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An Ore. county maps its way out of healthcare ‘chaos’

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Leaders from four of Jackson County, Oregon’s health institutions asked Cambridge Management Group (CMG) to help them formalize a community-wide collaborative approach to health-system improvement. Before starting, the sponsors rated the chances of success at “less than 50 percent”. Upon hearing this assessment, Marc Pierson. M.D., a member of the CMG team, pointed out that the strength and duration of leaders’ commitment would trump probability projections.

The CMG team  also included Bob Harrington and Annie Merkle. (Biographical sketches of all CMG staff members may be found at this link to the CMG Web site’s “Professional Staff” page.)

Participation and commitment grew as members of 13 institutions, along with 6 patients, documented the key parts of their county’s healthcare system. As they went along, they noted where and how they could improve the connections among their organizations—for stronger operational efficiencies as well as to better serve their shared patients.

These collaborating clinicians, administrators and patients developed a clearer understanding of the opportunities to work together to improve patients’ journeys among emergency rooms, inpatient hospitals, post-acute outpatient care and social-service agencies. It became clear to all that these improvements would help achieve the “Triple Aim’’ goals — better care, lower cost and improved care experience.

In the second joint meeting they prioritized a set of improvements and defined the criteria for measuring success. The collaborative two-day process of mapping the county’s healthcare-related parts and connections, priority-setting and defining specific improvement programs was a new experience. But as participants saw the emerging picture and practical opportunities, they became optimistic and committed to proceed with improving their institutional interactions. “People were delighted when they saw the practical work they could do together,’’ Dr. Pierson said.

Jackson Care Connect, a not-for-profit regional insurance organization, thus took the opportunity to invest some of the savings from the preceding year’s improvements (One such improvement was to improve the efficiency of “handoffs’’ – when patients move from one healthcare institution or clinician to the next).

This community program began with in-depth listening by CMG to the perspectives of institutional stakeholders and patients who would be participating in the system mapping and program definition. Midway through the project, 30 institutional leaders and 6 patients met for a day to map the community’s overall system and note the key linkages and interactions that support patients and institutional operations. This information was organized, shared, clarified and used to define seven initial system-improvement programs.

By explaining the linkages through a “system and process lens,’’ CMG helped them make order out of the seeming “chaos’’ of the community health environment.

Here’s a poster describing the linkages of Jackson County’s healthcare entities and related information: OHA Summit 2015 Jackson Poster am.ppt (PowerPoint file will download).

A report, with graphics, on the findings and recommendations of the CMG engagement is linked here (PDF) and appendix here. (PDF)

For  a look at this ambitious project by  Jennifer Lind,  Jackson Care Connect’s chief executive, hit this link















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