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  • hospital impact - Change Agent 103: Sometimes revolutions are easier than evolutions
    On the other hand going back to Preventive Health Research Institute the folks going through Dr Ornish s tough and radical program saw quick dramatic results Feeling and seeing those tangible results told them hey this is working and motivated them further Deutschman goes on with a truth telling research study done by management consultant gurus Bain Co Read Bain s Rip Off the Band Aid Quickly PDF Whitepaper Almost all successful corporate transformations were substantially completed in 2 years or less Early victories produced momentum silenced the nay sayers and served as emotional fuel to take on the challenges ahead Change Agent Series 101 Why preventative health doesn t work 102 Give people a new frame not a new picture 103 Revolutions easier than evolutions 104 Learn to play the accordian 6 comments Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in with moms Hospitals must train millennial nurse leaders in empathy frontline engagement St Louis hospital creates unit to improve outcomes through innovation 4 ways hospitals can foster family centered care Pediatric ER seeks to limit stressors for autistic patients Nurses hospital groups clash on Massachusetts bill to improve response to violence Superbug linked scopes Feds failed to act on earlier outbreak 8 developing healthcare trends Hottest Products Compare Top Solutions in Hospital Management Electronic Medical Billing Software Healthcare Revenue Cycle Management Practice Management Software Clinical Information Systems CIS Clinical Data Repository Software CDR Medical Billing And Coding Medical Transcription Services Healthcare EDI Systems Evaluate more than 4 000 products

    Original URL path: http://www.hospitalimpact.org/index.php?blog=6&title=change_agent_103_sometimes_revolutions_a&more=1&c=1&tb=1&pb=1 (2016-02-10)
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  • hospital impact - Change Agent 104: Learn to play the accordian
    one day a week everyone in the company spends the day working on a different discipline marketing folks give software design a shot designers think about business issues etc Merzenich sees this as a productivity booster not drainer since people are actually rejuvenating their brain and creative abilities Merzenich takes it one step further My suggestion is learn Spanish or the oboe or the accordian Of course I m not saying to have your billing clerks perform brain surgery In fact I m not sure how we could apply to our hospitals How do we establish a learning culture I take this one as more of a personal challenge I need to examine my own stubbornness flexibility How good am I at learning new things and handling change As leaders if we do nothing else we have to lead by example Change Agent Series 101 Why preventative health doesn t work 102 Give people a new frame not a new picture 103 Revolutions easier than evolutions 104 Learn to play the accordian 6 comments Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in with moms Hospitals must train millennial nurse leaders in empathy frontline engagement St Louis hospital creates unit to improve outcomes through innovation 4 ways hospitals can foster family centered care Pediatric ER seeks to limit stressors for autistic patients Nurses hospital groups clash on Massachusetts bill to improve response to violence Superbug linked scopes Feds failed to act on earlier outbreak 8 developing healthcare trends Hottest Products Compare Top

    Original URL path: http://www.hospitalimpact.org/index.php?blog=6&title=change_agent_104_learn_to_play_the_accor&more=1&c=1&tb=1&pb=1 (2016-02-10)
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  • Hospital Impact - Election's over, now what for healthcare?
    to state Medicaid funding described in the ACA Liberal and conservative governors are both coming up with experimental pilot projects to achieve the goals of decreasing per capita cost and increasing quality Oregon Gov John Kitzhaber D has received federal approval to embark on a 1 9 billion Medicaid experiment with coordinated care organizations Kitzhaber s plan is to slow Oregon s Medicaid growth to a rate similar to the rest of the economy If it fails he will forfeit the 1 9 billion federal investment South Carolina Gov Nikki Haley s R local experiment does not include participating in ACA mandated Medicaid expansion Instead her catalyst for payment reform depends on close collaboration with private companies such as GE Boeing and Walmart The fiscal cliff means less money for hospitals and doctors I predict Obama will get his grand bargain during the lame duck Congressional session and that the sequestration cuts will not go into effect Elections have consequences During a Nov 11 Sunday talk show influential Conservative Weekly Standard editor Bill Kristol advised the GOP to accept tax increases on the wealthiest Americans as part of a deal to raise taxes and cut federal spending in the amount of 4 trillion The bottom line for healthcare leaders is that we get less money for hospitals and providers no matter what happens with the fiscal cliff The sequestration cuts are crippling to our industry The hopefully smaller healthcare cuts in a grand bargain will still be plenty painful Data is king long live data Healthcare leaders need to absorb the lesson of Obama s innovative and cutting edge use of data to win an election that many thought favored the Republican nominee because of the economy We are just now after the election understanding how the Democrats used microtargeting and social networks to build a superior ground game and decisively win the election One cannot go to a healthcare leadership conference without hearing a presentation on big data Representatives from the U S Department of Health Human Services and the Centers for Medicare Medicaid Services enthusiastically talk about liberating healthcare data and moving from a closed to an open national healthcare data environment Federal initiatives like Blue Button and Section 10332 of the ACA with its public performance reports do have the potential to transform the American healthcare delivery system IT consultants healthcare legacy experts and numerous start up companies are offering their big data solutions to hospital and healthcare leaders I would advise leaders to step back and consider what data solutions they really need to succeed in the new value business model where providers compete on metrics generated by Medicare and private insurers One wag summarized the 2 700 page ACA with one sentence No outcome no income The AHRQ recently summarized data requirements for healthcare transformation and every hospital CEO and CIO needs to read its report I am intrigued by the contrarian view that advocates using tiny data to succeed in our perverse healthcare marketplace

