Hospital CEOs release 10-point checklist for high-value care

Discussion paper emphasizes hospital leaders' role

Topics: Leadership, Workforce, Leadership Culture, Quality, Performance Improvement, Methodologies

June 6, 2012

Eleven prominent hospital CEOs on Tuesday outlined 10 strategies to help hospital leaders improve the value of their patient care.

The 10-point checklist was included in a discussion paper from the Institute of Medicine Roundtable on Value & Science-Driven Health Care. It was drafted by Cleveland Clinic CEO Delos Cosgrove, Partners HealthCare CEO Gary Gottlieb, Kaiser Permanente CEO George Halvorson, and eight other hospital leaders.

Checklist for high-value care

The checklist calls on hospital executives and governing boards to publicly promote and ensure effective, efficient medicine using the following 10 strategies:

Foundational elements

  • Governance priority: Senior executive leaders and board members should provide visible and determined leadership on quality goals and progress.
  • Culture of continuous improvement: Hospital leaders should commit to ongoing, real-time learning to ensure the sustainability of quality efforts.

Infrastructure fundamentals

  • IT best practices: Hospitals must ensure automated, reliable information to and from the point of care.
  • Evidence protocols:  Hospitals must use evidence-based protocols to deliver effective, efficient, and consistent health care.
  • Resource utilization: Hospitals must efficiently use finite resources by optimizing the use of personnel, physical space, and other resources.

Care delivery priorities

  • Integrated care: Hospitals must provide the right care in the right setting using the right providers and teamwork approach to care.
  • Shared decision making: Clinicians must collaborate with patients on treatment plans.
  • Target services: Hospitals should tailor community and clinic interventions for resource-intensive patients.

Reliability and feedback

  • Embedded safeguards: Hospitals must establish procedures and safeguards to reduce preventable patient harm.
  • Internal transparency: Hospital leaders must establish a visible process that monitors and shares performance, outcomes, and costs across the hospital.

Implementing the checklist

Noting that an estimated 30% of all health care expenditures in the United States do not improve health, the 11 CEOs conclude that the checklist may "hold the key to capturing this lost value."

However, they write that implementing the checklist depends on "close partnerships" between management teams and governing boards. "Ultimately it is our responsibility to improve care delivery in our institutions," they write, adding, "More broadly, as health care community leaders, responsibility rests with us for eliminating waste from the system and reinvesting it to maximize the quality and efficiency of health care in the United States." 

Commenting on the checklist, American Hospital Association President and CEO Rich Umbdenstock said it "provides a succinct view of what the future looks like and how the new models of care can improve the quality of services provided to patients (IOM paper, 6/5; AHA News, 6/5; McCarthy, National Journal, 6/5; Evans, Modern Healthcare, 6/5 [subscription required]).

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