Intermountain Health Care - Term Paper Example

Case analysis of Intermountain Health Care al Affiliation Intermountain Health Care is an organization that is doing business officially as a non-profit structure, and is hence one of the major healthcare providers. It provides basic hospital and medical services within Idaho and Utah, and on the other hand, tends to offers an integrated managed care system under an insurance brand termed as the Select Health enterprise. Its headquarters is found in the Salt Lake City known as Utah, and has so far employed more than 33,000 workers (Baker & Denis, 2012). At the onset of its inception, the Intermountain Healthcare’s board members have always operated as unpaid volunteers. The perspective of fundraising was often done based on the bond market within a very short period of time. The Intermountain hospital’s level of market share has constantly remained consistent at an average value since its formation. IHC has mostly been a subject to a greater review by the primary Utah State Legislature simply because of the firm’s non-profit objective and the ownership of almost 21 out of its 60 hospitals. The competitor’s proposals to force the Intermountain organization to sell off the hospital or the insurance components with regards to an organization are fruitless. In the year 2005, the State Legislature went to the extent of hiring an external research firm so as to review the Utahs healthcare system. As much as the independent professionals failed to address the challenges that face Utahs healthcare venture, the researchers conclude that the substantial evidence tend to exist with the aim of supporting the ultimate conclusion that the Utahs health-care premises are performing in a competitive manner (Baker & Denis, 2012).The ultimate intervention by this Legislature towards promoting competition within these entire markets is unnecessary. The study gave an ultimate recommendation that this kind of legislature should refrain from creation of more rules and regulations. Evaluation of the Quality and Efficiency of the Delivery System Intermountain Health Care is a leader in the clinical quality enhancement for almost a decade. It has an incorporated delivery system that is based in the Salt Lake City, and consists of a number of hospitals. Its cognitive efforts of injury reduction because of medical complications has led to the production of the most remarkable gains based on the effected program. The outcomes of the IHC has also pioneered innovative approaches to quality improvement that has enhanced diabetic patients, those with pneumonia, as well as those with respiratory failure, have been duly witnessed on various perspectives regarding its sites. In addition, various substantial programs that educate the physicians and many other clinicians on how to emerge successful with regards to quality improvement have been established. In spite of its success with regards to quality development and the subsequent persistent market position within its geographic area, IHC has however encountered various challenges regarding the aspect of disseminating its ultimate successes. He hence states that only 3 out of the 65 inventive programs have continuously spread throughout the IHC. The elements that have led to massive hindrance to a more haphazard adoption tends to include the physician’s resistance, barriers within the within the organizational units, perverse fiscal incentives, as well as the high investment costs in a vigorous information system resolutions. The IHC’s quality has also been boosted immensely with the perspective of life flight introduction. It is based on the fact that, the Intermountain Healthcares has a well-established air ambulance unit that provides an emergency form of air transport system as well as the non-emergency transportation system for various victims specifically in the most remote areas and the emergency scenes whereby time factor happens to be a very critical element. In addition, Life Flight on the other hand offers various search-and-rescue services in the entire region. It comprises of 5 helicopters and 3 fixed-wing aircrafts. The Life Flight initially began its operations in the year 1972 with a fixed-winged aircraft. This was until 1978 when it performed the first transport of patients by the helicopter, thereby emerging as the seventh helicopter medical overhaul within the entire United States. It currently runs two outstanding ambulance helicopters. The entire Life Flight team tends to Commission on the Accreditation aspect of the certified Medical Transport Systems. The entire Life Flights choppers routinely utilize the night vision goggles. On the other hand, its Agusta Grand tends to function in the high-altitude conditions. It can generally offer a 24 hour medical control, and more so, its entire staff does not often rely on the prevailing protocols or standing orders, as it is done by various other equivalent air medical services. To fully enhance its efficiency, it operates under several teams. First and for most, it bases its operations on the Adult Team. The other segments are that of the pediatric team, Neonatal Team, Respiratory Team, LVAD Team that assists those who are in dire need of the ventricular assist devices, as well as the Hoist and Rescue Team (Baker & Denis, 2012). All these teams are very essential when it comes to any act of trying to provide excellent health services in one way or the other. So, with all these, Intermountain hospital has indeed worked towards ensuring greater levels of quality and efficiency that are aimed towards