Hospitalists Key Partners in Healthcare’s Future, Evolution
After a career working for hospitals, I am about to retire as president and CEO of the American Hospital Association (AHA), an organization that represents some 5,000 hospitals and health systems. This moment compels me to look at the past—what we have learned and how hospitals have changed—and consider the possibilities the future holds for hospitals and hospitalists.
I have watched as hospitals have triumphed over tragedies, from natural disasters to mass shootings. More recently, I saw hospitalists pour their hearts and souls into preparing for the possibility of Ebola. Time and time again, you have responded through your deep-seated commitment.
I have observed the journey toward operational excellence through a punishing recession, a government shutdown, and burdensome regulations that make day-to-day operations amazingly complicated. Yet costs have moderated in historic ways. In fact, hospitals are tackling the tough problems of quality and safety that have plagued us for generations, from preventable infections to disparities to system fragmentation, with a commitment that says to all: This is not acceptable. This will change. And the results show great improvements.
On a clinical level, we’ve made dramatic advances. New technologies and treatments mean that we routinely cure conditions in patients who would once have been without hope. We can also restore quality of life to patients who previously, after an illness or injury, would have spent the rest of their lives struggling with the tasks of everyday living.
But the most remarkable transformation that has taken place in America’s hospitals over my lifetime is in the culture. The focus on patient-centered care has required a new mindset that empowers patients to make decisions about their own care and pushes healthcare workers to much higher levels of coordination and communication. A significant factor in this has been the introduction, growth, and maturation of the hospitalist specialty.
One result of this transformation is that physicians, nurses, and other clinical staff, who once worked in separate silos, are increasingly working as teams. Hospitalists often lead these teams. Clinical integration is the catalyst for profound improvements in patient care. Team-based care is more efficient; sharing information about a patient lessens the chance of duplication of services and increases the use of protocols shown to improve patient outcomes. Clinical integration also helps hospitals develop and implement best practices, and that is making it possible to achieve dramatic progress in tackling some stubborn problems that have plagued these facilities for years, such as healthcare-associated infections.
Moving forward, hospitals are intensely focused on achieving three critical goals: improving the patient care experience, improving the overall health of the community, and reducing the per capita cost of health care. Accomplishing those goals means accelerating the pace of change even further.
For years, we’ve been moving toward a system that is more integrated, with hospitals, physicians, and post-acute care providers combining forces to make true systems of care available to patients. Payments are more at risk as we move away from the fee-for-service model we’ve had for decades to a system that rewards value and outcomes. Healthcare is also becoming far more accountable and transparent about quality and pricing. Hospitals that tried to do better with less are now trying to do less with less, demanding that expensive procedures lead to better patient outcomes. They are focusing more on prevention and less on intervention.
