Professional Integration, Case Study Example

Hospitals have always strived to improve hospital and physician relationships.  This has  always been a challenge for the trustees of the hospital.  From a strategic perspective, it has been found that there’s not a single strategic model that might be universally adopted.  That said, the federal government announced in October 2006 that it had enacted a safe harbor policy in order to facilitate clinical integration. The new concept of clinical integration was to embrace [1] quality and outcome tracking and reporting.  [2], information sharing and improving community care.  [3] cost management at the patient level, and [4] community level, disease management, thereby improving health levels.

The transition to ambulatory services has divided both hospitals and physicians.  For the last 20 years we have witnessed healthcare delivery moving towards low-cost models.  This has seen the outpatient services moving closer to the physician business model than that of the in patients model.  Few hospitals have been in a position to address this change.  There continues to be a move towards facility care, migrating to an outpatient setting.  These all in turn lead  towards a disintegration of hospital services.  [Fig 1 refers] (Duffy, 2007) ” Physicians traditionally regarded hospitals as work sites or cooperatives for providing patient care, teaching, or doing research.  Hospital management, governance, and concern over the bottom line were generally left to professional managers and community trustees” (James B. Goes, 1995)

Figure 1 Hospital service fragmentation

St. Joseph’s Hospital is a small hospital located in the South Metropolitan area of Kansas.  It is an acute care facility with 300 beds and supports a primary care network of satellite clinics.  Prior to 1986 the hospital board of trustees focused upon control and adopted a non-collaborative approach to the medical staff.  The administration was dismissive to physicians and decision-making was bureaucratic based on consensus.  Those little senior leadership.  This resulted in the alienation of the medical staff.  The hospital had no coherent plan and little business experience for development.

In 1986 a new CEO was appointed and encumbered set about changing this in terms of clinical integration.  The administrative staff were reduced by 50%, a new obstetric unit was built, a new hospital entrance constructed.  New medical officers were constructed at new hospital boards were est. comprising the physicians and administrators.  A workshop retreat was held to look at improved integration, and this resulted in the appointment of a new medical director and a medical staff development plan.  The hospital board, strategic planning committee redefined the goals for physicians, payers and patients.  “They changed the attitude and institutional culture of the hospital.” (Cummings, 1994). ” A major focus of Saint Joseph’s efforts has entailed integrating medical staff members into the hospital’s institutional boards and committees. Currently, 12 physicians serve on these various boards and committees, only one of which (president of the medical staff) is present in an ex officio capacity. The current hospital board chair is a senior physician. (Cummings, 1994).

Works Cited

Cummings, K. C. (1994, 6). Physician-hospital integration in a community hospital: a case study. Retrieved 5 11, 2010, from Health Care Industry: http://findarticles.com/p/articles/mi_m0843/is_n6_v20/ai_15564980/

Duffy, J. H. (2007). Hospital Physician Clinical integration. Chicago Il: American Hospitals Association.

James B. Goes, C. Z. (1995, 10). The effects of hospital-physician integration strategies on hospital financial performance. Retrieved 5 11, 2010, from Health Care Industry: http://findarticles.com/p/articles/mi_m4149/is_n4_v30/ai_17635044/