1. Foster leadership collaboration for a shared vision
Creating a shared vision among leadership is a key first step to breaking down silos. What should the patient journey look like? How do we create a north star that guides our strategic plans? Having an interdisciplinary team to give input is essential, and keeping the patient at the center of the conversation can help focus the priorities. Regardless of whether a patient is interacting in oncology, psychiatry, cardiology, or primary care, the leaders need a shared vision as to what that experience will be for it to successfully trickle down throughout the organization.
As the vision for a strategy or a workflow process improvement starts coming to fruition, conflicting priorities can create friction. One speaker noted the power of food in bringing a group together, not only for the meal but to help smooth out relationships and foster dialogue. In one of my EHR implementations, cookies customized with the project logo were more than a snack as they were given to recognize teams on the spot for positive, constructive attitudes. The most important thing is building bridges and relationships across disciplines for long-term, systemic changes.
2. Aligned communications for a more patient-centric experience
With aligned communications, teams can work together to build a more patient-centric process. One of the panelists shared how their team refocused on the patient experience, intentionally built more structure, and “de-implemented” the technology element when needed. This created a culture where the entire care team comes to the bedside and discusses treatments and tests with the patient and family, as well as proactively thinking about the discharge plan.
Ultimately, if leaders aren’t communicating with each other, system-wide change is nearly impossible. Even in federated systems where data and processes are more individualized among care sites, leaders can discuss what’s working at different sites and identify best practices or new processes.
For example, how is care management being communicated? Are managers and coordinators integrating to avoid silos between acute and ambulatory care management? Are patient education strategies considering the ways care teams will use content within workflows and how patients can access it at home? What considerations are needed for different site locations? Staying connected to local leaders who can report upwards on specific site characteristics can be helpful in creating a shared organizational vision and strategy that still supports and respects those unique cultures.
3. Optimizing resources for more efficient care
As a shared vision is identified, leaders can look for opportunities to become more financially sustainable across teams and share best practices and resources. Sometimes the answer isn’t more resources, it’s just using current ones more efficiently. One panelist discussed how emergency department (ED) providers were underutilized while they waited for a patient to be assigned an available bed. The department changed to vertical strategies so more patients could be seen by available providers and get care started—and even completed—before a bed is made available.
Conversations around resourcing will often bounce between quality, efficiency, and cost, and whether investing in tools is worth initial poor margins for longer-term financial savings and improving staff burnout. At what point will financial savings impact outcomes or the patient experience? How can better care processes lead to improved financial performance, such as reduced length of stay and fewer readmissions?