    Original URL path: http://www.hospitalimpact.org/index.php/2012/11/14/p4167 (2016-02-10)
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  • Hospital Impact - Patient empowerment: Next step in accountable care
    Healthcare policy experts and payers have embraced the argument outlined above and patients reports of their satisfaction with both physicians and hospitals have increasingly been used to calculate financial rewards For instance a recent Hay Group survey of 182 healthcare groups documented that about 60 percent of physicians are paid under an incentive plan 66 percent of which incorporate patient satisfaction scores But critics of such an approach have become more vocal and their objections can be classified into three major types 1 Patient feedback should not be tied to compensation because patients do not know enough about medical science to give meaningful feedback 2 Patient experience measures may be confounded by factors that are not directly associated with the quality of care delivered 3 Patient experience scores may reflect fulfillment of patients a prior desires such as wanting a drug regardless of evidence based medical benefit A Forbes article earlier this month captured physician anger with being judged by patient satisfaction scores The current system might just kill you Many doctors in order to get high ratings and a higher salary overprescribe and overtest just to satisfy patients who probably aren t qualified to judge their care And there s a financial cost as flawed survey methods and the decisions they induce produce billions more in waste It s a case of good intentions gone badly awry and it s only getting worse However a New England Journal of Medicine article this month disputed the Forbes analysis The North Carolina academics concluded Both theory and the available evidence suggest such measures are robust distinctive indicators of health care quality Therefore debate should center not on whether patients can provide meaningful quality measures but on how to improve patient experiences by focusing on activities such as care coordination and patient engagement found to be associated with both satisfaction and outcomes evaluate the new care delivery models on patientsâ experiences and outcomes develop robust measurement approaches that provide timely and actionable information to facilitate organizational change and improve data collection methods and procedures to provide fair and accurate assessments of individual providers My guess is that the proponents of using patient satisfaction scores to hold providers accountable will in the end prevail However the level of dissatisfaction of some physicians with patient satisfaction surveys documented in the Forbes article highlights how important changing physician culture will be in successfully reforming the delivery system and ensuring healthy and satisfied patients Dr Kent Bottles is a Senior Fellow at the Thomas Jefferson University School of Population Health Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in with moms Hospitals must train millennial nurse leaders in empathy frontline engagement St Louis hospital creates

