Irvine-Calif.-based Hoag Orthopedic Institute recently earned a five-star
rating from the Centers for Medicare and Medicaid Services for patient
experience and quality; making it one of only eight hospitals in California
to receive the ranking. Dereesa Reid, CEO at Hoag feels the CMS rating
is exciting and believes that CMS, with the value-based program, is creating
a "gold standard" for clinical quality and transparency.
Hoag Orthopedic Institute is 51 percent owned by Hoag Memorial Hospital
in Newport, Calif., and 49 percent owned by physicians. Hoag Orthopedic
Institute also includes a 70-bed hospital in Irvine and two surgery centers
— one in Orange and one in Newport Beach.
With the latest CMS program, besides simply providing a rating, consumers
and professionals can compare clinical quality and patient satisfaction
"apples to apples," as Ms. Reid puts it.
Why five stars is important
The comparison and the star rating is a huge boost for consumers as well,
who are able to quickly understand what a star ranking could mean, and
how it could impact their decisions about healthcare.
"The five stars is just a really progressive way that our fellow
government is trying to be a catalyst for healthcare reform. I think it's
good," says Ms. Reid.
Hoag Orthopedics has been publishing their annual outcomes report for
the last four years, but with their recent five star ranking, the hospital
has seen a larger amount of mainstream press and attention that they may
not have otherwise. This attention will help and encourage hospitals with
excellent ratings continue to provide excellent care.
"Once you start consumerizing this message, it gets out to local
papers, and I had people walking up to me at the gym and asking if that
was my hospital. And I had people walk up to me in the hospital and say
they read about this," explains Ms. Reid.
The physician ownership advantage
One of the unique features about HOI is the physician ownership. The Patient
Protection and Affordable Care Act no longer allows physicians to establish
new physician-owned hospitals, but HOI was established before the law
changed and has been able to maintain its status. HOI is a hybrid between
a community based, non-profit hospital and physician owned hospital.
"I do believe anytime you are allowed to align physicians and employees,
and get people on the same page, you get a different outcome. You are
able to align organizational needs and hit the goals in a straight line
of sight ," says Ms. Reid. "The big win here is it goes back
to what Dr. Michael Porter and Dr. Elizabeth Teisberg wrote about in Redefining
Healthcare. I think you start seeing better quality and higher patient
satisfaction in large centers of specialty care withhigh volume and specialized
Ms. Reid puts emphasis on not only providing care, but the passion that
can come from these sorts of specialty centers, noting her employees come
to work passionate about orthopedic care. The physicians and staff are
empowered to focus the patient first and provide better practice orthopedic
care . Nurses and staff are also empowered to develop new and improved
methods of care coordination and champion emerging new best practices.
"I think when physicians are empowered to lead, and administrators
focus on removing barriers so they can practice their profession at the
top of their game, you get a different result. It just so happens that
because of physician ownership our physician leaders are actively involved
with the hospital and our entire team. Similarly, I see evidence in academic
medicine of really great physician empowered organizations; Cleveland
Clinic is a good example," says Ms. Reid.
Ms. Reid was initially drawn to the physician empowerment of HOI when
she saw a group of physicians who were committed to being a solution to
healthcare reform, and who were fortunate to establish the hospital before
the law changed, but admits there are good and bad examples everywhere.
"For orthopedics, especially for joint replacement, we have an aging
population that are wearing their joints out more quickly because of obesity,
so I don't think that we are doing more [procedures than we need to].
We even look at ways not to do surgery," says Ms. Reid.
HOI also takes emergency cases and has trauma doctors that cover EDs in
Irvine and Newport Beach, as well as take admissions from other hospitals.
"It is not all just elective surgeries," says Ms. Reid.
Pushing quality higher
As for healthcare reform and a push for higher quality healthcare, Ms.
Reid would urge physicians and healthcare administrators to find ways
to step-up and have a vision to understand how to do something differently
with excellent outcomes and value.
"As a nation, we've got to quit thinking about partisan politics
and come to the table as Americans, and in healthcare, as Americans who
have the opportunity to make an impact on our entire country," says Ms. Reid.
Some of the ways Hoag has been able to reach high levels of patient satisfaction
and quality lie in a number of factors, including using Press Ganey, reacting
to patient satisfaction reports immediately and collecting their own data
"There is also a technology out on the market that allows our patients
and nurses to interact via our television. We might ask them, 'is
your room clean?' or 'how is your noise level?' So we intervene,
in other words, if your patient needs something right now and we have
a mechanism that lets us know that, we can go solve that right now. Then
they see their needs are being taken care of in a timely fashion and they
are happy," says Ms. Reid "You can not sustain this type of
patient satisfaction and this type of clinical quality without a team
of people who get up in the morning and come to work totally committed.
This organization is about them."
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