Move to a System of Care Centers Is Key to Future for Southcoast

Renee Clark, Vice President of Clinical Care for Medicine, Southcoast Health System, and Paul Iannini, M.D., Physician-in-Chief, Medicine Care Center, Southcoast Health System

Q: Can you give us an overview of what makes a care center system a better way to deliver health care?
Dr. Iannini: Organizing medical services into a unified care center allows us to align medical specialties and clinical support services across all settings along the continuum of care. We are able to better manage the flow of patient care from one provider to another, from the community setting to acute care and to post-acute care. It also helps us to focus on the way we provide care so we can improve patient safety, quality of care and the overall satisfaction of our patients and clinicians.
Clark: The goal of the care center model is to provide an increased focus on our clinical departments and clinical programs in order to enhance the coordination of services so they meet the needs and expectations of our patients and providers.

Q: How does this model play into the issue of health care reform that has been on everyone’s minds lately?
Dr. Iannini: There are multiple drivers of health care reform, but payment reform is what will truly drive change. The United States is moving toward an accountable care organization model for both providing and funding health care. There will ultimately be a single payment for all phases of patient care, and the dollars will be apportioned to all providers who participate, as opposed to fees for service and daily rates that we currently receive. The successful health care system of the future will fully integrate all phases of care to improve outcomes and reduce cost.

Q: It would seem that it is vital for the clinical staff and the administrative staff to be on the same page. Can you talk a little about ways you work together to integrate care?
Dr. Iannini: The care center concept revolves around a partnership between clinical and administrative leaders that focuses on the patient. Having both allows for concurrent development of clinical and management structures designed to achieve the same goal.
Clark: The partnership is designed to foster the development and implementation of programs that are needed to promote the wellness of the patients and communities we serve.

Q: What are some of the keys to success in bringing this new care center system into place?
Dr. Iannini: To be truly integrated, we all need to work together. We each have expertise in areas, and we need to combine all of that expertise for the benefit of the patient. We also have to come to consensus on how all care should be delivered, that ensures the use of standardized evidence-based diagnostic and treatment regiments as key components to providing safe, high-quality outcomes.

Q: What has been the biggest lesson you have learned during the process of implementing these changes?
Clark: It is difficult to communicate concepts and to achieve consensus among three distinct hospitals and staffs. We need to establish new ways to engage the medical staff to support changes.

Q: There are numerous specialties operating under the care center system at Southcoast. How do you coordinate care between the various specialties when the need arises, as well as between the hospital and the various care centers?
Dr. Iannini: Coordination of care among more than one care center happens frequently with cardiac patients, orthopedic patients and surgical oncology patients, as examples. We must work together to understand the needs within our communities, recruit new providers to fill gaps in specialty services and build programs that engage all care center providers whenever appropriate.
Clark: Communication among care centers is constant. We work as a team across care centers to provide patient-centered care in all settings.

Q: What are the priorities and the goals of the Medicine Care Center going forward?
Dr. Iannini: The Medicine Care Center’s priorities for the coming years are the management of chronic disease, avoiding preventable admissions, reducing 30-day readmissions, assuring appropriate and timely transitions of care for patients in the hospital and lowering the costs of providing care in the hospital setting.
Clark: The key is to transform the health system into a patient-centered organization that is value-based. Patient satisfaction increases when outcomes are improved and there are smooth transitions of care. The challenge is lowering costs while improving quality and value to patients.
Dr. Iannini: A good measure to use as we design and deliver care is to think, ‘How would I want care for my family member if he or she was the patient?’ If the answer is ‘not the way we are doing things now,’ then we know we have to make a change.

MD News Future of Health Care 2011, Greater Boston



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