More than elbow room
July 6, 2011
We’re halfway through the year and enrollment growth remains ahead of 2011 goals—with the majority of new members choosing our group practice for care.
Growth is a good problem to have in turbulent economic times. But as I’ve heard from you in medical staff business meetings and conversations, growth is hard on your daily life at work.
Our group practice is working to see that we have the right people, facilities and equipment to handle demand for our services—now and through next year. In fact, we expect to grow over many years. Learning to keep pace with people, facility, and equipment needs as we maintain our culture and our approach to care is critical.
Many teams have simply needed more clinicians
Over $20 million in new hires have been approved and are underway. Now, fitting new hires into our spaces and schedules is the hardest problem to solve—and our Tacoma and Bellevue medical centers need relief right away.
In the short term, moving Behavioral Health Services from Bellevue to Factoria and Redmond, and redistributing departments within Bellevue Medical Center will help us maintain current access levels and accommodate new medical staff through 2012.
Next month a seven-phase construction and remodeling plan kicks off at Tacoma Medical Center. By late 2012 there will be dozens of changes, among them additional primary care exam rooms and enlarged, 24-hour Urgent Care.
While our integrated care and facility design (ICFD) efforts will yield repurposed spaces and new buildings over the next 18 months, sustaining service-by-service capacity takes more than additional square footage. We will have to focus on efficiency and best use of the space and people we have. In many cases we will have to live with some tight quarters and sub-optimal space for awhile. We know this won’t be easy; thank you for your patience and for your flexibility in making it work.
We’ve taken a thorough look capacity in specialty
We’ve been analyzing service capacity and utilization data in Tacoma and Bellevue. The same analysis will be done at our Capitol Hill Campus in August and at Olympia Medical Center later this fall.
Vicki Oyadomari, Carol Taylor and Dr. Judith Nielsen did detailed analysis with group practice business planners to understand the complex factors affecting schedules and service.
Departments they worked with included
- Bellevue’s Gastroenterology, Neurology, Cardiology, Orthopedics, Pulmonary, and Ob/GYN/Midwifery services.
- Tacoma’s Cardiology, Dermatology, General Surgery, Neurology, and Pulmonary services.
They measured key time intervals to help us think about being as efficient as possible while our long-term footprint is enlarged and constructed. Having more elbow room, or new buildings, doesn’t mean we ease up on efficiency and continuous improvement. The very way we remodel and build—integrated care and facility design—hinges on operational efficiency.
Time, space and flow have to work together
Space design—such as universal, flexible-use exam rooms— is only part of the picture. Things like material flow, information flow, hours of operation, partner hospital schedules, clinician availability and daily time use are as critical as new square footage. These are complex, inter-related processes that need active daily management to really click. Everything new that we’re doing to increase space use depends on the foundation of Lean and operational efficiency that we’ve built over the last five years.
Service line leaders, assistant medical directors and administrative leaders in each affected building will continue working closely with facilities planners and Lean consultants on short-term solutions. Operational leaders in all of our facilities will get ongoing support from Lean consultants in assessing their use of space.
The bottom line is that unless we experience more growth than we expect in 2012, we should be able to manage current and planned clinical staff additions through a combination of departmental moves, building modifications, and operational improvements in Bellevue and Tacoma.
Beyond 2012, we will be looking at more physical capacity through new spaces and in some cases, new clinical partnerships outside our physical footprint. We are working with Bain & Company consultants to develop service delivery planning that will inform our decisions going forward.
President and Chief Medical Executive
Read Dr. Soman's latest Open Mike article.
- 2012
- | 2011
- | 2010
What if the “new normal” doesn’t feel normal at all, for many years? I try to remind myself and others that the current turmoil in health care is driven by market forces—not politics—and can only be solved by directly addressing the market. Our “new normal” is all about reaching across silos to work with partners in new ways.
Business problem? Diagnose it.
03/21/2012
I’m about halfway through my 2012 clinical immersion. When I tried this last year it was new for all of us, and it felt right to start our conversations around values. This year I'm trying to dig a little deeper.
What will your legacy be? 02/24/2012
What a night! It felt terrific to see over 700 clinicians and special guests at the GHP Annual Meeting on February 15. “A Legacy of Leadership” was our theme for the evening, touching on our shared past, present, and future.
Only nine Medicare Advantage plans in the country earned 5 stars overall, and Group Health Cooperative’s Medicare Advantage plan is one of them!
Looking back, and ahead: reflections on my first three years 9/17/2011
The last three years have passed quickly, largely because I’ve had such an amazing group of people to work with. What you’re capable of no longer surprises me. It inspires me.
Our people are our culture, and we’re constantly evolving 8/17/2011
One thing I’ve noticed since my last Q&A on Group Health culture with Scott Armstrong is that conversations like ours are spreading.
Erikson and Soman on partnership and growth 6/15/2011
Sustaining growth isn’t about Michael and I being leaders; it’s about teams of seasoned, excellent colleagues and leaders and clinical teams. We both have tremendous confidence in them.
The good, the bad and everything in between 5/11/2011
I went all over the state in March, talking with small groups of GHP physicians and other clinicians about critical issues.
Why are we here? 3/23/2011
Easily eight out of ten of you mention that our philosophy of medicine—the way we practice—drew you here. And paired with the people and relationships in your workplaces, it’s a major thing that keeps you here.
Culture at Group Health: 7 questions for Scott & Michael 3/9/2011
Scott and I kicked off some fresh thinking about culture and respect for people at our Leadership Conference about five weeks ago. Recently, we sat down to check in with each other about it.
Put some passion in your workplace 2/17/2011
What satisfies you, motivates you, or makes you want to tell your friends and family about your day? Do you know how your co-workers would answer these questions? Talk to each other to learn from each other.
Sometimes growth don't feel like it should 1/28/2011
We know that taking on new patients—and engaging them in their own good health—takes time. But it’s what’s unique and important about our kind of medicine.
About 350 leaders from the Group Practice and throughout Group Health gathered for the Group Practice Annual Fall Forum on November 12.
Demystifying clinical integration
11/3/2010
Clinical integration is the key, so let’s define what that phrase means.
Step back and take it all in. You’re making great things happen. 10/21/2010
In the last issue of Open Mike we had just learned that we had won the 2010 Acclaim Award from the American Medical Group Association.
Group Health sees a big jump in NCQA private plan rankings 9/22/2010
Group Health is one of the highest rated health plans and among the top 50 in the nation, according to the National Committee for Quality Assurance (NCQA).
Innovation is where we shine 9/8/2010
I am very excited to share that the American Medical Group Association (AMGA) has honored our work with its 2010 Acclaim Award.
Notes from the Colorado Health Symposium 8/11/2010
During the last week of July I traveled to the Colorado Health Foundation’s annual symposium in Keystone, CO.
Measuring up 7/28/2010
Quality. Ask a hundred people to define it, and you’ll get a hundred answers.
The risk and opportunity of Accountable Care Organizations
6/30/2010
Shared values, physician-led care models, and aligned incentives can bridge the distance between organizations in the world of accountable care.
Let’s start a conversation about our workplace 4/4/2010
People are our most important resource, our “secret sauce.”
Decreasing “unwarranted” variation in clinical care 3/24/2010
As you read this, we are in the midst of unprecedented reform to our national health care system.
Making the transition from “I” to “we”
2/10/2010
Last night the Group Health Permanente Annual Meeting left me feeling inspired and confident.
Looking ahead to 2010 1/13/2010
First, for 2010, our goal is as follows: We will lead the top delivery system in the state.