    Original URL path: http://www.hospitalimpact.org/index.php/2013/01/30/is_patient_empowerment_the_next_step_for (2016-02-10)
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  • Hospital Impact - Avoiding the dangers of leadership goal-setting
    goal and or a financial incentive were more likely to cheat than those who were only instructed to do their best In his book The Antidote Happiness for People Who Can t Stand Positive Thinking Oliver Burkeman tried to track down an often quoted 1953 Yale study of goals that found the 3 percent of graduates with written goals had amassed greater financial wealth than the other 97 per cent combined and concluded the study never took place Even though Tony Robbins Brian Tracy and Zig Ziglar all include the Yale study in their motivational goal setting speeches Yale University can find no evidence of any such study In Destructive Goal Pursuit The Mount Everest Disaster management science professor Chris Kayes finds similarities between the 1996 mountaineering accidents that claimed the lives of 8 professional climbers and business failures In both cases a goal is set and greeted with enthusiasm evidence emerges that the goal is unwise the negative evidence makes the participants invest more effort and resources to succeed disaster occurs Burkeman used Kayes approach to understand how pre bankruptcy General Motors goal setting campaign concentrated on the number 29 the percentage of the American car market that GM wanted to recapture from the Japanese manufacturers This campaign failed because the company was so fixated on the goal of 29 percent that it spent all its money unwisely on advertising instead of research that might have produced innovative cars that Americans would want to purchase Wharton professor Maurice E Schwitzer worries that too much emphasis on goals can inhibit learning and undermine intrinsic motivation If the goal is to earn a certain score on a math test then that goal takes over A love of learning or understanding of the elegance of math gets beaten out Kayes concluded that the Everest tragedy and many business failures are caused by a passion for goals His hypothesis was that the more they fixated on the endpoint the more that goal became not just an external target but a part of their own identities of their senses of themselves as accomplished guides or high achieving amateurs It would have become progressively more difficult for them to sacrifice their goal despite accumulating evidence that it was becoming a suicidal one Indeed that accumulating evidence Kayes was convinced would have hardened the climbersâ determination not to turn back My advice for 2013 is not to abandon goal setting entirely My advice is to choose goals wisely and continue to monitor them in light of changing conditions and the well documented downsides of blindly following them at the expense of people and ideals Dr Kent Bottles is a Senior Fellow at the Thomas Jefferson University School of Population Health Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House

    Original URL path: http://www.hospitalimpact.org/index.php/2013/01/07/title_85 (2016-02-10)
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  • Hospital Impact - Avoid 3 IT pitfalls to deliver high-value, low-cost care
    hospital CEOs are ignoring several IT pitfalls that are already out there ready to trip up well meaning executives as they transition from a disease system to a wellness system of care Pitfall 1 Data breaches The analysis of healthcare data breaches from 2009 to 2012 should make sleep difficult for any American hospital CEO There have been 495 breaches reported that affected more than 500 individuals and 57 000 breaches reported that affected fewer than 500 patients While hospitals and health plans are getting better at securing their data physician offices are getting worse And since physician offices are increasingly connected to the hospital computer system the hospital CEO should be worried One expert estimates that the going rate for comprised hospital records is 1000 per patient The hospital CEO who cares for thousands of patients must be concerned Pitfall 2 Tiny data versus big data When I speak at accountable care organization conferences there always is an IT consultant presenting on how big data will be essential for any ACO to succeed I doubt most hospital CEOs really understand the concept of big data Steve Lohr provides the best quick definition of big data that I have read Big Data is a shorthand label that typically means applying the tools of artificial intelligence like machine learning to vast new troves of data beyond that captured in standard databases The new data sources include Web browsing data trails social network communications sensor data and surveillance data Before jumping into an expensive consulting contract with an IT wizard the prudent hospital CEO should at least consider the advice of those who advocate utilizing tiny data to decrease per capita healthcare cost These contrarians advise hospital CEOs to concentrate on limited data sets that are readily available by identifying high risk patients establishing registries for common chronic diseases and partnering with payers for data and analytics Pitfall 3 Pesky patients want their damn data Empowered patients are challenging everyone in the healthcare establishment for transparent access to their own health care data Recent NPR and Wall Street Journal articles expand the traditional argument about hospital and physician medical records to the data from implantable medical devices A blog post by e Patient Dave a kidney cancer survivor and healthcare activist commemorating the three year anniversary of his Medicine 2 0 Keynote in Toronto entitled Gimme My Damn Data has a good summary of what empowered patients want in the way of data transparency Health IT will be critical to successfully transition from fee for service to global value based payment systems and change from a disease centered healthcare system to a wellness healthcare system Hospital CEOs must better understand the three pitfalls outlined above to avoid failure in this difficult time of transition Dr Kent Bottles is a Senior Fellow at the Thomas Jefferson University School of Population Health Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www

