Written by Liana Passantino
"The only thing certain right now in healthcare is change. The challenges are daunting but the opportunities are immense."
– Paul D. Cleary, PhD, Dean of Yale School of Public Health and Chair, Epidemiology and Public Health
This year, I had the pleasure of attending the 10th annual Yale Healthcare Conference. Dr. Elizabeth (Betsy) Bradley, Professor of Public Health, Yale University received the John D. Thompson Distinguished Visiting Fellow Award and was the keynote speaker. Professor Bradley gave an excellent presentation that echoed the Case for Change presented by John August at our April 1st Quality and Systems Improvement Conference and supplemented many of the facts and figures with additional research and perspectives on public health and public policy. She explained that all too many people see the equation that health = healthcare, but through her presentation she demonstrated that the drivers of health show that healthcare is not simply enough and health ≠ healthcare. The determinants of health indicate that spending on social services is critical and that social determinants of health are important for everyone, not just the poor. It is true that the United States spends more than other OECD countries with worse outcomes but when you compare combined healthcare and social spending (which researchers have called total investment in health as GDP), the US is still in the middle of rankings on outcomes. By comparing the ratio of healthcare spending to social services spending, you can see how the US comes in last place. For every $1 the US spends on healthcare, $0.90 is spent on social services compared to OECD countries where for every $1 on healthcare, $2 is spent on social services. Looking at the research from this angle shows that the American system is definitely broken. It struck me that there is clearly still a role for unions if they are at the forefront of efforts of moving towards more community-oriented, patient-centric integrated care models.
Common features of healthcare innovation are using an integrated health and social service approach, an interdisciplinary, team-oriented staff, and an ethic of client empowerment. Going forward, Professor Bradley encouraged the audience of health professionals to think about a new platform with incentives for innovation to promote health, rather than healthcare. Social systems are imperative to improve health outcomes while containing costs. There is a mindshift needed from producing healthcare to using a variety of approaches to produce better health outcomes and mobilizing to solve the collective problem will require trust, thinking about longer time horizons, and motivation to see the whole picture, rather than cutting up the world into many little parts.
Throughout the conference, there were many comments and discussion of change, innovation, and being patient-focused. However, a key element that was not addressed was the individuals who need to adapt to these changes: the frontline staff. Organizational change cannot take place without engaging the frontline staff throughout the change process and incorporating their feedback. These employees are critical to the improving the patient experience, which includes access to and quality of care.
Keywords: Yale Healthcare Conference, frontline staff, health outcomes, publich health, innovation, Elizabeth Bradley, Paul D. Cleary, Yale School of Public Health, Case for Change
Posted on: April 23, 2014