1st Edition

Optimizing Your Capacity to Care A Systems Approach to Hospital and Population Health Management

By MPHM Story Copyright 2016
    252 Pages 28 B/W Illustrations
    by Productivity Press

    252 Pages 28 B/W Illustrations
    by Productivity Press

    252 Pages 28 B/W Illustrations
    by Productivity Press

    Our nation's capacity to care is becoming increasingly stressed as an aging and increasingly unhealthy population collides with a relative reduction in the numbers of clinicians and ever-tightening financial resources. If even the mildest of future-state predictions are to be believed, we need a significant restructuring of our entire healthcare system and its total Capacity to Care, such that we can simultaneously improve care capacity, cost, quality, accessibility, and resource gratification.

    Optimizing Your Capacity to Care: A Systems Approach to Hospital and Population Health Management provides comprehensive guidance to a new way to optimize and manage community-wide Care Capacity via a unique, holistic approach to healthcare operations. Through clear examples and actual project results, the book demonstrates the outcomes of a systems-level way of thinking about a community's Capacity to Care that incorporates and integrates the full spectrum of available clinical and communal resources into the care of patients, including hospitals, physicians, emergency departments, surgical services, local churches, civic organizations, pharmacies, and volunteers.

    The book details operational models for each major department of the hospital and a fully integrated communal resource pool to demonstrate how the optimization of capacity, resource utilization, cost, and clinical outcomes can be attained. And by providing healthcare leaders with a deeper understanding of key elements missing from the most common process improvement methodologies and approaches, this book offers fresh perspectives and bold alternatives for hospitals, health systems, and entire communities.

    Introduction
    Why This Topic?
    Goals of This Book
    A Caveat to the Claim of "Holistic"

    Healthcare Cost: An Overview of the Issues
    A Frank Conversation about the Cost of the U.S. Healthcare System
    Waste
    Perversion
    The 80–15–5 and the Population’s View
    Relative Health
    End of Life
    Summary

    Introduction to the Section on Workplace Culture

    Making the Transition from a Culture of Accountability to a Culture of Ownership, by Joe Tye
    Introduction
    The Journey from Accountability to Ownership
    Culture Eats Strategy for Lunch
    Fostering a More Positive Healthcare Culture
    Key Lessons for Fostering a Culture of Ownership
    Conclusion

    Terminology of This Book
    Care Circle Networks
    Downstream
    Dynamic Capacity Analysis, Matching, and Management
    Interdependencies
    Health Ownership
    Outlier
    Upstream
    Hour of Day, Day of Week, Week of Month, and Season of Year
    The Five Pillars of Healthcare Capacity Optimization

    Introduction to Section on Hospital Capacity Optimization

    Dynamic Capacity Management: An Approach to Capacity Optimization
    Healthcare Is Different
    Variability and Interdependencies
    Demand Patterns and the Relevance of Ranges
    Making Capacity Dynamic
    DCAMM and Other PI Methodologies
    Summary

    The Blocking and Tackling of Hospital Capacity Management: An Overview

    Blocking and Tackling of Capacity Management in the Emergency Department
    Breaking Down the Arrival Data
    Blocking and Tackling of ED Capacity
    Other ED Performance Improvement Concepts
    Summary

    Blocking and Tackling of Capacity Management in Surgical Services
    Block-Scheduling Overview
    OR Data Analytics for Optimization
    Surgeon Utilization
    Other Analytics
    Additional Analytics and Tips
    Creating the New Schedule
    Review of the Blocking and Tackling of Block Scheduling
    Summary

    Blocking and Tackling of Inpatient Capacity Management
    Capacity Variance
    Essential Elements
    Managing Inpatient Capacity Patterns
    Summary

    Physicians and Their Role in Optimization
    Until Then, What Now?
    Final Thoughts: Legal Protections
    Summary

    Preparing for Coming Change: Forming a PHO, by Peter Wood
    Introduction
    Culture and Behavior
    Getting Started
    What Does the Operational Structure Look Like?
    Funding the PHO Operations
    Pulling It All Together: A Real Case Model of a PHO
    Is This All for Real? Does It Exist Elsewhere?

    Care Circle Networks: An Introduction
    Background
    Achilles’ Heels
    Summary

    The Care Circle Network Concept
    CCN Description
    Application Overview
    An Engineered Approach
    CCN Components
    Managing Communal Resources
    Technology Infrastructure
    Palliative and End-of-Life Care
    Assimilation and Passion
    Capacity as Strategy
    Other Important Attributes of the CCN
    An Additive Solution
    A Caveat to the Contents of This Book
    A Missing Element
    Summary

    Assessing the Community and the Patient Population
    Selecting Patients
    Size, Scope, and Scale of Your CCN
    "Assimilation Propensity"
    Summary

    Building the Communal Resource Pool
    Overview
    Resource and Capacity Variance
    Resource Options
    Resource Selection
    Selecting Physicians
    Creating a Care Circle Team
    Using the Care Strategies
    Personalizing the Resource Pool
    Resource Assimilation
    Resources for the Resources
    Resource Education for Assimilation
    Leadership and Core Values
    Group Dynamics™ for Resources
    Outcomes and Incentives
    Challenges and Obstacles
    Summary

    CCNs, Palliative Care, and End-of-Life Planning
    Palliative Care: Definition and History
    EOL Planning and Care
    Integrating EOL and Palliative Care into the CCN Model
    The Payor Role
    Government and EOL Planning
    Summary

    Final Thoughts
    Summary

    Index

    Biography

    Pierce Story is the co-founder of Capacity Strategies, Inc., a firm dedicated to the optimization of the "Capacity to Care" in hospitals and communities. His unique expertise lies in "Dynamic Care Capacity Management" (a concept he has developed over the past 15 years); process and systems optimization; resource utilization; and the application of systems dynamics and process simulation to healthcare environments.

    During his 25-plus-year healthcare career, Story has developed several innovative care and business models to improve health system operations and promote population health outcomes. His passion lies in creating holistic, systemic responses to key constraints facing healthcare, especially in low-income and at-risk communities. He has worked extensively in departmental and hospital-wide performance and capacity optimization as well as new facility planning throughout the care continuum, including work in Emergency Departments, Surgical Services, inpatient units, and community-based health clinics.