Frontiers of Health Services Management

If you are not confused, you don't know what's going on. -Jack Welch In commenting on the business environment today (1994), Jack Welch could have been talking about healthcare organizations experiencing the double-barreled assault on two sweeping changes simultaneously. Not only are hospitals preparing for yet-to-be-determined changes in national healthcare delivery systems but they are doing so in the midst of shifting demographics in both the population and employee base. While many make the case for managing diversity, we would like to go one step further in offering a framework for developing an organization's ability to build an inclusive environment that gets the best from its staff and provides the best service to its customers...

At the downturn of the COVID-19 pandemic, JPS Health Network sought creative ways to ramp up services and reengage patients in care. The network's strategies for population health management, community engagement, and access to care came together in 2022 with the initial development of the JPS Health and Wellness Program. Today, the program supports patients-particularly those most in need-in navigating the continuum of care. Offerings include classes and resources covering behavioral health, heart disease, diabetes, COVID-19, nutrition, and injury prevention...

It comes as no surprise that healthcare leaders today face unprecedented challenges. Some are immediate. Others are long-term. Many are interrelated. All are complex. None of them are small, as they include financial sustainability, mission, quality and patient safety, rapidly advancing technology, changing consumer expectations, new market entrants, healthcare inequities, and more regulation. One challenge, though, tops that list: workforce shortages. Although many individuals continue to be drawn to healthcare, the numbers are insufficient to meet increasing demand...

Nurses are the backbone of healthcare. Their retention and recruitment are essential to the success and sustainability of healthcare providers. For many years, Portland, Oregon-based Legacy Health enjoyed the luxury of a registered nurse (RN) turnover rate consistently as low as 7.6 percent and a vacancy rate of 2.49 percent. Suddenly, COVID-19 and a confounding exodus of nurses from the profession overran this excellent track record. Today, Legacy Health is rebuilding its RN workforce and staff resilience through new initiatives...

All healthcare systems are challenged to provide sufficient access to appropriate care for the individuals and communities they serve. Among the commonly discussed interventions in an era of clinical shortages is the establishment of team-based care, where team members can practice at the top of their license. This solution ensures that talent and ability are amplified. However, this vision has been thwarted by several barriers. Recognizing that complex causes prevent team-based care, CommonSpirit Health leadership has embarked on a multifaceted implementation of tactics to mitigate the barriers...

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Healthcare leaders have two especially profound responsibilities. In addition to ensuring quality, they must also drive sustainable practices that benefit their organizations, communities, and the planet. Environmental, social, and governance (ESG) principles-along with sustainability and corporate social responsibility (CSR) concepts-have gained significant prominence in recent years, and an understanding of their nuances within healthcare and in the general business context is essential for effective governance and implementation...

All leaders of healthcare organizations, individually and collectively, must make critically important decisions every day. But how are those decisions made? What factors must leaders take into account? And how has the way they make those decisions changed over the years? In today's fast-moving world, healthcare leaders face increasing pressures to make far-reaching decisions not only accurately, but also more quickly than ever. Especially for a small critical access hospital, there is little room for error or delay...

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The simple fact is that hospitals that do not innovate today may not be solvent tomorrow. Although not every hospital has a budget for a million-dollar innovation laboratory, a pop-up innovation lab can be set up for less than $1,000 with materials available at a local superstore. In 2014, Drs. Ibata and Olver visited leading innovation labs to identify best practices for curricula and materials. The site visits were funded by a grant to support the development of a rapid-cycle innovation training program. The lessons learned are shared here with sample agendas and material lists to set up a low-cost innovation lab...

Healthcare organizations are facing exponential growth in change-not just to compete, but to survive. Amid the widening gap between expenses and reimbursements, hospitals must manage the adoption of expensive advanced technologies, continuous synthesis of emerging clinical knowledge, intensive regulatory readiness, and public ranking of quality outcomes. And they must handle all this as patient expectations grow. At Methodist Le Bonheur Healthcare (MLH), we have approached these challenges by nurturing an organizational mindset of transformational innovation...

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University of Chicago Health System-UChicago Medicine-recently joined forces with AdventHealth's Great Lakes Region to expand access to services, treatment options, and clinical trials to residents in Chicago's western suburbs. Other organizations may want to follow that approach in developing and maintaining a high-quality and integrated healthcare ecosystem-one that not only increases access to care for underserved populations but also responds to changing consumer preferences and behavior. Building partnerships with other systems that possess similar values and complementary strengths is an effective way to provide patients with convenient, high-quality care closer to home...

Doing more with less has been a business mantra for decades. Healthcare leaders have implemented flex scheduling and job sharing, streamlined workflows, committed to process improvement techniques such as Lean, hired retirees, gained efficiencies from remote work ... and the list goes on. Each tactic has yielded productivity improvements, yet the need to do more with less continues. Postpandemic challenges include staff recruitment and retention, labor inflation, and dwindling margins, all of which must be addressed while maintaining corporate cultures...

The founding of Ochsner Ventures followed the natural evolution of more than a decade of growth and expansion of Ochsner Health's offerings and capabilities beyond traditional patient care. This growth has enabled the health system to bring critical services to underserved communities across the Gulf South. Ochsner Ventures supports promising companies both in and beyond the region while bringing forward new solutions to healthcare sector challenges and improving health outcomes, access, and equity. In a dynamic healthcare environment amid the persistent effects of the COVID-19 pandemic, Ochsner Health is executing a multiyear strategic plan to reinforce its mission and maintain a position of strength in the region...

For health systems seeking a path forward and upward in a value-based environment, ownership of a health plan can yield many positives, including a chance to drive value-based care, financial margin improvement, and opportunities for rewarding partnerships. However, being both a payer and a provider-a "payvider"-can make extraordinary demands on both the health system and health plan. Developing this hybrid business has been a learning experience for UW Health, an academic medical center that, like others in academic healthcare, was built on a fee-for-service model...

Changes in underlying cost structure, intensifying competition for nonacute healthcare services, heightened costs of capital, and lower investment returns have put many health systems on an unsustainable path forward. Traditional performance improvement efforts remain important but cannot fully remedy the underlying causes that have disrupted operational and financial performance. Health systems must consider a fundamental transformation of their business model. Transformation requires a disciplined assessment of the health system's current portfolio of businesses, services, and markets...

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When governing boards of healthcare organizations resolve to support their executive teams' commitments of time and money to create strategic action plans that meet their communities' environmental and social criteria-and when those healthcare organizations work with others that share their passion to measurably improve health-their communities can realize remarkable benefits. For example, this case study describes Chesapeake Regional Healthcare's collaborative approach to a community health need that began with data from the hospital's emergency department...