{"title":"Systemness: Leading Healthcare Systems from Theory to Reality.","authors":"David A Rubenstein","doi":"10.1097/HAP.0000000000000112","DOIUrl":"https://doi.org/10.1097/HAP.0000000000000112","url":null,"abstract":"DOI: 10.1097/HAP.0000000000000112 David A. Rubenstein, FACHE, is an executive consultant to the US Army Medical Command in San Antonio, Texas. He served as Commanding General of the US Army Medical Department Center and School and Chief in the US Army Medical Service Corps, retiring in 2012 as major general. He also served as 2008–2009 chair of the Board of Governors of the American College of Healthcare Executives. The feature article authors in this issue of Frontiers of Health Services Management perform an important service for leaders at all levels of health and healthcare organizations. Let’s applaud them for that. Retired Memorial Hermann Health System leaders Charles D. Stokes, FACHE, and Rod Brace provide research and a description of what needs to be done to reach systemness; Aimee Daily, FACHE, chief transformation officer at Memorial Health System in Illinois, provides a useful description of her organization’s road to systemness. We should take lessons, tools, and challenges from both feature articles and add them to our professional toolboxes. Then, we owe it to our teammates, patients, and many other stakeholders to develop the mindset to go beyond systems in name only to systems that exhibit true systemness, ones that successfully move from theory to practice. Achieving systemness is a journey. Christopher D. Van Gorder, FACHE, whom I will introduce later, has been on that journey as CEO of a system for more than 20 years. Others I will introduce have been on their current CEO journeys for shorter, but just as impactful, times. Drawing from their stories, I will discuss the mindset of executive leadership that describes the goal and moves the system from theory to reality.","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"37 4","pages":"28-33"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10312964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How to Lead an Organization Toward Systemic Transformation.","authors":"Abi Sriharan","doi":"10.1097/HAP.0000000000000115","DOIUrl":"https://doi.org/10.1097/HAP.0000000000000115","url":null,"abstract":"","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"37 4","pages":"38-41"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10312965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How One Healthcare Organization Is Creating a True System.","authors":"Aimee Daily","doi":"10.1097/HAP.0000000000000114","DOIUrl":"https://doi.org/10.1097/HAP.0000000000000114","url":null,"abstract":"<p><strong>Summary: </strong>Founded in 1897 as a 12-bed hospital and training school in Springfield, Illinois, Memorial Health System (MHS) today serves communities throughout central Illinois with five affiliated hospitals, ambulatory care services, and behavioral health programs. The system includes Memorial Medical Center in Springfield, Abraham Lincoln Memorial Hospital in Lincoln, Taylorville Memorial Hospital in Taylorville, Passavant Area Hospital in Jacksonville, Decatur Memorial Hospital in Decatur, and the Memorial Physician Services, Memorial Home Services, and Memorial Behavioral Health network across central Illinois. The evolution of MHS from a system in name only-lacking full integration of organizational functions-to its current status as an optimized health system has been marked by challenges, from the initial doubts of employees and the community to the upheaval caused by the COVID-19 pandemic. Systemness requires visionary and sure-handed leadership to identify and realize economies of scale, share best practices for operational improvements, and reduce unwanted variation to improve quality of care. As the MHS story illustrates, that all starts, grows, and endures with strategic planning.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"37 4","pages":"4-16"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10345678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Power of Systemness: Adding Value to Healthcare.","authors":"Trudy Land","doi":"10.1097/HAP.0000000000000116","DOIUrl":"https://doi.org/10.1097/HAP.0000000000000116","url":null,"abstract":"","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39019387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Pursuit of Systemness Calls for an Intentional Approach.","authors":"Kira M Carter-Robertson","doi":"10.1097/HAP.0000000000000113","DOIUrl":"https://doi.org/10.1097/HAP.0000000000000113","url":null,"abstract":"","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":" ","pages":"34-37"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39019388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Implementing a New Service Line Model to Support Growth and Serve Patients.","authors":"Peter S Fine, Kathy Kuhlenbeck","doi":"10.1097/HAP.0000000000000104","DOIUrl":"https://doi.org/10.1097/HAP.0000000000000104","url":null,"abstract":"<p><strong>Summary: </strong>Many healthcare organizations are reinvesting in clinical service lines to differentiate themselves, standardize evidence-based care, and add value. Typically, service line structures are built around hospital-based procedures and are accountable solely to local operations. That can be a blueprint for missed growth and lost value.Banner Health, based in Phoenix, Arizona, with operations in six southwestern states, has pivoted to a systemwide service line strategy to foster growth and support value-based care. Service lines are now organized to maximize both revenue and quality across the continuum of care, to the benefit of both the system and its patients. The new, team-based structure allows Banner Health to respond nimbly to changes in the healthcare environment because it is based on the ways patients access the system. In 2021, just two years into this complex transition, the results have demonstrated that this service line model can achieve measurable benefits that include growth; improved financial performance, safety, and clinical outcomes; and increased collaboration in value-based payment models-all helping the system to realize its mission of making healthcare easier so that life can be better for our patients.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":" ","pages":"4-13"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25401067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Service Line Development Serves to Support the Entire System.","authors":"Sarah Roberts","doi":"10.1097/HAP.0000000000000107","DOIUrl":"https://doi.org/10.1097/HAP.0000000000000107","url":null,"abstract":"","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":" ","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25401068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Changing Times Point to New Directions in Clinical Service Line Leadership.","authors":"Richard J Priore","doi":"10.1097/HAP.0000000000000109","DOIUrl":"https://doi.org/10.1097/HAP.0000000000000109","url":null,"abstract":"","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"37 3","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10364927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Service Lines: Working Toward a Value-Based Future.","authors":"John A Lutz, Paula M Zalucki, Maria Finarelli","doi":"10.1097/HAP.0000000000000105","DOIUrl":"https://doi.org/10.1097/HAP.0000000000000105","url":null,"abstract":"<p><strong>Summary: </strong>The primary drivers for service line development have historically been market differentiation and profitable growth. In the current transition to value-based care, however, several other factors are now driving service line strategy. Specifically, in a value-based world, service lines must be patient centric, not provider centric; they must focus on more than hospitals; and they must be market facing.To build the operating model of the future and succeed in a value-based world, health systems need to reimagine the clinical, operational, and financial features of today's service lines. In working toward this future state, a coordinated, evidence-based care model with a multidisciplinary care team must replace today's episodic care. Easy access to prompt solutions and a seamless, low-stress experience for both patients and providers will be new competitive differentiators, along with cost transparency. Outcomes, patient convenience, and the total cost of care will drive future service line relationships between health systems and physicians. The criteria for selecting physician partners will be materially different, too.In implementing this future-state model, healthcare organizations will need to reconcile several opposing forces and tear down structural and operational silos. Health systems that can navigate through these challenges can realize numerous benefits.</p>","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":"37 3","pages":"14-28"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10364925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Service Lines: An Organizing Framework for a Value-Based World.","authors":"Trudy Land","doi":"10.1097/HAP.0000000000000108","DOIUrl":"https://doi.org/10.1097/HAP.0000000000000108","url":null,"abstract":"","PeriodicalId":39916,"journal":{"name":"Frontiers of Health Services Management","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25401066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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