Jose Joe Rodriguez
HSM 500 Management & Organizational Theory & Practice
Situation
Intermountain Healthcare was identified as a premier healthcare model in the U.S. for being able to offer high-quality care at cost below average, Through changes in infrastructure, clinical care management, protocol development, clinical integration and integration of management structure; Intermountain Healthcare has been able to lead the way is reduction of per capita health care spending in Utah. Leading the way in implementing this success was Dr. Brent James and Dr. Deming
Questions
1. How did Intermountain become a high quality care provider?
2. What model did they integrate?
3. How did they manage buy in from staff?
Hypothesis
Evaluation: The drive to provide high quality care Intermountain Healthcare aimed to encourage competition based on quality, not cost, in order to create a positive pressure to raise the standard of health care
Hypothesis: By implementing and instituting change, clinical Integration was IHC’s approach to delivering care. It referred to both an organizational structure and a set of tools. It involved administrative and medical staff working together to implement a system of gathering, storing, and making accessible detailed medical data on each patient and then analyzing that data across all patients to create protocols that helped medical providers determine the best medical interventions for each patient and also increase efficiencies.
Proof and Action
IHC had begun to tinker with the concept of clinical-care management in 1986, with a series of investigations aimed at examining variation in clinical practice. Dr. James attended a lecture by Dr. Edwards Deming, who introduced the idea: higher quality could lead to lower cost. Dr. James tested Deming’s idea in pre-existing IHC clinical trials. The result was that they added cost outcomes to their traditional clinical trials and proved it to be true and effective within a few months. Dr. James felt that in order to build a successful clinical management system there had to be an overarching guidance structure, and Dr. Deming challenged Dr. James to do just that. He had approached IHC’s vice president for Health Care Delivery Research, and began to form a strategic quality plan for IHC. Dr. James stated that the key to engaging physicians in clinical management is aligning data collection to work processes. This represented a pivotal shift in mental model and in practice. Managers think in terms of cost-per- facility. By contrast, physicians think in terms of tests and treatments required for a specific condition. By doing so Dr. James Philosophy was that you manage what you measure, doctors manage patients, not money. In order to facilitate the transition from a traditional management structure focused on managing the facilities within which clinical care took place, to one oriented around clinical quality and clinical processes, Dr. James built a clinical administrative structure to be the clinical counterpart of the administrative structure at each level in the organization. In addition guidance teams, development teams and protocol development committees were formed.
