Leadership
Clip
It Takes a Health Crisis (02:44)

Does it take a health crisis for partnerships to form that try to resolve issues like opioid addiction?

Yes, says Michael Englesbe, because everyone already has so much to do, so many daily priorities to tackle. “If it wasn’t for that day where I had to listen to those three stories [about people who had overdosed on opioids], I doubt I would have ever reached out to Chad and Jen and started plugging away at this problem,” he says.

“It does take a crisis, at least for people to listen,” Englesbe adds. “We started banging our drum and everyone was listening, and things started rolling.”

While Joneigh Khaldun agrees, she reminds the audience that “when it comes to the opioid epidemic, there have been issues with opioids in urban minority communities for decades,” along with people in those communities trying to address the epidemic.

“There wasn’t really that conversation or that excitement or that crisis during those times, and so I love that we’re all coming together now and bringing partners to the table,” she says.

“A crisis can often unmask deep, underlying disparities and disadvantage in the communities we serve,” says John Ayanian. He points to another health crisis, the recent hepatitis A outbreak in Michigan, and asks Khaldun for her perspective.

The hepatitis A outbreak has mostly occurred in southeastern Michigan, with about 20% of the cases in Detroit, Khaldun explains. The people at highest risk during this outbreak have been those who are homeless, making up about 50% of cases; those who struggle with substance use disorders — not just opioids, but marijuana and other substances, as well — and men who have sex with men.

“What we decided was, as a health department, we cannot do this alone,” Khaldun says. The HAV vaccine works if it’s received quickly enough, and so the Detroit Health Department partnered with hospital emergency departments to implement HAV vaccination programs, including screenings for those at highest risk.

“We as local public health went to our hospital partners and said, ‘Hey, this is a crisis that’s going on and this is how you can help,’” she says. “And they really stepped up to help us with this epidemic.”

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.

More From Leadership
The Largest Share of Organizations Do Not Have a Formal Strategy for Clinician Engagement

Leadership Survey: Why Clinicians Are Not Engaged, and What Leaders Must Do About It

Clinician engagement is vital for improving clinical quality and patient satisfaction, as well as the job satisfaction of clinicians themselves. Yet nearly half of health care organizations are not very effective or not at all effective at clinician engagement.

Rowe01_pullquote - clinician well-being - fighting clinician burnout and creating culture of wellness takes all stakeholders

Defending the Term “Burnout”: A Useful Tool in the Quest to Ease Clinician Suffering

Health care leaders must take a preemptive approach to clinician well-being that is supported by all stakeholders and prioritized on an equal footing with essential clinical and financial measures.

Screenshot from the NewYork Quality Care Chronic Condition Dashboard

Success in a Hospital-Integrated Accountable Care Organization

How NewYork Quality Care achieved shared savings — by strengthening collaboration, enhancing care management with telehealth, and transparently sharing performance data.

Miller03_pullquote social determinants whole-person

How a State Advances Whole-Person Health Care

Pennsylvania addresses social determinants of health by bringing together managed care and social services organizations to expand access to vital resources.

Abigail Geisinger Scholars Program for Medical Students -Ryu02_pullquote

Why a Teaching Hospital Offers an Employment-Based Tuition Waiver Program

Geisinger Commonwealth School of Medicine subsidizes medical students’ education in exchange for their willingness to practice at Geisinger Health System.

Michael Dowling and Charles Kenney headshots

Rebooting Health Care: An Optimistic Outlook

The U.S. health care system may seem broken, but it’s on its way to greatness, according to the authors of Health Care Reboot. They discuss their optimism for U.S. health care reform, particularly on the social determinants of health, payment, consumerism, and technology.

Action Steps for Risk-Share Contracts for Medical Devices

Challenges and Best Practices for Health Systems to Consider When Implementing Risk-Share Contracts for Medical Devices

When done right, value-based contracting for medical devices can ameliorate shrinking margins at health systems, leading to a virtuous circle.

Health Care Organizational Culture Emphasizes Patient Care Only Slightly More Than the Bottom Line

Survey Snapshot: Who Should Lead Culture Change?

NEJM Catalyst Insights Council members feel that culture change at their organizations is heading in the right direction, but differ on who it should come from, and reveal too much balance between emphasis on bottom line and emphasis on patient care.

Culture Change Within Health Care Organizations Is Changing for the Better

Leadership Survey: Organizational Culture Is the Key to Better Health Care

Although three-quarters of Insights Council survey respondents say culture change is a high or moderate priority at their organizations, survey results show a lot of work on organizational culture remains to be done.

Metraux01_pullquote - dinners to combat burnout in the health care community

“Breaking Bread” to Combat Burnout

Can a simple dinner create community among health care providers?

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

Leading Teams

169 Articles

Leadership Survey: Why Clinicians Are Not…

Clinician engagement is vital for improving clinical quality and patient satisfaction, as well as the…

Team Care

109 Articles

Leadership Survey: Why Clinicians Are Not…

Clinician engagement is vital for improving clinical quality and patient satisfaction, as well as the…

Rating the Raters: An Evaluation of…

Some promising innovation is taking place among organizations that rate hospital performance, but major systemic…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now