Define value
Even though Kelsey-Seybold was founded as an ACO in 1949, Berthelsen’s challenge is maintaining a culture focused on value creation more than 60 years later.
“It requires a constant energy of activation to be applied, continuously focusing the organization on the things that create value and the need to do that (for) competitive survival and to maintain the vitality of the organization,” says Berthelsen, who oversees 365 physicians and 2,150 other employees in 20 locations.
It starts, simply, with defining what value is at your organization and why it matters.
“We need to express carefully to everybody in the organization why value is so important, and then identify the elements that increase the value of our services so that everyone understands that value creation is the ultimate goal and all decisions should be measured against whether or not it increases the value of our services,” Berthelsen says.
To make the broader message more digestible, condense it into something specific. Berthelsen does that by defining value and supporting his definition with metrics.
“Value is a ratio of quality divided by cost,” he says. “There are a number of ways to measure quality, and we use as many of those as we can: the frequency that beneficial preventive services are applied, the complication rate — for instance, infection rate in our ambulatory surgery center — the quality of the credentials of our physicians and the outcomes that we have.”
While those measurements may differ for your company, the key is that you do measure your indicators of quality — and that you make those metrics visible to employees. Thanks to electronic medical records, for example, Kelsey-Seybold employees can access patient information from any location.
“So much of what a patient needs is determined by what they’ve had in the past or what is known about them, both to avoid duplication and gaps in care,” Berthelsen says. “Having this information about what the patient has received in the past and how their problems have been approached and what worked and what didn’t turns out to be a very key thing to get the right treatment for them.”
But quality care should also come at the right price. Berthelsen keeps costs in check by benchmarking Kelsey-Seybold against other hospitals. Just because his costs are about 15 to 20 percent lower doesn’t mean he can put it aside.
“Looking for areas of unnecessary cost that we can take out is a constant search because we’re never done with that,” he says. “The basic way we do that is we ask ourselves for every decision, ‘Is this helping my patient in proportion to the amount that it costs our patients in time and money?’ So every decision has to pass that hurdle, both small decisions about whether to prescribe a generic or a brand-name medication or the large decisions about whether or not a patient should be admitted to the hospital.”
By communicating those components regularly, you plant value awareness in your employees’ minds.
