POPULATION HEALTH – DEFINING OUTCOMES BY ASKING THE RIGHT QUESTIONS
Value-based healthcare delivery in its simplest form is the practice of measuring changes in health outcomes against the cost of producing them. Yet, effectively measuring these outcomes is a complex process that requires the intervention of mission-focused, adaptive leadership. One of the most common barriers to producing meaningful outcomes is our failure to ask the right questions. In traditional patient satisfaction surveys, hospitals often inquire about the taste of food quality, staff communication, or the state of the facilities. In essence, we are asking, “How were we?” What we should be asking is, “How are you? Has your health improved? What do you value in your healthcare experience and how can we help you develop and achieve your own health goals?” In this presentation, Benjamin tells the story of how one frontier healthcare delivery system is making the transition from an internal focus on traditional process improvement to patient-centered outcomes by successfully soliciting the input of 80% of the households in its culturally diverse county. This collaborative survey process leveraged relationships with a medical school, local government, healthcare, public health, law enforcement, employers, education system, and area migrant services. The data was surprising and has redefined this county’s strategy for improving the health of its population.
SHARED DECISION MAKING AND CARE COORDINATION– LIFE OR DEATH
In March of 2013, Benjamin’s 34-day-old daughter was hospitalized with an acute cardiac condition that caused her heart rate to increase to over 300 beats per minute. Within 24 hours, she was transported by ambulance and airplane through three states and to three different hospitals. By the time she arrived at her final destination, she was in critical condition. With this true story, Benjamin leads his audience through an exhilarating and, at times, the disheartening journey of seeking healing for his vulnerable, first-born daughter. His experience was complicated by the fact that as the CEO of the first hospital where she received care, he felt partly responsible for the disjointed systems that led to her extreme suffering. Fueled by knowing that much it would have been avoided with integrated care coordination and effective shared decision-making, Benjamin makes a compelling case and offers tools for developing integrated healthcare delivery systems, including collaborative processes that allow patients and their providers to make evidence-based health care decisions together.
AN ETHICAL CASE FOR EXCELLENCE IN HEALTHCARE DELIVERY
As the US grapples with the implementation of legislation that could afford all citizens access to healthcare coverage, rural communities face additional challenges. First, insurers are still paying generously through the Critical Access Hospital program for high-cost inpatient and emergency services with very little focus on incentivizing population health. To make matters more difficult, rural healthcare delivery systems often lack the basic primary care and community-based infrastructure to properly manage the health of their populations. Put simply, even if insurers incentivized interventions that would lead to better overall outcomes for people, those services are not available in many rural communities. In this presentation, Benjamin tells the story of the rapid growth and transformation of Kearny County Hospital, a frontier healthcare delivery system in one of the United States’ most culturally diverse and medically underserved areas. He addresses the fatalism that has become common in rural communities while referencing the Four Principles of Biomedical Ethics to make a compelling case for essential steps to effective, sustainable reform.
MISSION-FOCUSED MEDICINE IN RURAL AMERICA – AN INNOVATIVE SOLUTION FOR PHYSICIAN RECRUITMENT AND RETENTION
The American Association of Medical Colleges predicts a shortage of between 12,000 and 31,000 primary care physicians in the US by 2025. Those shortages will be even more concentrated in rural or frontier areas. Kearny County Hospital (KCH) in Lakin, Kansas, was turning away an average of 50 patients per week from 2014 to 2015. This led to the inappropriate use of Emergency Department services among its diverse patient population. To address this issue and to appeal to the millennial generation of physicians, KCH bolstered its recruitment plan to include, among other incentives, paid time off for doctors to serve internationally as medical missionaries. Because southwest Kansas has become home to 30 different nationalities, KCH has come to realize that having international experience better equips doctors to work in rural areas of Kansas, and vice versa. Since the program’s implementation, the hospital’s primary care footprint and annual budget have more than tripled as patients travel from up to 120 miles away to receive services there. Furthermore, the frequency of non-emergent ED visits has decreased by 91%. In this presentation, KCH CEO Benjamin Anderson provides audiences practical tools for physician recruitment and retention and the development of a mission-focused culture to attract them.