The American Institute of Architects
Title: Healthcare 201: The Implications of Healthcare Reform - One State's Perspective
Type: Presentation
Size: 5329920
Description: This webinar gives participants an understanding of health care reform and its implications for hospitals. Specifically, the webinar will focus on the need for hospitals to adopt best practices in all areas of operations, including facility design and construction. Presented June 14, 2011.

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the implications of health care reform

the implications of health care reform

Slide 3

reform in

america

employer-sponsored health care

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employer-sponsored health care

government-sponsored health care

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government-sponsored health care

    To provide coverage for the elderly as well as poor women and children, Congress enacted Medicare & Medicaid in the mid-1960s.

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employer mandate?from a republican??

?What I am proposing will require employers to provide basic health insurance for their employees. In the past, we have taken similar action to assure workers a minimum wage, to provide disability and retirement benefits. We should go one step further and guarantee that all workers will receive adequate health insurance protection.?

President Richard Nixon

February 18, 1971

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health care for all?through an unfunded mandate

    The Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986 requires hospitals to screen and stabilize (treat) every patient who comes to the hospital ED seeking care, regardless of the patient?s ability to pay and regardless of what it costs the hospital to provide the care.

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government-centric reform?

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no thanks!

Dole and his fellow Republicans argued for a market-based system designed around an individual mandate and the creation of state insurance exchanges.

Slide 14

2006

medicare expanded

the affordable care act

2010

the affordable care act

strategic directions

strategic directions

? coverage

? delivery system
reforms

? payment reforms

? transparency

? health IT

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implications for hospitals

implications for hospitals

? achieve solid hospital-physician (clinical) alignment

? measure, report and deliver
superior outcomes

? reduce costs

? form strategic alliances

implications for physicians

implications for physicians

? apply evidence-based practices to achieve best clinical results

? deliver the right care?at the least cost

? coordinate your patients? care with other providers

? learn to manage risk in partnership with hospital and physician colleagues

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To repeal, or not to repeal?

Slide 26

players in the repeal drama

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Slide 28

Questions so far?

implications for hospitals

implications for hospitals

? achieve solid hospital-physician (clinical) alignment

? measure, report and deliver
superior outcomes

? reduce costs

? form strategic alliances

Slide 31

?The study of ?high reliability??or consistent performance at high levels of safety over long periods of time?began with investigations of organizations that manage extreme hazards with exemplary safety records, far better than those in health care today.? Chassin & Loeb, Health Affairs, April 2011

?The study of ?high reliability??or consistent performance at high levels of safety over long periods of time?began with investigations of organizations that manage extreme hazards with exemplary safety records, far better than those in health care today.? Chassin & Loeb, Health Affairs, April 2011

Three requirements for achieving high reliability:

    Leadership

    ? Safety Culture

    ? Robust Process Improvement

heart attack patients given pci within 90 minutes of arrival

heart attack patients given pci within 90 minutes of arrival

Collaboration accelerates performance improvement!

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high reliability

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if 99.9% were good enough?

if 99.9% were good enough?

? Major plane crashes 3 per day

ATM errors 37,000 per hour

Pacemaker incorrectly installed 291 per year

Babies given to wrong parent 12 per day

Erroneous medical procedures 107 per day

Slide 39

Transmit Transport Treat

mission lifeline



mission lifeline data





mission lifeline data



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2010, American Heart Association

average door to balloon time

average door to balloon time

Time in minutes

improvement rate: 33%

state comparisons

state comparisons

Hospital Compare latest data

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the implications of health care reform

the implications of health care reform

stop bsi collaborative

stop bsi collaborative


Baseline and Remeasurement Rates for STOP BSI Collaborative


Baseline and Remeasurement Rates for STOP BSI Collaborative

36% reduction

21% reduction

safe surgery 2015

Goal: 100% of South Carolina?s acute care hospitals using the surgical checklist in every operating room for every surgical patient by 12/31/2013

safe surgery 2015

implications for facility design

implications for facility design

? quality and reliability will be of paramount concern to hospitals

? design features and materials that can reduce unintended harm will be prized

? evidence-based practices will prevail; expect hospitals to favor design professionals who demonstrate willingness to learn from others? mistakes (in addition to their own)

    
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