Staffing Model Innovation in the NICU

Like all healthcare organizations, children’s hospitals face mounting pressure to reduce costs. Hospital leaders face the challenge of hitting ambitious new financial targets without compromising the quality of care. This is an especially delicate balancing act in the neonatal intensive care unit (NICU), where many of their sickest and most vulnerable patients are located.

In their article Needing More From Your NICU, ECG consultants Shelby Jergens and Clark Bosslet urge NICU leaders to turn a critical eye to their unit processes. They identify three areas that present the greatest opportunity for impactful change—staffing models, compensation methodology, and care coordination—and offer actionable plans based on what they’ve seen work with their clients. Here, Shelby and Clark talk about the work they’ve done with pediatric organizations around staffing model innovation in particular. Continue reading

Pediatric-Research Affiliations – A Culture Clash With Upside

As the healthcare industry delves more deeply into a system driven by value-based care delivery, the effects of reform mandates are becoming more pronounced for children’s hospitals. Shrinking margins and financial pressures have led pediatric providers to revisit long-standing affiliation agreements and explore new modes of partnership.

A similar dynamic has unfolded with regard to research enterprises. Ongoing cuts to traditional sources of public funding are a growing concern for pediatric hospitals and their affiliated AMCs. NIH funding decreased 10% between 2010 and 2013,1  a drop felt most profoundly by smaller research centers. Public funding has recovered since that time but has yet to achieve its previous heights, leading some children’s hospitals to alleviate their financial constraints by pursuing partnerships with nontraditional sources – such as pharmaceutical and biotech companies. Continue reading

Time to Revisit – and Reboot – Your Affiliation Agreement

Children’s hospitals and academic institutions have traditionally enjoyed a mutually beneficial relationship. For hospitals, prestigious affiliations result in an enhanced reputation and the chance to attract top physician talent. Medical schools, conversely, gain access to a specialty hospital for teaching, clinical training, and research.

This arrangement has been such a natural fit for so long that the agreements governing such relationships often go unexamined. “If it isn’t broken”…right? A partnership between a children’s hospital and medical school might not be broken, but in an industry marked by constant change, long-standing agreements may now be outdated and irrelevant. Continue reading

Collaboration in Pediatric Healthcare: Hospital and Health System Affiliation

The prospect of health reform once loomed like storm clouds on the horizon – dark, mammoth, and all but inevitable. Regardless, industry leaders uncertain about the scale of the impact sensed the changing climate and began preparing.  As a result, between 2009 and 2012, mergers and acquisitions doubled1 as hospital and health system leaders sought to offset challenges such as access to capital, low margins, and increased competition. It’s a trend that’s expected to continue as the ACA nears full implementation and reform mandates take hold, pushing the industry toward an environment based on population health management (PHM). Just this week, the U.S. Department of Health & Human Services announced plans to tie 30% of fee-for-service Medicare payments to care quality, through models such as accountable care organizations or bundled payment programs, by the end of 2016. Continue reading