Since his promotion in July from chief operating officer to president and CEO of the Memorial Hermann Health System in Houston, Chuck Stokes has intensified the organization’s focus on clinical care redesign.
Stokes says the goal is to encourage each of Memorial Hermann’s 25,000 employees, 5,500 affiliated physicians, 17 hospitals and more than 200 outpatient clinics to demand greater value from health care.
Clinical care redesign “improves the quality and safety of our care, improves the patient experience in our hospitals and reduces costs, because if you efficiently move patients through the in-patient experience, that’s going to reduce the overall cost of care,” Stokes explains. “All of that translates into an improvement in the value proposition for health care today.”
A key objective is to reduce variation in how Memorial Hermann provides care to individuals with specific diagnoses. “For example, if a patient needed open heart surgery, we have to make sure the care that we’re providing is the same every time, no variation,” Stokes says. “What do evidence-based practice protocols say is the highest level and the highest practice of care, every time?”
A second component of clinical care redesign calls for having a multidisciplinary team of physicians, nurses and other allied health care professions make multiple daily assessments of a patient’s progression through the health care system. “They are trying to get this patient ready for what happens at discharge, and they are trying to do this in the most efficient manner.”
The third part is care and case management. “They are part of the multidisciplinary team, and are trying to make sure that when the patient gets through the acute-care phase, proper services have already been secured,” Stokes says.
Clinical care redesign’s final prong ensures that Memorial Hermann’s staff accurately document what happens to patients during their acute care experience. “The reason that’s so important is, when patients move to post-acute care, their primary care physician can go into electronic records and get an accurate indication of what happened during the acute-care phase.”
Taking a deep dive into the patient’s journey, reviewing processes, examining all touchpoints and identifying opportunities for improvement are expected to eventually yield Memorial Hermann $200 million in cost savings.
The pillars of clinical care redesign, and their abilities to positively impact such metrics as length of stay, cost per discharge and surgical site infections, are well known. What’s new is the unrelenting focus the initiative is getting.
“It’s a cultural transformation, there’s no question about it,” he says. “We’ve been working on this a little better than a decade and we’re trying to get it hard-wired into our system, in terms of this is how we move forward as a system.