Imagine: You are a hospital Chief Executive Officer, Chief Financial Officer, medical or nursing director, patient safety specialist, quality improvement professional, or a doctor or nurse on the front lines of patient care. Every day you’re aware that patients and families should be more engaged in their care so they would fare better both in the hospital and after discharge; their care could be safer and more seamlessly coordinated; patients should be ready for discharge sooner and readmitted less often; your bottom line stronger; your staff more fulfilled. You enter into new payment models such as bundling with an uneasy awareness that your organization is at risk because you don’t know what the care you deliver actually costs. Like most healthcare leaders, you are also still searching for a way to deliver care that will help you to achieve the Triple Aim: care that leads to improved clinical outcomes, better patient and family care experiences, and reduced costs. Sound familiar? If so, then it’s time to read The Patient Centered Value System: Transforming Healthcare through Co-Design. This book explains how to introduce the Patient Centered Value System in your organization to go from the current state to the ideal. The Patient Centered Value System is a three-part approach to co-designing improvements in healthcare delivery—collaborating with patients, families, and frontline providers to design the ideal state of care after listening to their wants and needs. Central to the Patient Centered Value System is seeing every care experience through the eyes of patients and families. The Patient Centered Value System is a process and performance improvement technique that consists of 1) Shadowing, 2) the Patient and Family Centered Care Methodology, and 3) Time-Driven Activity-Based Costing. Shadowing is the essential tool in the Patient Centered Value System that helps you to see every care experience from the point of view of patients and families and enables you to calculate the true costs of healthcare over the full cycle of care. Fundamental to the Patient Centered Value System is the building of teams to take you from the currents state of care delivery to the ideal. Healthcare transformation depends not on individual providers working to fix broken systems, but on teams of providers working together while breaking down silos. The results of using the Patient Centered Value System are patients and families who are actively engaged in their care, which also improves their outcomes; providers who see the care experience from the patient’s and family’s point of view and co-design care delivery as a result; the tight integration of clinical and financial performance; and the realization of the Triple Aim.

Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

The evidence is undeniable. By any measure, the US spends more on healthcare than any other country in the world, yet its health outcomes as measure by longevity are in the bottom half among developed countries, and its health-related quality of life has remained constant or declined since 1998. In addition to high costs and lower than expected outcomes, the healthcare delivery system is plagues by treatment delays as it can take weeks to see a specialist, and many people have limited or no access to care. Part of the challenge is that the healthcare delivery system is a large, complex, and sophisticated value creation chain. Successfully changing this highly interconnected system is difficult and time consuming because the underlying problems are hard to comprehend, the root causes are many, the solution is unclear, and the relationships among problems, causes, and solution are multifaceted. To address these issues, the book carefully explains the underlying problems, examines their root causes using information, data, and logic, and presents a comprehensive and integrated solution that addresses these causes. These three steps are the methodological backbone of this book. A solution depends on understanding and applying the principles of patient-centered care (PCC) and resource management. PCC puts patients, supported by their primary care physicians, back in the role as decision makers and depends on patients being responsible for their health including making good life-style choices. After all, the best way to reduce healthcare costs and increase quality of life is to improve our health and wellness and as a result need less care. In addition, health insurance must be rethought and redesigned so it is less likely to lead to overuse. For many people with health insurance, the out-of-pocket cost of healthcare are small, so healthcare decision making is often biased toward consumption. Effective resource management means that healthcare providers must do a better job of acquiring and using resources in order to provide care quickly, productively, and correctly. This means improving healthcare strategy and management, accelerating the use of information technology, making drug costs affordable and fair, reducing the incidence of malpractice, and rebuilding the provider network. In addition, implementation is difficult because there are many participants in the healthcare delivery value chain, such as physicians, nurses, and medical technicians, as well as many provider organizations, such as hospitals, clinics, physician offices, and labs. Further up the value chain there are pharmaceutical companies, equipment providers, and other suppliers. These participants have diverse and sometimes conflicting goals, but each must be willing to accept change and work in a coordinated manner to improve healthcare. To overcome these problems, strong national leadership is needed to get the attention and support from the people and organizations involved in healthcare and to make the comprehensive changes that will lower healthcare costs, improve healthcare quality, eliminate delays, increase access, and enhance patient satisfaction.

