Critical care organizations: Business of critical care and value/performance building Journal Article


Authors: Leung, S.; Gregg, S. R.; Coopersmith, C. M.; Layon, A. J.; Oropello, J.; Brown, D. R.; Pastores, S. M.; Kvetan, V.; for the Academic Leaders in Critical Care Medicine Task Force of the Society of the Critical Care Medicine
Contributor: Halpern, N. A.
Article Title: Critical care organizations: Business of critical care and value/performance building
Abstract: Objective: New, value-based regulations and reimbursement structures are creating historic care management challenges, thinning the margins and threatening the viability of hospitals and health systems. The Society of Critical Care Medicine convened a taskforce of Academic Leaders in Critical Care Medicine on February 22, 2016, during the 45th Critical Care Congress to develop a toolkit drawing on the experience of successful leaders of critical care organizations in North America for advancing critical care organizations (Appendix 1). The goal of this article was to provide a roadmap and call attention to key factors that adult critical care medicine leadership in both academic and nonacademic setting should consider when planning for value-based care. Design: Relevant medical literature was accessed through a literature search. Material published by federal health agencies and other specialty organizations was also reviewed. Collaboratively and iteratively, taskforce members corresponded by electronic mail and held monthly conference calls to finalize this report. Setting: The business and value/performance critical care organization building section comprised of leaders of critical care organizations with expertise in critical care administration, healthcare management, and clinical practice. Measurements and Main Results: Two phases of critical care organizations care integration are described: "horizontal," within the system and regionalization of care as an initial phase, and "vertical," with a post-ICU and postacute care continuum as a succeeding phase. The tools required for the clinical and financial transformation are provided, including the essential prerequisites of forming a critical care organization; the manner in which a critical care organization can help manage transformational domains is considered. Lastly, how to achieve organizational health system support for critical care organization implementation is discussed. Conclusions: A critical care organization that incorporates functional clinical horizontal and vertical integration for ICU patients and survivors, aligns strategy and operations with those of the parent health system, and encompasses knowledge on finance and risk will be better positioned to succeed in the value-based world. © 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Keywords: intensive care; health care system; leadership; health care organization; regionalization; critical care; health care planning; human; priority journal; article; critical care organization; horizontal integration; value-based care; vertical integration
Journal Title: Critical Care Medicine
Volume: 46
Issue: 1
ISSN: 0090-3493
Publisher: Lippincott Williams & Wilkins  
Date Published: 2018-01-01
Start Page: 1
End Page: 11
Language: English
DOI: 10.1097/ccm.0000000000002696
PROVIDER: scopus
PUBMED: 28863012
DOI/URL:
Notes: Article -- Export Date: 2 January 2018 -- Source: Scopus
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  1. Neil A Halpern
    151 Halpern
  2. Stephen Pastores
    250 Pastores