'Self-funding project' for four-site campus

In an article which first appeared in Canadian Healthcare Facilities, the monthly magazine of the Canadian Healthcare Engineering Society (CHES), Michelle O'Brodovich and Etienne deMuelenaere, of independent, ISO-certified, energy efficiency specialist, Ecosystem (which has offices across the U.S. and Canada), describe a wide-ranging energy conservation programme, involving 29 different measures at four hospital sites, currently being implemented for Lakeridge Health in Ontario, Canada.

Using a social entrepreneurial approach to enhance the financial and social value of health care organizations

In this study, a conceptual framework was developed to show that social entrepreneurial practices can be effectively translated to meet the social needs in health care. We used a theory-in-use case study approach that encompasses postulation of a working taxonomy from literature scanning and a deliberation of the taxonomy through triangulation of multilevel data of a case study conducted in a Taiwan-based hospital system. Specifically, we demonstrated that a nonprofit organization can adopt business principles that emphasize both financial and social value. We tested our model and found comprehensive accountability across departments throughout the case hospital system, and this led to sustainable and continual growth of the organization. Through social entrepreneurial practices, we established that both financial value creation and fulfilling the social mission for the case hospital system can be achieved.

Success factors for strategic change initiatives: a qualitative study of healthcare administrators' perspectives

Success factors related to the implementation of change initiatives are well documented and discussed in the management literature, but they are seldom studied in healthcare organizations engaged in multiple strategic change initiatives. The purpose of this study was to identify key success factors related to implementation of change initiatives based on rich qualitative data gathered from health leader interviews at two large health systems implementing multiple change initiatives. In-depth personal interviews with 61 healthcare leaders in the two large systems were conducted and inductive qualitative analysis was employed to identify success factors associated with 13 change initiatives. Results from this analysis were compared to success factors identified in the literature, and generalizations were drawn that add significantly to the management literature, especially to that in the healthcare sector. Ten specific success factors were identified for the implementation of change initiatives. The top three success factors were (1) culture and values, (2) business processes, and (3) people and engagement. Two of the identified success factors are unique to the healthcare sector and not found in the literature on change models: service quality and client satisfaction (ranked fourth of 10) and access to information (ranked ninth). Results demonstrate the importance of human resource functions, alignment of culture and values with change, and business processes that facilitate effective communication and access to information to achieve many change initiatives. The responses also suggest opportunities for leaders of healthcare organizations to more formally recognize the degree to which various change initiatives are dependent on one another.

Engineering a fail-safe health system. Memorial Hermann wants to eliminate health care errors (really)

Memorial Hermann Healthcare System is on an all-out mission to eliminate health care-acquired infections. Despite a bit of physician resistance, the results so far are astonishing.

Betting on change: Tenet deal with Vanguard shows it's primed to try ACO effort, new payment model

Tenet Healthcare Corp.'s acquisition of Vanguard Health Systems is a sign the investor-owned chain is willing to take a chance on alternative payment models such as accountable care organizations. There's no certainty that ACOs will deliver the improvements on quality or cost savings, but Vanguard Vice Chairman Keith Pitts, left, says his system's Pioneer ACO in Detroit has already achieved some cost savings.

Reducing pharmacy costs through improved utilization

Strategies Trinity Regional Health System in Rock Island, III., used to reduce pharmacy expenses included: Leveraging benchmarking information to identify opportunities for cost savings. Implementing change management techniques, bolstered by well-presented and coherent data, to promote acceptance of change. Forming a multidisciplinary team of clinical and financial leaders to address quality, outcomes, and cost issues and collaborate on solutions.

Competing for consumers. Coming coordinated-care squeeze prompts providers to push into insurance market

Squeezed by coordinated-care initiatives, a number of hospital systems are looking to help fill beds and reap more revenue by offering insurance plans on the state exchanges set to launch this fall. Some will use narrow networks, a strategy that allows systems to create a captive customer base. "I think it's going to be a huge growth area in the exchanges," says Jonathan Gruber, left, a professor of economics at MIT.