saving the individual’s lives. The IHCs reputation regarding the clinical excellence has always been based on the strong evidence-based foundation inclined to the clinical and medical process administration that has led to a dramatic outcome with regards to the improvements in both patient costs and outcomes. These have been witnessed in several occasions encompassing this firm’s operations. For instance, in the year 1999, the homogeneous healthcare processes included the prescription of the adequate medications meant for the cardiac arrest patients such as the beta-blockers, ARB/ ACE inhibitors, statins, warfarin, as well as the anti-platelet medications. In a two-year time period, the cardiac patients’ proportion who received adequate medications at a discharge period improved by almost 50 percent to the ratios greater than 90%, thereby exceeding the prevailing United States’ average (Intermountain Healthcare, 1993). These IHC’s process improvements have generally been linked with major improvements in the clinical outcomes regarding this category of patients. They include essential reductions in readmission and mortality rates of the congestive ischemic heart disease and heart failure patients. In the year 2001, the IHC also went to the extent of standardizing cognitive processes for initiation of suitable elective inductions intended for women who are at the delivery bay. The entire outcome was hence a substantial reduction in the induction rates as from 29 percent to 5 percent within a time period of two years. It hence exceeded the ultimate objective of declining the proportion of unsuitable inductions by around 50%. It hence led to a substantial reduction in the number of the unplanned average labor hours and the cases of Caesarean sections. In the year 2002 the IHC clinicians on the other hand standardized the aspect of bilirubin screening amongst the babies. It thus increased by around 80 percent, from the usual 12 percent, even up to 99 percent in the year 2005. It has hence resulted in a substantial decrease in the development of hyperbilirubinemia condition and its associated complications amongst the babies who are born at this entire hospital. On the other hand, this hospital’s clinicians assumed measures for maintenance of tighter glucose management amongst the patients within the ICU’s (intensive care units). Such transformations led to a significant decrease in the mortality rates. This ultimate improvement is currently spread to the patients who are undergoing the cardiovascular surgery using the same process. Finally, in the year 2004, the clinicians back at IHC have standardized the patient’s care on ventilators, hence decreasing the number of days taken by each and every patient in a ventilator. Such kinds of improvements were linked with a ten percent decrease in the average rate of pneumonia that is associated ventilator. It also led to a massive reduction with regards to the entire costs. On top of all these operational factors, there are also other aspects that have been responsible for determination of the quality and efficiency regarding the service provision within this organization. The first element has to do with the aspect of physical infrastructure (Intermountain Healthcare, 1993). It revolves around issues that include system integration, and technological assessments, among other enduring questions with regards to the maintenance of the quality physical plant, that tends to enhance production of high quality services. The other aspect has to do with professional infrastructure that has been established within these hospital units. This is due to the fact that; high-quality health care system often depends on the availability of a well-trained and dedicated health care managers and professionals. Most of the customary quality assurance exertions have primarily concentrated on the maintenance of this essential area. The good examples tend to include the graduates’ medical education, the continuing medical learning, the traditional review, as well as the compliance with the ultimate standards that are set by the external bodies. On the other hand, there exists an ultimate aspect regarding the decision to treat within IHC. Unsuitable diagnosis can end up into unnecessary treatments and hospitalizations. The latest research gives a suggestion that; within some diagnostic and procedural prospects, a considerable proportion with regards to the health care intrusion is often inappropriate. The unsuitable therapy tends to waste a lot of resources and on the other hand causes greater damages to the entire patients. The IHC’s quality and efficiency is also largely determined by the treatment approach. Various research studies have highly demonstrated a larger level of variation with regards to resource utilization so as to attain comparable outcomes for specific procedures and diagnoses. IHC quality and efficiency levels can also be measured through the perspective of productivity waste. This is a very pivotal issue when it comes to the health care financiers as well as the areas whereby hospitals are at greater risk with regards to resource utilization. Finally, the aspect of mitigating errors is also very significant for IHC’s quality assurance and efficiency. This is simply because the entire health care process is tremendously complex. The utilized systems should be capable of monitoring the overall health care process, while detecting errors, and correcting them before any occurrence of an impending damage. The approach Intermountain takes to manage clinical care Intermountain management team has