Frontiers of Health Services Management

The time has come for healthcare organizations to improve their efforts regarding their impact on the environment, particularly on the communities they serve. For years, healthcare has been at the forefront in addressing social needs with public health initiatives but has lagged on environmental concerns. By carefully reviewing their energy usage and aging infrastructures, healthcare leaders and their facility managers can do a better job of controlling healthcare's environmental impact. Green practices are key indicators of an organization's ethically focused sustainability efforts...

The healthcare sector's role in every community is inextricably linked to the health of those it serves. As research and media reports point to the significant impact of people on our planet's ecosystems, Ascension has responded by setting several environmental sustainability goals. Our work is defined by three pillars: Net Zero Places focuses on carbon sources associated with Ascension's physical environments-carbon footprint, operational efficiency of facilities, and sustainable transportation.Responsible Supply Chain focuses on the flow of goods from procurement to disposition-responsible purchasing, product usage management, recycling, and waste management...

Climate change is a crisis with a devastating impact on health. The warming atmosphere is increasing the tolls of deaths and illnesses from heat waves, extreme weather, poor air quality, insect-borne diseases, and other conditions. Healthcare is connected to climate change in a way that is not fully appreciated by many healthcare leaders-in fact, the sector generates a significant share of greenhouse gas emissions that cause climate change. As additional costs, healthcare providers' margins are put at risk from treating more climate-related disease and illness, supply chain disruptions, and damage from severe storms and wildfires...

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Addressing ethics issues in healthcare is essential to living out an organization's mission, vision, and values. In addition to exacerbating existing ethical dilemmas, the COVID-19 pandemic raised many new and complex questions for leaders and their organizations. Ethical issues related to the workforce require a deliberate and comprehensive consideration of values. The case study scenarios presented here demonstrate examples of common ethical staffing challenges that healthcare leaders have faced, notably the allocation of care providers among COVID-19 patients and the balancing of care quality with staff and patient safety...

The US healthcare sector differs from others, particularly with regard to how its workforce is compensated. In healthcare's third-party payer system, the consumer (i.e., the patient) typically is not the one paying for the service. Moreover, the payment for a given service is negotiated by the provider and the third-party payer before the patient ever seeks care-and the payment for the same service may differ among payers and patients. To further complicate matters, myriad overlapping federal, state, and local statutes and regulations govern how providers interact with patients and each other...

"Using a blindfold, I want you to find your way to the front door of the school building," our elementary schoolteacher instructed. This was to teach us what it would be like to live without vision. We lined up on one side of the schoolyard and took turns when the teacher called our name. I watched as my fellow students, one by one, wandered about, never getting close to the school's front door. They eventually were guided along by other teachers. Then came my turn.As I pulled the blindfold over my eyes, I noticed it was windy...

The clinical staffing shortages that the US healthcare sector is experiencing are sure to become even more profound as the general population continues to grow and age. With more people living well beyond age 65, more physicians will be needed to provide care.A solution to help fill the gaps in physician coverage is centered on the use of advanced practice practitioners, especially in the ambulatory setting. The growing shortage of primary care physicians could be significantly reduced or eliminated if the appropriate contributions of advanced practice practitioners-including physician assistants/physician associates (PAs) and nurse practitioners (NPs)-are considered when calculating financial costs...

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Workforce shortages, a dark reality for healthcare organizations even before the arrival of COVID-19, are being exacerbated by the persistent side effects of the pandemic. Burnout, more retirements, opposition to vaccination mandates, and intense competition from other industries are adding to the challenge. Those factors are keenly felt by hospitals and healthcare systems that are located beyond better-resourced major metropolitan areas. Many years will be required to resolve staffing shortfalls, and that work must begin now...

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Technology has become a mission-critical part of healthcare business operations. The electronic health record, medical equipment, revenue cycle, enterprise resource planning, marketing, legal, planning and building new facilities… every component today is dependent on automated tools. When computer systems go offline, everyone feels the stress of conducting business and delivering care without access to all the information they need. Downtimes are especially dangerous for patients.While there are many reasons that these systems go offline, cybersecurity breaches are primary culprits...

Hospitals have been facing an epic crisis, with the COVID-19 pandemic overwhelming emergency departments and forcing the implementation of surge protocols to manage care delivery and treatment. These realities have affected both inpatient care delivery and caregiver effectiveness. The need to reevaluate clinical operations is challenging the healthcare delivery structure and its leadership to think differently-digitally. Supporting care for patients in the home has played an important role in mitigating many safety and access issues, accelerating telehealth adoption and solidifying its place in the ongoing transformation of healthcare delivery...

Digital innovations are arriving in healthcare at an increasing rate. Electronic medical records provided the foundation for this growth, and now thousands of technology companies are servicing every aspect of healthcare. Since 2018, Houston Methodist has been cultivating digital disruption, working to speed up the development of new initiatives. As our digital innovation has grown exponentially over the past few years, we have kept the patient at the center of all activities. We hold the philosophy that patient empowerment should be a process whereby patients understand their role and have access to knowledge that enables them to engage with their providers in a bidirectional relationship...

Digital transformation strategies in healthcare are presenting unique ways to support patient acquisition and retention efforts. Montefiore Health System is on a multiyear, multipronged digital transformation journey with interventions centered on improving access to care.Our patients can search for a provider, schedule a visit, get details about their visit, and check in through a welcoming digital front door. Asynchronous e-communication and video visits have also been implemented, and these added options are optimized by technologies including a new provider data management tool to support an enhanced provider directory, electronic health record system integration with online scheduling, telehealth/virtual care, and text message communications...

The University of Pennsylvania Health System was founded in 1993 as one of the nation's first integrated academic medical centers. Over the past 29 years, Penn Medicine has systematically built a care delivery system based on three core values: innovation, integration, and impact. The operating strategy is designed to meet the patient's needs in a traditional brick-and-mortar hospital as well as in an increasingly virtual world. Today's patient is demanding an omnichannel experience with superior outcomes. Although long discussed in healthcare, such a comprehensive, seamless patient experience is only possible when all four channels of care delivery-hospital, ambulatory, home, and virtual-are sustainably integrated to improve the health of the population through digital innovation and analytics...

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As healthcare nears year three of the COVID-19 pandemic, hospitals and health systems should consider accepting significant responsibility for the total cost of care from all sources, per covered life, over time. One place to start: Reduce avoidable spending on chronic conditions, which, combined with mental health conditions, account for most healthcare expenditures. This shift will necessitate investments that strengthen the ability to identify at-risk populations and react in ways that help avoid complications and reduce unnecessary costs...

Healthcare is in the midst of a "great disintermediation." New care delivery models are offering novel ways of accessing care and moving the US healthcare system from a hospital-centric to a consumer-centric focus. This transformation is opening new opportunities for technology-enabled, risk-ready innovators intent on disrupting traditional ties among health systems, primary care physicians, and consumers.

How can healthcare organizations best attain sound financial results and, in turn, sustain market growth? Leaders at St. Joseph's Hospital and Medical Center, part of Dignity Health Arizona, realized that they could not cut their way to success. They needed a plan for strategic growth that fit their corporate mission and expanded their market. They moved forward with a proven productivity process that would engage stakeholders at all levels of the organization. Supported by commitments to the necessary financial investment and the patience to see the plans through, their efforts have paid off with substantial improvements in margin...