RADICAL REDESIGN USES ‘INCH-WIDE, MILE DEEP’ STARTING POINT Set your hospital’s goals to zero post-surgery infections and 100 percent of patients getting the right care and see what kind of solution you’d come up with, says John Toussaint, M.D., CEO of the Thedacare Center for Healthcare Value. The former CEO of Thedacare, a seven-hospital system headquartered in Appleton, Wis., writes in the Harvard Business Review that by striving for perfection you can see that a radical redesign of care delivery is needed. The article describes the step-by-step, “inch-wide, mile-deep” process each health care organization employed for their radical makeovers. A makeover of a whole system starts with one unit. Toussaint suggests making one unit a “model cell” for the entire organization. In Appleton, he chose a medical-surgical unit that was also being physically rebuilt in a wing of the hospital.

THE GODFATHER OF HEALTH CARE PREDICTIVE ANALYTICS: NETFLIX The Washington Post compares the most recent complex predictive algorithms in health care with the undeniably complex data crunching that Netflix uses to tell you that, because you watched Lilo & Stitch, you might like Lilo & Stitch 2. The Q&A with University of Chicago researchers, and founders of the Clinical Research Data Warehouse, discusses a recent U of C study using big data to help predict what patient in a unit might be more likely to go into cardiac arrest. The data analysis uses many more indicators that might usually be available bedside, and can be monitored in real time to alert caregivers when a patient might be in danger of coding. Of course, Netflix tells me that the Nicholas Cage-Angelia Jolie epic Gone in 60 Seconds is recommended viewing right now, so let’s hope health systems’ algorithms can tell the difference between indigestion and heart failure.

BOSTON’S MENTALLY ILL LEFT BEHIND IN NEW ERA OF CARE, SO FAR New methods of care, and the way they’re paid for, may be improving coordination of some kinds of health care and driving down some costs, but people with mental illness have yet to see those benefits, according to a Harvard Medical School study, reported on by the Boston Globe. The study found that, under a new payment model, Blue Cross Blue Shield of Massachusetts’ Alternative Quality Contract, the mentally ill still had rising health care costs and uncoordinated care, while providers concentrated on managing costs and coordination for other conditions, like diabetes. The Alternative Quality Contract pays doctors based on how well they meet quality measures and stick to a certain budget. “Folks with mental illness, their care is plagued by fragmentation,” said Haiden Huskamp, a professor of health care policy at Harvard Medical School and an author of the study. Husk amp said that there is evidence that the approach to mental health is changing, but that there is more work to be done.

WHAT IF THE PATIENTS RAN THE HOSPITAL? Well, maybe it hasn't come to a patient coup, but the Wall Street Journal explores the trend of using patient advisory councils. The article describes how patient volunteers can become advocates advising on things like room design, communication with nurses and even watching doctors while they’re on their rounds. A Health Research and Educational Trust survey found that hospitals with patient and family advisory councils had a higher percentage of patients who rated the hospital a nine or 10 on satisfaction surveys. The HRET survey also found about 38 percent of hospitals surveyed were now using advisory councils of some sort.

MAKING NEW JOBS IN BALTIMORE Hospitals and hospital rate-setting authorities in Baltimore have agreed on a plan, floated first by hospitals, to fund the creation of 375 new jobs for Baltimore residents living in the struggling neighborhoods where rioting broke out last April, the Baltimore Sun reports. Up to $10 million in annual hospital rate increases and some $5 million a year from hospital budgets will fund the job creation. Johns Hopkins Hospitals had originally proposed a plan to fund 1,000 jobs, but compromise lead to a lesser amount in hospital rate increases and hospital expenditures.

BETTING THE FARM ON KEEPING PATIENTS AWAY The Dallas Morning News reports that new “value vs. volume” programs at two area health systems, Baylor Scott & White Health System, Dallas, and Texas Health Resources, Arlington, are working to keep patients out of the hospitals and eventually bring health care costs down. Baylor will have some 400,000 patients in a new care system in which nurses and other care coordinators contact the patients to ensure they are taking preventive measures like staying on their meds and getting other flu shots. Texas Health Resources is backing Fort Worth’s Blue Zones, a wellness campaign aimed at patients with obesity and other lifestyle diseases by getting them to eat less, exercise more and find spiritual fulfillment. “It’s kind of counterintuitive for a hospital CEO to say I’m trying to keep people out of the hospital and keep them well, but I truly believe that the future is moving away from the inpatient to the outpatient, to the physician’s office and, ultimately, the patient’s home,” said Joel Allison, Baylor Scott & White CEO.