since boosted their general performance through the formulation and implementation of various cognitive approaches. Through the entire analytic work, there is a greater ability of identifying a few categories regarding patients with the likelihood of succumbing to very high costs without any intended solutions. Based on this perspective, the organization has begun a development regarding the programs that are aimed towards supporting such patients. There has also been a launch of two pilot programs that are aimed towards addressing the sections of the costly patient’s population. This is thus an opportune area especially in relation to the general increment in risk. As a section of such a pilot program, there has been an inclusion some basic factors of identifying the rise in risk patients (Health Care awareness and perceptions analysis, 1992). There are various analytical capabilities that have been brought together so as to improve the ultimate capabilities with regards to the proactive identification of the rising risk patients. The main effective scheme is to begin with the population comprising of the high costs and care needs. This is ultimately aimed towards the promotion of an evidence-based methodology towards the maternity care, the partnership that is aimed towards the development of the chronic care assets, as well as design of a positive approach for the dual eligibles. This kind of approach offers care for each and every population thereby establishing a few universal themes that regards the right site direction of care, collaboration within the existing care team, as well as the incorporation of community resources. Intermountains strategy for introducing a new approach to managing clinical care The Intermountain hospital has emerged successful primarily due to the aspect of the most appropriate approaches it has applied ever since its inception. It is estimated that the full implementation and formulation of the most Affordable Care Acts will work towards extending the entire coverage of up to 32 million Americans. The rapidly increasing health care expenses can thwart such an effort to a greater extent. Since the year 1988 the Intermountain Healthcare unit has practically the ultimate health care delivery insights that tend to claim that the most appropriate way of reducing costs is the perspective of quality improvement Intermountain (Health Care awareness and perceptions analysis, 1992). It attained such a quality-based methodology through understanding, measuring, as well as the management of variations amongst the clinicians in the provision of the most needed care. It created a data management and systems structures that worked towards increasing the accountability, driving improvement, as well as the production of substantial savings. For instance, a latest delivery protocol assisted in reduction of the elective induced labor rates, the admissions towards the newborn ICU’s, and the spontaneous cesarean sections. This kind of protocol and approach tends to serve a long-term objective since it ensures a massive reduction with regards to the subjected costs. The Intermountain Healthcare thus happens to be an incorporated system that is responsible for a number of health resolutions. Even though it has an employed group of physicians as well as the health insurance scheme, the greater part regarding its care is often performed by the independent physicians who are paid by the commercial payers and the government. Intermountain has also been identified with the ultimate characteristic of subjecting much lower costs at the expense of a high-quality provision. It has ensured various practical improvements with regards to the clinical quality that hence tends to lower the care delivery costs. These kinds of successes emerge from 2 primary factors. They include the development of the ultimate ability of measuring, understanding, and sending cognitive responses back to the clinical leadership and clinicians through the outcome data and detailed clinical variations. The second element includes the system’s creation of an administrative pattern that utilizes its strong clinical data to supervise the general care delivery performance as well as the aspect of driving a positive change. A good example was in the year1986 when an Intermountain group launched a pivotal effort that was aimed at measuring the practical variation that duly focused on the entire care details in particular, common treatments. The team hence studied the perspectives of transurethral prostatectomy, total hip replacement, cholecystectomy, coronary artery graft surgery, cardiac pacemaker implantation, as well as the community-acquired pneumonia (Greenes, 2014). After receiving patients who had earlier received such treatments, there was a critical review of their ultimate medical records so as to quantify the rigorousness of the main disease. This was basically aimed towards identification and quantification of all the comorbid conditions; as well as the identification and quantification of the in-hospital problems that may have occurred. The outcome was a comprehensive record of the factors that were involved in treatment, For instance, such a research study tracked the subjected laboratory tests including imaging examinations; risk-adjusted hours; drug doses; risk-adjusted operation minutes; among other primary clinical elements. So, all these operational approaches have generally worked towards boosting the hospital’s performance to a greater extent. How Intermountain systematically improve performance overtime A number of physicians who are