Teaming: Locum Tenens Are Poised to Deliver High-Value Health Care
The team-based model of care (teaming) developed at ThedaCare hospitals in Wisconsin now rebranded as Catalysis [Catalysis Provides Healthcare Leaders with Proven Programs and Resources to Inspire and Accelerate Healthcare Value] reduced costs per case by 25 percent in its first year, while patient satisfaction scores soared and readmission rates fell. The organization was the first to adapt and share lean methodologies along with other change management methodologies to ultimately enhance healthcare value. The organization's mission is to redesign three interdependent components of the healthcare industry which will result in improved value for patients. This will be accomplished by collaborating with patients and leaders in the provider, employer, insurer, and government communities.
But implementing a team-based model means health system leads must reorient the way clinicians think about their work; the strategic agenda for moving to a high-value, team based, health care delivery system has six components. They are interdependent and mutually reinforcing. This progress will be easiest and fastest if they are advanced together (broadly referred to as Teaming).
- Organize into Integrate Public Units (IPUs)
- Measure Outcomes and Cost for Every Patient
- Move to Bundled Payments for Care Cycles
- Integrate Care Delivery Systems
- Expand Geographic Reach
- Build an Enabling Information Technology Platform
At the core of the value transformation is changing the way clinicians are organized to deliver care. The first principle in structuring any organization or business is to organize around the customer and then the need. In health care, that requires a shift from today's siloed association by specialty department and discrete service to organizing around the patient's medical condition. The term associated with such a structure was referred to as an Integrated Practice Unit. In an IPU, a dedicated team made up of both clinical and nonclinical personnel provides the full care cycle for the patient's treatment (Team Based Care).
"This is part of a move to really transform how we deliver care from care that's pretty siloed, that's pretty distant from the patient, whom sometimes focuses on the technology and the knowledge base rather than on reaching the patient's goals," ... "I think teaming as part of this new model of care becomes very, very important."
- John R. Combes, M.D., Senior Vice President at the American Hospital Association. Combes oversees the association's Physician Leadership Forum, which is aimed at improving care processes.
One of the biggest gaps was a team-based approach to care, and the need for physicians to actually understand teaming and value the strength of each individual team member.
"Frankly, our health care professionals are not trained to be team members; they are trained to be individual heroes... What we have to do, basically, is undo all of that training, whether it's in medical school, in residency, nursing school, PT school, pharmacy school and rewire the thinking process."
- John S. Toussaint, M.D., President and CEO of the ThedaCare Center for Healthcare Value.
"If we expect practitioners to work in teams, we really do have to expose and train them to work in teams"... "It's not something that you can just, sort of, show up and do."
- NEHI's Schuetz
"That exercise showed me that there is a clear recognition among CEOs that this [team based; high-value, patient centered care] is a very important aspect of care delivery in the future."
- John R. Combes, M.D
Combes sees team-based care as a logical element of high-value, patient-centered care. Health care executives and administrators need to utilize the services of temporary providers that already enjoy the ability to make an immediate impact. This is mainly because locums are trained to approach new settings and quickly adapt to their environment. They're able to collaborate with permanent staff and offer knowledge of system processes from their experiences at different healthcare facilities that may benefit another practice in ways previously not considered. Practice administrators who utilize locum tenens to offset being short-staffed are able to sustain satisfaction rates, while seeing more patients and meeting revenue goals.
Exciting news for locums: these new approaches make it easier for a new physician to make a smooth transition into a clinical team. It's a win-win situation. This focus on physician's working more closely with nurses and other members of the healthcare team supports locum tenens quick adjustment to a new assignment; allowing for a great opportunity for all members of the health care team to get properly acquainted.
