More than 40 years ago, the Institute of Medicine released its Educating for the Health Team report that advocated cross-functional provider teamwork over siloed service areas. But fee-for-service payment models kept such forward thinking from taking hold.
Under value-based reimbursement, which incentivizes providers to take on risk, inter-professional collaboration is now the rule rather than the exception. Several prominent health organizations, including the Robert Wood Johnson Foundation and Institute for Healthcare Improvement, are championing the cause.
Virginia Mason Medical Center (VMMC) in Seattle has been a positive outlier in this area, having long-advocated teamwork over the traditional paradigm of the physician as the sole controlling practitioner. “If people want to work in silos here, that doesn’t work very well; they’re not very comfortable, and they aren’t able to move agendas very quickly that way,” said Charleen Tachibana, DNP, RN, FAAN, VMMC chief nursing officer and senior vice president for quality and safety.
A culture of inter-professional collaboration has allowed Virginia Mason to improve quality of care, especially around sepsis management. A top killer in many hospitals, sepsis requires fast intervention via a four-element treatment bundle. Using protocols developed by multidisciplinary teams, VMMC nurses were routinely and quickly able to implement the first three elements of the bundle prior to the patient being evaluated by a physician. A physician is required to implement the fourth component — delivery of an antibiotic. When a delay in the administration of the antibiotic was identified, team members from the organization’s pharmacy department addressed the bottleneck, and intervention time was dropped to minutes in some cases, Tachibana said.
To succeed in value-based models, Tachibana believes other providers will need to break down service siloes. Download the Spring/Summer edition of Optum RISKMATTERS to read more about how Virginia Mason made interprofessional collaboration part of their culture.
About the Author:
Population Health Management Consulting lead, Optum.
Andrew has 16 years of health care management consulting experience, focused on assessing, designing, implementing, and launching Population Health Management, Quality, and Provider Engagement system and business solutions for payers and providers