Works in Progress
Numerous professional organizations are working to advance some or all aspects of hospital medicine and administration. Some of the work that is currently underway includes:
- The Institute for Healthcare Improvement (IHI) hosted the 1st Annual International Summit on Redesigning Hospital Care, June 2005 in San Diego, where medical professionals and hospital executives attended sessions on critical care, patient safety, flow, and workforce development.
- The Agency for Healthcare Research and Quality (AHRQ) awarded 108 grants totaling $139 million to advance the use of information technology in healthcare to reduce medical errors, improve the quality of patient care, and reduce the cost of healthcare.
AHRQ also created a National Resource Center for Health Information Technology and is facilitating expert and peer-to-peer collaborative learning and fostering the growth of online communities who are planning, implementing, and researching health information technology (IT).
- Denver Health (DH) has received a $350,000 hospital redesign grant—an Integrated Delivery System Research Network Project Award, which is part of the AHRQ. Its focus will be removing silos of care, or independent treatment groups, between and across hospital disciplines. DH is redesigning its internal and external processes, as well as its infrastructure.
DH is receiving input from operational, organizational, and regulatory experts (among them representatives from the Joint Commission on Accreditation of Healthcare Organizations, CMS, IHI, Microsoft, Siemens, and Ritz Carlton), providers and administrators, patients and their families. DH is creating a hospital command center to collect, control, and disperse information from a central location. It’s also focusing on improving operating room turnover time to accommodate more surgeries.
Hospitalists as Change Agents
Who will be involved in redesigning the hospital? Currently the major players in designing and implementing change include professional, nonprofit, and government associations (such as those listed above), universities, and independent healthcare consulting groups. Many groups work directly with hospitals on pilot programs for change.
Once change reaches the hospital level, different professionals can become involved, including administrators, physicians, and nursing staff.
But what role can (and should) hospitalists play in getting their institution to become a hospital of the future? “In looking farther to the future, one role that hospitalists may increasingly assume is that of change agent,” says David L. Bernd in “The Future Role of Hospitalists.”2 “The nature of the hospitalist’s work ideally situates him to act as a change agent, enabling him to identify process management initiatives and corral physician support. As a result, hospitalists will increasingly serve as administrative partners and leaders of medical staff initiatives to help facilitate organizational change. … hospitalists themselves may become the solution to some of the systems that need changing.”
Dr. Wellikson agrees: “Hospitalists, who for the most part are in the beginning of a 20- to 30-year professional career, are primed to play significant roles in this changing dynamic.
Next Month: an In-depth Look
In a series of articles over the next year or so, The Hospitalist will examine specific aspects of the hospital of the future. Experts and leading thinkers will provide their perspectives and plans regarding everything from what the hospital of the future will look like in terms of its physical layout, to how the admissions process might work, to the role that specialty hospitals will play.
Our series will envision the future of medical records and medications, critical care, patient flow, and how teamwork and collaboration might change the way medical personnel work.
In addition, each month we’ll contrast this vision of the future with a look into the distant past of hospitals (see “Flashback: The power of words,” below), providing a glimpse of the earliest beginnings of the institution and the medical profession.