Meet the mandate to measure clinical quality

The mandate for health care organizations to be accountable for quality, as well as price, is now unavoidable. The Joint Commission's ORYX project is requiring every hospital to measure clinical outcomes of a majority of its patients within the next three years. This mandate can be met best with systems of clinical outcomes measurement that provide valid, reliable risk adjustment; yield meaningful information about many different diseases and procedures; and measure more than mortality or cost--all using primarily billing data. New outcomes measurement tools with all of these capabilities are available and have already enabled quality improvement in dozens of hospitals across the U.S.     

Does disease management work?

Is disease management the "solution of the month" or a valid approach to organizing patient care? In the era of rapid change in health care, disease management is emerging as one technique suited to improving measurable health care outcomes at greater cost effectiveness. By taking a leading role in the process, those physician executives who commit to this approach can greatly enhance the potential of these programs to accomplish the desired results.     

Our doctors are joining a labor union!

Are physicians going to join a union at your hospital, multi-specialty group, or HMO? Having recently lived through such an experience, the author shares the lessons that he has learned. This article outlines what physician executives need to do to prepare for the increasingly likely eventuality of physicians at their hospitals making a push for unionization. The best way to avoid a union is to manage people fairly, communicate with them constantly, and develop consensus for difficult decisions whenever possible. But if a petition lands on your desk, it is crucial to understand the laws governing union campaigns and the possible outcomes. From how to respond to a petition to election campaign strategies to the negotiation phase, physician executives need to be prepared for the very real possibility of physicians at their organizations deciding to unionize.