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This content was paid for by an advertiser and created in collaboration with Crain's Custom Content.
July 27, 2017 12:00 AM

Transforming into a high reliability organization in health care

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    The US health care system's long-held FFS payment model reimburses professionals based on a narrow set of regulatory or reimbursement incentives for discrete activities, such as a doctor's visit, with no compensation for coordination across the care continuum. This payment system encourages delivery of high cost/high margin services and discourages delivery of lower margin services or coordination of care. These incentives can lead to rising costs as well as inefficient delivery and potentially poor quality of care, such as adverse events, medical errors, and infections, among others. In the FFS model, since physicians and hospitals are rewarded based on the volume of patients treated rather than outcomes, there is minimal incentive to maximize patient outcomes or contain costs.

    In an effort to address this issue, the US health care system is currently undergoing a fundamental shift in its business model, moving from volume- to value-based care (VBC) with a focus on quality and outcomes. Many VBC incentives and penalties rely on quality measures. Thus, delivering quality health care consistently and reliably will be key to succeeding in a value-based environment.

    Download "Transforming into a high reliability organization in health care"

    Despite financial, clinical, and technology drivers – and dedicated efforts at many levels – the health care industry generally struggles to achieve widespread, consistent quality improvement. As noted by Mark Chassin, President of The Joint Commission, “It's clear that we've made progress in a number of areas, in reducing healthcare-associated infections, for example. But we still have very serious quality problems, partly because the goal posts keep moving… what constituted high quality 10 years ago is not the same as what constitutes high quality today. It's a constant state of activity to increase safety and quality.”1

    One answer to providing consistent, widespread quality in health care already exists in other industries: Become a high reliability organization (HRO).

    HROs are entities which are exceptionally consistent at:

    • Accomplishing their goals
    • Avoiding potentially catastrophic errors in an environment where normal accidents can be expected due to risk factors and complexity
    • Delivering consistently safe and high-quality service

    Over the past 20 years, increasing numbers of health care provider organizations have started the journey toward becoming an HRO that delivers quality care effectively, efficiently, and predictably. For many, though, the destination remains far ahead. Although it may take considerable time and effort to get there, this paper lays out a path for health care organizations that wish to embark on the journey.

    Explore critical success factors, a case study, and smart first steps in: Transforming into a high reliability organization in health care.

    Footnotes

    1. “We still have very serious quality problems.” Modern Healthcare, January 9, 2016. http://www.modernhealthcare.com/article/20160109/MAGAZINE/301099952.


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    Government regulations are becoming more complex. Compliance is more critical than ever. Margins are falling and the need to control costs is rising. Deloitte professionals offer a broad range of services and innovative approaches to meet these challenges and help lead your organization into the future.

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        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - AI and Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
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      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
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