Creating Advantages in the Face of Coming Health Care Change

Anesthesiology News
Editorial by Zeev N. Kain, MD

Health care changes are coming; we all know this. However, we don’t know what these changes will look like for medicine in general or anesthesiology in particular. We don’t even know when national changes will be instituted or begin to impact practitioners and departments. Given this uncertainty, at a grassroots level, how can we prepare to maximize clinical care, as well as efficiency and fiscal responsibility, while satisfying the demands of future changes?

When health care is remodeled at the national level, departments responding rapidly will likely fare better than those that are slow to change. We suggest that successful departments in the future will be those that welcome change rather than resist it. This may sound easy, but traditions, history and a “this is the way we have always done it” mindset result in real barriers, even when change is essential to survival.

The Department of Anesthesiology and Perioperative Care at the University of California, Irvine recently underwent significant changes. Although our experience is a case study of change in an urgent situation, it may offer valuable insights into ways other departments might cope with and succeed in the face of looming national health care changes.

For our department at UC Irvine, visits by the Centers for Medicare & Medicaid Services (CMS) in 2008, and significant past problems forced us to make sweeping changes on an extremely accelerated time line. One year later, we have a clean bill of health from CMS, a commendation from the Joint Commission, five-year accreditation from the Accreditation Council for Graduate Medical Education (ACGME), and new innovative clinical programs, and we have been ranked No. 24 in funding received from the National Institutes of Health (NIH). This accomplishment took nothing less than wholesale changes to almost every program within weeks to months. We were able to do this through the principles outlined below, and we suggest that these same principles are appropriate for any department or group practice.

For entire story please view the Anesthesiology News link below.      http://www.anesthesiologynews.com/index.asp?section_id=383&show=dept&ses=ogst&issue_id=564&article_id=14076