What are some health care partnerships that went well? John Ayanian, Director of the University of Michigan’s Institute for Healthcare Policy and Innovation, asks Joneigh Khaldun, Director and Health Officer for the Detroit Health Department, to describe a public health and health system partnership that tackled a tough problem.
Khaldun says that during her time as Chief Medical Officer in Baltimore’s health department, they decreased infant mortality by about 40% over several years. “They did that by doing the exact things I was talking about: bringing people together,” she says. “It started with public health and health systems, but it ended up being over 100 folks who were all on the same page; they aligned their resources, they talked about what are we doing well and what should we be doing more of, and then they talked about what are we going to stop doing.” As a result, the quality of home visiting programs improved and infant mortality decreased, too.
Ayanian next asks Michigan surgeon Michael Englesbe what ingredients brought people to the table in health care partnerships across the state of Michigan and kept them working together to improve the quality of surgical procedures and address the opioid epidemic.
Blue Cross and Blue Shield’s partnership with Michigan’s health systems “has been a particularly inspiring approach,” Englesbe says. The insurance company has invested significant resources to bring change in health care to the bedside while having frontline nurses and doctors drive that change. “It allows us, in our state, to respond to things like the opioid epidemic — understanding that I just talked about a small part of the opioid epidemic — but we can respond to it pretty quickly unlike any other state because we have this platform for change,” he says, adding, “And after long-term investment from Blue Cross, we have trust; the payers and the state and physicians trust each other to try to make Michigan the healthiest state possible.”
However, Englesbe does point to the challenges of health care partnerships. “Five emails today,” he says, illustrating the point that maintaining a successful partnership takes a continuous effort. He describes one strategy that has helped: “Every hospital is the best at something, so using data flows to identify excellence and partnering with that hospital to have them teach us what they are the best at,” he says. “Celebrating excellence, and really not focusing on the hospitals that are low performing. That’s kind of risen all ships, so to speak.”
This is a theme we heard from Mary O’Connor, Ayanian notes — celebrating progress and success. She described it within a team or within one hospital, and Englesbe says it’s an important factor across hospitals.
From the NEJM Catalyst event Essentials of High-Performing Organizations, held at the University of Michigan’s Institute for Healthcare Policy and Innovation, July 25, 2018.