Service distribution and optimization planning, including the design and execution of regionalization strategies, doesn’t occur through osmosis. It necessitates a deliberate process that encourages innovative thinking and ensures candid discussion of critical issues and available options. The numerous challenges of regionalizing health services are more easily conquered when guided by a well-defined framework. Regardless of how services are or will be redistributed across a system, there are critical elements that should be integrated into any framework for regionalization.
- Building a system-wide base of cultural readiness. Members of hospital staff are often loyal to and identify with the organization, campus, or building within which they work. Motivating leaders, providers, and staff to think beyond their silos and more systematically is arguably the most difficult task on this list.
- Establishing clear ground rules and transparent decision-making criteria. Establishing the decision-making path and criteria to be followed will help communicate an unbiased, stakeholder-inclusive, and system-centric approach to service distribution. It also promotes accountability and systematic rigor in the decision-making process.
- Organizing efforts by service line; start with those that have the greatest potential and build a compelling business case upon cost and quality. Instead of making sweeping changes, systems must thoroughly evaluate each service, build a business case for redistributing a service line across the system, and take manageable steps toward implementing regionalization strategies. It is incumbent upon system leaders to present a fact-based case for change, as well as a clearly articulated vision for the future of the system and individual hospitals.
- Including and engaging stakeholders at all levels. Staff reaction to regionalization efforts varies, often depending on whether their facility is losing or gaining services. Engaging stake-holders at all levels allows those affected to voice their questions and concerns while providing leadership with the opportunity to communicate the rationale behind such decisions. Staff buy-in can be best attained with participation in the discussion and decision-making processes. Additionally, reaching out to the community allows the system to proactively address commitments and agreements that may have been made earlier related to the level of services offered.
- Setting deadlines for reporting and recommendations. This is not a transition that can be managed periodically or during spare time. Firm timetables and high levels of accountability are critical in tackling the hard work of service distribution. Often, external expertise is critical to success.
- Communicating system decisions, strategy, and progress on a regular basis. Open and decisive communication with staff and stakeholders regarding plans can mitigate rumor and uncertainty about the system’s stability in this climate of change.
A growing number of health systems are faced with the reality of addressing overlapping services, declining patient volumes, and high costs. Regionalization strategies, though difficult, represent an opportunity to strategically align services in a manner that promotes accessible, high-quality care at sustainable costs.
To learn more about regionalization, read the Insight on our Web site.