This long awaited Third Edition fully illuminates the patient-centered model of medicine, continuing to provide the foundation for the Patient-Centered Care series. It redefines the principles underpinning the patient-centered method using four major components - clarifying its evolution and consequent development - to bring the reader fully up-to-

There have been great strides made in designing the administrative structures of patient-centered care, but it is still difficult to design truly patient-centered clinical routines that the entire healthcare team can enact. The kind of partnership, in which patients are fully part of the team that guides their own care, goes against so much of the training and socialization of health professionals and, for that matter, the expectations of many patients. This is particularly true for patients we sometimes call “complex.” In other contexts, we call them “high utilizers,” “disadvantaged,” “heartsink patients,” or “people with trauma histories.” Blount calls them “multiply-disadvantaged” patients. To successfully serve these patients requires our best versions of team-based care, including behavioral health and care management team members, though every member of the team needs help in engaging these patients and mutual support in adapting to the rapid changes in roles that new team approaches are creating. This book offers a summary of the approaches that are currently in growing use, such as health literacy assessment, motivational interviewing, appreciative inquiry, shared decision making, minimally disruptive care, trauma informed care, enfranchisement coaching, relationship-centered care, and family-informed care. Finally, it offers a transformative method, based on familiar elements, that is Transparent, Empowering, Activating, and Mutual: the T.E.A.M. Way.

"Nathan Tierney’s powerful storytelling is rarely seen in today’s health care business environment. We must redesign the health care delivery system---a team sport in service of patients, hold it accountable with measurement to improve outcomes, and quantify the resource costs over the full cycle of care. Value-based health care is a framework through which these goals are achieved, and Tierney provides a detailed playbook to get your organization there. Outlined in incredible detail and clarity, he presents core concepts and dives into the key metrics needed to build, maintain, and scale a successful value-based health care organization. Nathan shares a realistic vision of what any CEO should expect when developing their own Value Management Office. Nothing is more important to me than improving the lives of those I love. My personal mission is to create systemic change with an impact on the global stage. This playbook needs to be on the desk of every executive, clinician, and patient today." -Mahek Shah, MD, Senior Researcher and Senior Project Leader, Harvard Business School Our current healthcare system’s broken. The Organization for Economic Co-Operation and Development (OECD) predicts health care costs could increase from 6% to 14% of GDP by 2060. The cause of this increase is due to (1) a global aging population, (2) growing affluence, (3) rise in chronic diseases, and (4) better-informed patients; all of which raises the demand for healthcare. In 2006, Michael Porter and Elizabeth Teisberg authored the book ‘Redefining Health Care: Creating Value-Based Competition on Results.’ In it, they present their analysis of the root causes plaguing the health care industry and make the case for why providers, suppliers, consumers, and employers should move towards a patient-centric approach that optimizes value for patients. According to Porter, "value for patients should be the overarching principle for our broken system." Since 2006, Professor Porter, accompanied by his esteemed Harvard colleague, Profesor Robert Kaplan, have worked tirelessly to promote this new approach and pilot it with leading healthcare delivery organizations like Cleveland Clinic, Mayo Clinic, MD Anderson, and U.S. Department of Veteran Affairs. Given the current state of global healthcare, there is urgency to achieve widespread adoption of this new approach. The intent of this book is to equip all healthcare delivery organizations with a guide for putting the value-based concept into practice. This book defines the practice of value-based health care as Value Management. The book explores Profesor Porter’s Value Equation (Value = Outcomes/ Cost), which is central to Value Management, and provides a step-by-step process for how to calculate the components of this equation. On the outcomes side, the book presents the Value Realization Framework, which translates organizational mission and strategy into a comprehensive set of performance measures and contextualizes the measures for healthcare delivery. The Value Realization Framework is based on Professor Kaplan's ground-breaking Balanced Scorecard approach, but specific to healthcare organizations. On the costs side, the book details the Harvard endorsed time-driven activity based costing (TDABC) methodology, which has proven to be a modern catalyst for defining HDO costs. Finally, this book covers the need and a plan to establish a Value Management Office to lead the delivery transformation and govern operations. This book is designed in a format where any organization can read it and acquire the fundamentals and methodologies of Value Management. It is intended for healthcare delivery organizations in need of learning the specifics of achieving the implementation of value-based healthcare.

In Bringing Value to Healthcare: Practical Steps for Getting to a Market-Based Model, Rita Numerof and Michael Abrams lay out the roadmap to a healthcare system that is accountable for delivering optimal patient outcomes at a sustainable cost. This is the handbook for payer, provider, pharmaceutical, and medical device executives seeking to preserve today‘s profitability while positioning their organizations for success in the very different markets of tomorrow. The book‘s guidance is illuminated by case studies and each chapter concludes with a self-assessment tool and key questions.

Sponsored by the Picker/Commonwealth Program for Patient-Centered Care In this comprehensive, research-based look at the experiences and needs of patients, the authors explore models of care that can make hospitalization more humane. Through the Patient's Eyes provides insights into why some hospitals are more patient-centered than others; how physicians can become more involved in patient-centered quality efforts; and how patient-centered quality can be integrated into health care policy, standards, and regulations. The authors show how, by bringing the patient's perspective to the design and delivery of health services, providers can improve their ability to meet patient's needs and enhance the quality of care.

For decades, the manufacturing industry has employed the Toyota Production System the most powerful production method in the world to reduce waste, improve quality, reduce defects and increase worker productivity. In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compe