involved in the execution of the Intermountain’s primary clinical functionalities are often the independent, locally based medical practitioners. It hence tends to protect this hospital unit from any form of un-expected blunder. They do not even try the aspect of trying to take control of the practical behavioral changes involving the physicians’ through a top-down control and command through a cognitive employment relationship. Instead, they rely on the solid outcome and process of data, the professional figures that points focus on the patients’ requirements, as well as the shared culture with regards to high quality. Quality enhancement is innately one of the ultimate preventive strategies. It attains most of the cost savings through the upstream improvement of care, thereby avoiding any form of downstream failures as well as their associated costs. Most savings regarding the clinical thus tends to stem from the reduced hospitalizations, emergency departmental visits, as well as the decreased levels of resource consumption in a care delivery scenario. There are various specific examples that were provided by coauthors and David Clark regarding the cost of savings resulting from the clinical enhancement efforts within Intermountain. Such form of savings tends to extend beyond the administrative improvements. The today’s health care providers unfortunately are precisely paid for such forms of care delivery efforts that are aimed towards reduction by the quality improvement unit. As much as the Intermountain groups tend to implement the clinical management set up, the outcomes are often the aspects of improved services and reduction in the ultimate costs. The entire payments for Intermountain however dropped even further as compared to the operational costs. For instance, although the Intermountain’s improvement in the suitable elective induction proportions saved Utah’s citizens more than almost $50 million per annum through the reduced payments, the Intermountain’s costs on the other hand only dropped by around $41 million (Greenes, 2014). Thus, the aspect of implementing much better care units required them to invest heavily in education, new data systems, as well as the flow redesign. Why Intermountain does it this way and how the applicability of their approach towards managing other care delivery units: The Intermountain hospital unit doe its operations in the above discussed ways so as to achieve its ultimate organizational goals and objectives. This is a form of cognitive strategic plans for the entire organization. Strategic Planning works towards structuring of appropriate plans that tend to keep the entire members of the organization highly informed. Information is often one of the primary elements regarding the level of production in each and every Company. Through the establishment of a clear and proper strategic plan, the members of a given organization will be in a good position of knowing what to do next, thereby preparing them psychologically (Greenes, 2014). This often ensures high productivity levels since the stress factors that usually emanates from some unexpected organizational changes will be reduced to a greater extent. On the other hand, strategic planning enhances the increment of awareness with regards to some of the external factors. This leads to the aspect of cognitive preparation due to proper preparations. For instance, an employee who is aware of what will happen next will be at a higher level of ensuring maximum performance levels because of adequate preparations. In addition, it results in creation of a much bigger visual view of the entire organization, thereby leading to a better understanding of both the external and internal surrounding. It hence allows for the entire work force as well as the top management to focus towards achievement of higher production heights so as to boost their competitive levels against other similar Companies that produce the same products. In line with this, it leads to the perspective of better resource allocation and distribution. It is duly because; strategic planning is often encompassed with the aspect of budgeting. This aspect is hence very essential towards ensuring better accountability with regards to the resources. It also works towards opening up an individual’s mind with regards to future plans involving the Company operations. The most significant aspect behind this perspective is that; it boosts the employees’ morale and workability due to the instilled focus. They feel as if they are part and parcel of the firm’s management unit. Their approaches towards handling the health-care units with regards to their fully fledged strategic plans are very practical in nature. This is mainly due to its major aspects such as the elements physical infrastructure among others (Greenes, 2014). It revolves around issues that include system integration, and technological assessments, among other enduring questions with regards to the maintenance of the quality physical plant, that tends to enhance production of high quality services. References Baker, G. R., Denis, J.-L., & Canadian Health Services Research Foundation. (2012). A comparative study of three transformative healthcare systems: Lessons for Canada. Ottawa, Ont: Canadian Health Services Research Foundation. Greenes, R. A. (2014). Clinical decision support: The road to broad adoption. Amsterdam: Elsevier/AP. Intermountain Health Care awareness and perceptions analysis. (1992). Rural IHC hospitals awareness and perception study: Presented to administrators of Intermountain Health Care. (1993). Read More