the PO. 这种安排承认,没有云顶集团40011官网的支持和参与,战略举措几乎没有成功的机会.
Financial Integration
Given the realities of the fee-for-service environment that most organizations still operate in, the majority of patient care reimbursement accrues to the children’s hospital. We know that in most organizations, physician revenues alone are not enough to sustain operations of the clinical practice, much less spin off the funds needed to subsidize investments in 研究 and 教育. 结果是, most POs rely on clinical and academic support from the hospital to supplement professional fees.
Financially integrated children’s health systems are transparent on the financial performance of the hospital and the PO; they collectively develop budgets and manage financial performance. 许多机构已过渡到以预算为基础的方法来管理PO的财务,而不需要医院补贴或合同赤字供资(避免期望PO必须收支平衡或更好)。.
They have adopted performance-based funds flow models that use incentives (e.g., 生产力目标和质量/安全指标),使医院和采购部的财务利益保持一致. 一体化的金融模式避免了关于合同和一次性交易的无休止的内部谈判, 哪些因素会将注意力从面向外部的战略协作上转移开,使组织变得不那么敏捷.
Integrated Network with Community Providers
While children’s hospitals have historically built their services around specialty care, 儿童云顶集团40011官网已扩大其重点,通过直接雇用或与私人执业儿科云顶集团40011官网建立网络联系,在社区环境中提供初级保健. Primary care coordination is fundamental to succeeding in value-based models. In more competitive markets, alignment with pediatric primary care is a key strategy for preserving or gaining market share.
儿童云顶集团40011官网正越来越多地探索与社区医院的合作模式,以便在离患者居住地更近的地方提供复杂性较低的护理. 综合护理系统协调提供儿科初级和专科护理,改善患者体验和云顶集团40011官网在接诊和随访方面的满意度,这些都是执行基于价值的护理计划的核心组成部分.
Joint Managed Care 承包
承包 with payers jointly, on behalf of the hospital and the PO, 确保报销决定是在企业的最佳利益,而不是个别业务单位的利益. Financial integration is typically a prerequisite to effective joint managed care 承包.
仅仅依靠专业费用报销来资助薪酬池或支持学术努力的POs将不可避免地缺乏灵活性,无法以不同的方式思考管理式医疗战略和其他关键的财务决策. Performance-based funds flow models are typically delinked from revenue for this reason. 有效的共同付款人合同使儿童云顶集团40011官网能够优化报销,并使云顶集团40011官网在基于价值的模式下取得成功.
Shared Infrastructure
绩效的提高和可持续性取决于效率的最大化和管理费用的精简. Shared resources—enterprise-level revenue cycle, IT, 承包, 法律, 和人力资源平台——比重复和孤立的云顶集团更有效地部署和提供更广泛的规模和更高性能的支持云顶集团.
在项目干事或部门一级增加重复的支助云顶集团和人员是对资源的低效利用,这些资源本可以更好地用于增长倡议或学术使命.
There Is No Single Model for Success
While many organizations have attained some of the characteristics above, 通过实现所有五个核心特征,大多数儿童医院都有机会发展成为一个更加综合的儿童云顶集团40011官网. Certain features may be more or less feasible in different organizational structures,[2] 但是,在任何组织结构中,通过更大的整合都可以实现更高的绩效. 最终 the ability for a children’s health system to act as one, regardless of corporate structure, will be a competitive advantage and accelerator for performance.
虽然许多备受尊敬的儿童医院在财务上和公司上往往与他们的PO整合, variation exists in terms of how they structure this relationship. 统一的主题是,成功的组织致力于作为一个综合儿童云顶集团40011官网发挥作用的共同理念,使它们能够以最高水平发挥作用.
一体化良好的儿童云顶集团40011官网能够减少组织内部的碎片化. They are better equipped to provide high-quality, 以家庭为中心的护理,以改善患者体验并确保患者在医疗保健系统中移动时护理的连续性. 最终, 这使儿童云顶集团40011官网能够最好地实现其总体目标:增进所云顶集团社区儿童和家庭的健康和福祉.
访问ing pediatric care is different.
Learn strategies for improving your patients’ experience.
了解更多脚注
- 1.
Depending on the organization, pediatric specialists may be employed through the hospital, PO, or university/school of medicine. In many examples where they are not directly hospital employed, their professional services are leased or contracted.
- 2.
The corporate structure of the children’s hospital, PO, and medical school, and the employment model of the physicians, varies across organizations and may create (real or perceived) obstacles to full integration.
Published May 31, 2022