New York City's public hospital system is becoming a provider of choice and is a model of performance excellence and efficiency, according to a comprehensive case study published by The Commonwealth Fund
HHC has weathered financial and management difficulties that gave it a controversial reputation in the past,” cites the report by The Commonwealth Fund, the prestigious national private foundation that advocates for high performance in healthcare. “Because of its ongoing transformation and improving levels of performance, HHC is increasingly a provider of choice for the people of New York City, an organization where concern for clinical quality and the patient experience go hand-in-hand with a commitment to serving those in need.”
The report highlights a series of improvement initiatives undertaken by the corporation that have transformed the organization's culture, systems and care processes:
Advanced use of clinical information systems - A common electronic medical record for each patient links HHC's facilities and helps coordinate care across inpatient, outpatient and nursing home settings. The system improves patient safety, quality and efficiency by reducing medical errors and giving clinicians the information they need to provide high quality care.
Collaborative team approach to share best practices and improve patient care - Clinical leaders with specialty expertise meet regularly to share their experiences as they consistently apply best practices to the treatment of specific conditions. Improvements in the management of chronic diseases like diabetes and heart failure, reduced mortality, and marked reductions in hospital-acquired infections have resulted.
Expanded healthcare access for underserved communities - HHC has continually found new ways to provide care, regardless of financial or immigration status. For example, improvements in primary care have reduced waiting times in most clinics to under 60 minutes. Investments in expanded language services for HHC's multi-lingual patients have topped $30 million and bilingual "patient navigators" assist patients in getting their healthcare needs met.
Multiple strategies to bolster financial health - - HHC has repeatedly confronted financial challenges with creativity, contracting exclusively with fully capitated managed care plans to stabilize revenue, and expanding relationships with community providers to attract additional Medicaid-insured patients. Another innovation is the application of a highly successful industry model of "lean thinking" to reduce waste, reduce costs, and improve efficiency and quality throughout the system.
"This vote of confidence is further evidence that continuous, effective performance improvement is deep in the fabric of our work," said HHC President Alan D. Aviles. "There is a growing recognition that our road toward even higher performance translates into more value for the healthcare dollar and puts us in a stronger position to face the spiraling economic downturn."
The complete 45-page report is available at www.commonwealthfund.org.
November 2008
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