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By Sheryl S. Jackson

September 29, 2016 | Formats: Article | Content Areas: Administration, Environmental Sanitation Operations | Tags: Environmental hygiene and sanitation, Leadership, Patient Experience of Care, Population Health Management

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There is no doubt that the healthcare field looks very different today than it did 50 years ago. Back then, lengthy hospital stays, care coordinated primarily by physicians, lack of respect for patient involvement, and a focus on treating illness versus preventing them, were the norm. A combination of cultural changes, policy adjustments, the price of care and technological advances has led to changes that reflect the need for cost-effective care that includes a more patient-empowered approach that prioritizes prevention.

The Institute for Healthcare Improvement’s Triple Aim—better care, better health and lower costs—has guided the development of many initiatives to improve healthcare. The more recently defined Quadruple Aim expands upon the Triple Aim by acknowledging the importance of healthcare workers’ role in improving healthcare and identifies workforce engagement and employee safety as critical components of achieving the original three goals of the Triple Aim.

“As the healthcare environment continues to shift, we are redefining the role of hospitals, as well as the role of the association supporting our hospitals,” says Maryjane A. Wurth, executive vice president for the 91��������. (AHA) and president and CEO of the Health Forum, AHA’s subsidiary offering media, education and data solutions. “Although it is important that health organizations have widely adopted the Triple and Quadruple Aim, the world is changing, and AHA members have a vision of healthy communities.”

There are five elements that support the vision of healthy communities, says Wurth.

• The individual is at the center of health and their interaction—acting not just as a patient, but as a full partner with health providers.
• Every individual has access to affordable, equitable health services, including behavioral health and social services.
• The individual receives the best care that adds value to life.
• There is a focus on wellness in partnership with public organizations and individuals. 
• Seamless care coordination is provided by utilizing technology and real-time data, innovation and team-based care.

“Our country is large and diverse, so there are several different models of care, with each recognizing the specific needs of the communities the healthcare organization serves,” says Wurth. She points out that regardless of the type of healthcare model—hospital, health system or health organization—future success requires a focus on:

• Being a trusted partner and leader in the community
• Striving toward the vision to advance health in America
• Benefiting the community beyond the four walls of the hospital
• Creating new models of care and service in partnership with others

Value-based care is a significant change for healthcare, says Wurth. “Hospitals are focused on providing value versus volume as the payers move away from fee for service to value-based care,” she says. “No matter what size, location or model of service is used by a healthcare organization, no one can afford to sit still.” She identifies five significant changes with seismic, game-changing challenges:

Consumerism

Health organizations must think of patients as consumers and provide customer-centered care that is user-friendly and customer service-oriented, says Wurth.

Holistic focus on health

Healthcare providers can no longer focus on treating illnesses and symptoms, but must treat the “whole” person, points out Wurth. To achieve the goals of reducing costs, improving value and making healthcare affordable, prevention plays a critical role in today’s environment. “This approach requires a holistic strategy that includes behavioral, physical and mental care to address all factors that contribute to an individual’s wellness.”

High reliability with zero harm

Although patient safety is a key responsibility for clinical personnel, environmental services staff are also integral to a patient’s safety, Wurth points out. Environmental services helps ensure a safe environment by staying up to date on best practices to protect patients. 

Chronic care management

According to the Administration on Aging, an agency of the U.S. Department of Health and Human Services, the older population—persons 65 years or older— numbered 46.2 million in 2014 and represented 14.5 percent of the U.S. population. The percentage of people 65 years or older is expected to grow to 21.7 percent of the population by 2040. People are living longer due to advances in medical care, and this presents the challenge to better manage chronic conditions to ensure quality of life, says Wurth. “New models of care coordination with an emphasis on interdisciplinary care enable health providers to manage chronic conditions.”

Payment for value

The switch from fee-for-service to value-based care payments has led to new care models that provide affordable care that is focused on outcomes versus services, Wurth points out. “Hospitals strive to provide the right care at the right time in the right place with the right outcome at the right cost.”

An emphasis on outcome-based, value-based care has led to many new models of care, including the development of accountable care organizations (ACOs) that integrate services and provision of care vertically and share risks throughout every level of the organization—from physician office to inpatient hospital services. Integration, whether through a formal ACO or other form of organizational structure that enables care coordination, leads to better outcomes and better value for patients and providers, adds Wurth.

“One challenge that health organizations will continue to face in upcoming years is care for vulnerable communities—specifically rural and inner city areas,” says Wurth. Finding ways to implement best practices developed by other organizations while working with fewer resources is imperative to achieving the healthy community vision but is also difficult, she adds.

In spite of the challenges the healthcare field faces, Wurth is positive about the future of the field, the 91�������� and its personal member groups such as the Association for the Healthcare Environment. “Consumers want a partner in their pursuit of health. Hospitals are responding with new services that engage consumers, promote wellness and safety, and provide accessible, affordable healthcare,” she says.