Ten CEO Imperatives for Healthcare Transformation: Lessons From Top-Performing Academic Medical Centers.

EXECUTIVE SUMMARY: The transition from a delivery model based on volume to a model based on value is underpinning an unprecedented rate of change in healthcare. Our research identifies academic medical centers that have successfully moved their organizations from a volume-based care delivery model to a model that is based on value, achieving top decile performance in the transition. We asked senior leaders about their key imperatives in achieving system-wide healthcare transformations.Major teaching hospitals were sampled using data envelopment analysis to identify hospitals that produced the best value-based purchasing process of care, Hospital Consumer Assessment of Healthcare Providers and Systems scores, and mortality scores with the most efficient utilization of human and financial organizational resources. On-site interviews were conducted with the CEOs of the top-performing hospitals. Content analysis of the transcribed interviews revealed 10 clear imperatives that our sample of CEOs said were essential.

Why hospital improvement efforts fail: a view from the front line.

In the 21st century, healthcare executives are facing changes of unprecedented magnitude in virtually every area, affecting their ability to compete. That hindrance brings with it a greater need for rapid and effective organizational change and improvement. Yet changes in the U.S. healthcare delivery system have historically been criticized as slow and less than effective in responding to the changes necessary for rapid performance improvement. To that end, the purpose of this applied research study was to help healthcare executives better understand the barriers to effective organizational change and improvement from the perspective of frontline leaders. Focus groups were conducted with 167 frontline leaders from four community hospitals to explore why hospital change efforts fail. Participants representing 11 different functional areas, including all facets of hospital operations, were asked to identify the primary causes of failure of a recent change initiative at their hospital. A content analysis of the focus group data identified 10 primary barriers to successful hospital change, some of which are ineffective implementation planning and overly aggressive timelines, failure to create project buy-in and ownership, ineffective leadership and lack of trust in upper management, unrealistic improvement plans, and communication breakdowns. Leadership lessons and recommendations based on the research findings are provided.