Academic Health Center in a Highly-Competitive Market

This client includes one of the first medical schools in the United States and its affiliated hospital, which became independent of the university in the 1990s and joined a regional health system. The organization provides the full range of services of an academic medical center in a highly competitive market. The hospital is an open staff model, with a large faculty practice and community-based private practice physicians.

Our relationship with this client began in 2002, when we worked with them on a study of physician executives that uncovered the necessity for strong physician leadership in order to realize hospital goals. The insights derived from this work served as the foundation for a series of patient care improvement initiatives that depended absolutely on the center’s physicians for their success.

The Challenge:

The chair of the department of medicine wanted us to help the hospital reduce patient length-of-stay, and improve the management of patients with acute coronary syndrome and heart failure.

The Solution:

Using the earlier study of hospital executives as a springboard, we:

• Performed a detailed cultural assessment of how the hospital and medical college interacted with their physicians
• Identified institutional barriers to providing efficient inpatient care 
• Established new leadership roles and teams by working with members across multidisciplinary medical center groups
• Redesigned inpatient processes
• Developed a new system and role for clinical coordination
• Adapted national guidelines to meet this center's unique needs
• Revamped teaching, conference, and rounding schedules
• Remodeled case management and nursing 

The Impact:

The hospital significantly raised the proportion of patients who receive evidence-based care, realized shorter length of patient-care stay, and strengthened the effectiveness of its teaching programs. 

This work has been published in Academic Medicine and is available here.