Forum: Accountable care
Over a decade ago, ThedaCare was facing the challenges of rising costs and stagnant quality. The group has since transformed itself by implementing healthcare reforms aimed at improving value creation.
ThedaCare adopted the principles and philosophy of LEAN management, emphasizing continual improvement of process flow. For example, the Collaborative Care Units initiative aims to redesign inpatient care by prioritizing those elements of the care pathway that added most value to patient experience, and de-prioritizing those that produced minimal value.
Interdisciplinary teams were established, consisting of a physician, a nurse, a care manager and a pharmacist, to work with patients to create a single, tailor-made and authoritative care plan. The team meets each day with the patient in a bedside care conference: the nurse monitors progress of the plan against agreed care guidelines and makes recommendations to the other team members to address any barriers to successful recovery; the pharmacist takes part in the daily rounds and can influence medication decisions at the point of care. Following admission, a social carer assesses every patient and arranges further assessments, home visits and ongoing support as required.
Under the scheme, patient-satisfaction scores have soared (95 percent of patients now give their care a 5/5 rating, compared with 68 percent before the launch of the Collaborative Care Units). Nurses comply strictly with care protocols, and as a result, the average length of admissions has fallen by 17 percent. The duplication of work by members of the provider network has declined and, as a result, the costs of direct and indirect inpatient care have fallen by 25 percent.