Tuesday, May 24, 2011

Being a Change Agent - the Critical Competency

There is hardly a day that goes by when the newspapers and TV news broadcasts are not sharing an important set of new inofrmation concerning the healthcare delivery process in the US. Just last week, two important articles were headlined......
         "Study: ERs shrink as demand rises"
         "New Nerve Stinulation Technological Makes a Paraplegic Walk"
Both of these articles reinforce my belief that the hospital of the future will look very different than that of the past and two major drivers of healthcare will continue to be the access point for the patients to recieve their initial care, and the technology that will be available to diagnosis and treat them.
Inorder to be successful in the future, I have been stating that healthcare systems will need to be capabale of providing  high quality, low cost products and services. The ability to achieve these goals is to assure that the patient receives their primary evaluation as quickly as possible, and that the addition diagnosis and treatment plans required are well coordinated. Certianly the trauma side of our Emergency Departments are not the place for the average non-acute patient to be seen. However, because of the lack of primary care entry points in the US due to the paucity of primary care physicians, and the reluctance of many physicians to embrace physisican extenders, most Emergency Departments have created non-acute tracks that function much like a primary care doctor's office, and make them available often 24 hours a day, but if not, at least 10am to 10pm. Recognizing that these non-urgent care tracks provide a stop-gap measure for many patients until we solve the primary care capacity issue, what will be the change needed to address the fact that the first article indicated that 1 in 3 ERs have closed over the last two decades. And even more serious consequences come from the reasons for the closures........
       >Have low profit margins
       >Serve patients below the proverty level
       >Serve those with lower forms of insurance, including Medicaid
       >Those in for-profit hospitals
       >The ones located in more competitive markets
All of these reasons cause problems for a large number of patients in the US who have, at this time, no other access point.
With regard to the new nerve stimulation technology story, this is supporting our prediction that neurosurgey will be a growing and changing service line which will provide more and new tretaments in both the inpatient and outpatients settings. These treatment plans will require much more space for intense reabilitation which, in the past, has not alwyas been profitable and therefore have not been incorparated into the offerings of many local and regional medical centers. And long reabilitations times for any patient are not best delivered miles from where the patient's family and support persons live on a daily basis. And if this technology can be made afforable and expandable to many other quads and paraplegics, present technolgies such as rotating beds, electrtic wheel chairs, and services such as "help dogs" and visitng home nurses may have to change what they are doing to serve the patients of the future, not the past!
What does all this mean for people working directly or indirectly, in tthe healthcare industry. Change will continue to occur at a rapid pace, and those that can embrace these changes with enthusiam and with passion will be both the formal and informal leaders of the future. Yes, being a change agent may be the most critical competency for healthcare providers as the future unfolds! these are interesting times, worth watching closely.

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