    Original URL path: http://www.hospitalimpact.org/index.php/2012/12/11/title_79 (2016-02-10)
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  • Hospital Impact - Pay for performance won't solve healthcare cost crisis
    children did not have the intended effect of getting the parents to the school earlier Instead the parents came later and choose to just pay the fine In both cases giving money destroyed intrinsic motivators such as altruism and being regarded as a good citizen social norms and made people do the opposite of what the policymakers wanted A Health Affairs article reviews recent healthcare pay for performance studies and concludes researchers have failed to demonstrate that financial incentives can improve patient outcomes and not for lack of trying Great Britain s large primary care pay for performance program documented physicians meeting the targets but population blood pressures and hypertension complications did not decrease There also was a disturbing quality decline for measures that were not incentivized In the United States Medicare s Premier Hospital Quality Incentive Demonstration saw no difference at five years between pay for performance hospitals and controls Patient outcomes also did not improve These findings would not surprise behavioral economics researchers and psychologists who have studied monetary rewards and intrinsic motivators in many fields outside of healthcare An Australian Government Productivity Behavioural Economics Public Policy Roundtable concluded Monetary rewards have a large effect in undermining motivation for intrinsically rewarding tasks Symbolic rewards such as praise do not undermine intrinsic motivation Monetary rewards can reduce cooperation and increase selfishness Monetary rewards can spread and undermine intrinsic motivation for tasks not directly involved in the monetary rewards program Surveillance deadlines or threats and specific task performance evaluation makes crowding out stronger There is general agreement that the United States needs to cut the cost of its healthcare delivery Pay for performance programs continue to be proposed as major ways to achieve this admirable goal Medicare and private insurers both are supporting pilot projects that utilize pay for performance techniques to encourage hospitals accountable care organizations and physicians to embrace high quality care delivered at a lower cost There is increasing evidence that pay for performance programs will not be successful in healthcare Behavioral economics provides a scientific reason for this failure that seems contrary to conventional wisdom It won t be the first time that conventional wisdom comes up with policy initiatives that simply do not work Greed got us into the healthcare cost crisis in the first place appealing to hospital and physician greed will not get us out of it Dr Kent Bottles is a Senior Fellow at the Thomas Jefferson University School of Population Health Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in with moms Hospitals must train millennial nurse leaders in empathy frontline engagement St Louis hospital creates unit to improve outcomes through innovation 4 ways hospitals can foster family centered care

    Original URL path: http://www.hospitalimpact.org/index.php/2012/10/16/pay_for_performance_won_t_solve_healthca (2016-02-10)
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  • Hospital Impact
    human health E None of the above If you are in my class the correct answer is E None of the above Let me explain Read more Leave a comment How will reform ruling affect healthcare challenges June 19th 2012 by Kent Bottles While waiting for the U S Supreme Court to deliver its healthcare reform opinion I am reminded of two of my favorite quotations Tom Peters famously observed If you re not confused you re not paying attention And Harry Truman once advised If you can t convince em confuse em Both seem to apply to the Supreme Court and the Patient Protection and Affordable Care Act ACA I have been reading that if the Supreme Court throws out the entire law President Obama will be the big winner because his liberal base will be energized for the November election Others contend that if the Supreme Court rules the entire ACA constitutional Gov Romney will win big because the conservative GOP base will finally get behind its sometimes moderate nominee Some pundits have contended that it does not matter what the Supreme Court decides the reform train has left the station and hospitals and doctors need to get on board or be left behind In this blog post I will attempt to cut through the spin Read more Leave a comment Understanding barriers to patient behavioral change May 16th 2012 by Kent Bottles Healthcare wellness hospital care and post acute care all depend on relationships between providers and patients The gap between health care professionals and the public that has been documented in Kaiser Family Foundation polls indicates that these relationships are not working perfectly For example professionals believe 30 percent of healthcare services are not necessary but 67 percent of the public say they do not get all the care they need Professionals state there is wide variation in quality of providers but 70 percent of the public believes there is not much difference in quality of physicians in their area Read more Leave a comment Exec pay for profit chains driving hospital closures April 24th 2012 by Kent Bottles Hospital leaders probably do not need to be reminded that their status quo is unsustainable However even the most experienced and jaded health system executive took notice of the following headline Why one third of hospitals will close by 2020 David Houle and Jonathan Fleece offered four reasons for their startling conclusion the federal budget deficit the alarming evidence of poor quality of care abysmal hospital customer service and the connectivity electronic medical records and transparency associated with healthcare reform Their blog post generated 313 comments when I checked last Read more Leave a comment Previous Page Next Page Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in with

    Original URL path: http://www.hospitalimpact.org/index.php?blog=1&s=kent%20bottles&page=1&disp=posts&paged=8 (2016-02-10)
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