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Physician-hospital partnerships: incentive alignment through shared governance within a performance improvement
1Crouse Hospital, Syracuse, New York 13210, USA. Fred_Hosler@mail.hcds.com
The Joint Commission Journal on Quality Improvement
|February 15, 2000
Summary
Collaborative physician-organization relationships are key for performance improvement (PI) in healthcare. Successful PI requires strong senior management support and aligned incentives for physicians and institutions.
Area of Science:
- Healthcare Management
- Quality Improvement
- Physician-Organization Collaboration
Background:
- Effective healthcare delivery necessitates collaborative physician-organization relationships for performance measurement.
- Governance and shared responsibility for performance improvement (PI) present complex challenges.
Purpose of the Study:
- To describe the redesign of a PI system by the Health Alliance of Central New York.
- To outline the development and implementation of joint performance indicators.
Main Methods:
- Established a plan for PI system redesign in February 1997.
- Developed joint performance indicators, the Family of Measures, in April 1998.
- Referred recommendations for process failures to executive and coordinating committees for action by PI Councils.
Main Results:
- Systemwide PI with collaborative decision-making represents a significant cultural transition.
- Senior management support is critical for overcoming institutional silos and enabling shared decision-making.
- Integrating information systems and securing physician buy-in through meaningful projects are crucial challenges.
Conclusions:
- Organizational readiness and strong senior management support are essential for successful systemwide PI.
- Overcoming institutional silos requires direct CEO involvement.
- Aligning physician and institutional incentives with salient improvements is vital for enduring success.