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.
Table of Contents
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
The 80–15–5 and the Population’s View
End of Life
Introduction to the Section on Workplace Culture
Making the Transition from a Culture of Accountability to a Culture of Ownership, by Joe Tye
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
Terminology of This Book
Care Circle Networks
Dynamic Capacity Analysis, Matching, and Management
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
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
Blocking and Tackling of Capacity Management in Surgical Services
OR Data Analytics for Optimization
Additional Analytics and Tips
Creating the New Schedule
Review of the Blocking and Tackling of Block Scheduling
Blocking and Tackling of Inpatient Capacity Management
Managing Inpatient Capacity Patterns
Physicians and Their Role in Optimization
Until Then, What Now?
Final Thoughts: Legal Protections
Preparing for Coming Change: Forming a PHO, by Peter Wood
Culture and Behavior
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
The Care Circle Network Concept
An Engineered Approach
Managing Communal Resources
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
Assessing the Community and the Patient Population
Size, Scope, and Scale of Your CCN
Building the Communal Resource Pool
Resource and Capacity Variance
Creating a Care Circle Team
Using the Care Strategies
Personalizing the Resource Pool
Resources for the Resources
Resource Education for Assimilation
Leadership and Core Values
Group Dynamics™ for Resources
Outcomes and Incentives
Challenges and Obstacles
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
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.