It seems like the challenges of healthcare are on everyone’s mind these days. Access to healthcare, concerns about the effectiveness or safety of treatment, and anxieties about the cost of care – including the cost of insurance, deductibles, and co-pays – are trending topics in conversations everywhere. One thing we know for certain; healthcare needs to change.
As we consider the ways healthcare needs to change, I think that the “quadruple aim” still captures the most important goals:
- Improve population health
- Improve the patient experience
- Reduce per capita costs of care
- Enable caregivers to find joy and meaning in their work
Achieving these goals on a large scale will require exceptional leaders and teams of people who possess a different skill set than what was needed to find success in years past. As you might expect, they’ll need expertise in strategy, innovation, finance, organizational structure, and continuous improvement. But even more importantly, successful leaders will need a deep understanding of the science and culture of clinical practice. The changes we need will demand us to greatly expand how we think about, provide, and finance the care for our patients.
As providers, we have an obligation to only provide services that reliably lead to optimal outcomes for our patients. At the same time, we need to avoid recommending unnecessary services that don’t improve outcomes. These unnecessary services often expose our patients to needless risks and costs.
We need to focus more on preventing illness and injury, and better managing chronic illness (including behavioral illnesses) to reduce the need for risky and expensive interventions that could have been prevented. We also need to recognize the influences of the social determinants of health and how they’re impacting health, healthcare needs, and healthcare costs in our communities.
To reduce the costs of care, we need to address the incentives of fee-for-service medicine. This model rewards high end “rescue care” of affluent communities and pays poorly – or sometimes not at all – when providers work to prevent major health problems that often lead patients into financial ruin. To achieve affordable costs, better health outcomes, and sustainable pricing, we need to change our payment system in healthcare.
These are intimidating changes, and they won’t happen without trusted physician leaders. Experienced physicians understand the science and the front-line culture of medicine. Their years of clinical service make them passionate about caring about the patient while caring for the patient, and working as a team to provide the best outcomes. They understand, in ways that non-clinicians can’t, what motivates their clinical colleagues and what burns them out.
Leading a complex healthcare organization, especially during such turbulent times and with such high stakes, is a daunting task. Few clinical leaders have the training or experience to assume a senior leadership role. Many think all they lack is some mentoring or classroom time in innovation, finance, organizational structure, or communications. But truly innovative healthcare leadership requires higher order traits such as emotional intelligence, consistency, personal courage, and, as Jim Collins describes in his definition of Level 5 leadership, deep personal humility combined with intense personal drive for excellence.
These higher order attributes are the focus of our Intermountain Leadership Institute’s flagship program. As we convene each two-week session, we learn about trusted leadership from outstanding faculty and from other participants through highly interactive classroom sessions, from small group and individual assignments, within executive simulation sessions, and from individual assessments.
Leading a health system these days is a great privilege, but no leader can succeed in the long run without earning the trust of the capable people who supply expertise and energy to help develop the strategy and engage frontline caregivers in our noble work. That kind of leadership, trusted leadership, is our focus at the Intermountain Leadership Institute.
- “The Quadruple Aim: care, health, cost, and meaning in work.” Sikka R, Morath and Leape L. BMJ Qual Saf 24:10 (2015)
Charles Sorenson, MD, FACS, is President and CEO Emeritus at Intermountain Healthcare and the Founding Director of the Intermountain Healthcare Leadership Institute. The Institute utilizes timeless, values-based leadership principles to help healthcare leaders more fully develop the combination of character and competence that inspires trust–which is at the core of great leadership.