We’re all familiar with the challenges of the external environment. Reimbursement is declining across the payer mix. Funding for medical research and graduate medical education is challenged. The need to cover for uncompensated care in support of our community is ever present. Given that backdrop, there are two things happening at Partners HealthCare about which I’m very enthusiastic. Through our Partners eCare program, clinical workflows are being redesigned and supported by enabling technology that will make care safer and more coordinated, and enable population health management. The program will also generate more robust datasets that will support our research and teaching missions. As a patient, I welcome these changes and believe they are taking us in the right direction.
As an employee of Partners, the second thing I’m excited about is our executive leaders’ commitment to Human Capital Development. About three years ago, after some organization changes, the executive leaders of Partners HealthCare — the “corporate” departments — set out to unite the culture of these departments and to raise the bar on performance to better serve our mission. I have been fortunate to serve on an advisory committee for this cultural change.
As with many organizational initiatives, we started by defining the role of these departments and we adopted a set of values around how we get our work done and how we treat each other. Identity is an interesting topic around Partners because some of the corporate staff are embedded in our hospital sites for functions like HR, IS and Finance. These folks often operate within a specific hospital culture reflecting that institution’s mission and values, and yet they are part of a corporate team as well. The trick is to be able to wear both hats respectfully. For most of the 21 years since Partners was formed, the hospital brands were the most prominent. However, initiatives like the integrated EHR and Population Health Management put a focus on the integrated delivery system. Both hospital and corporate employees have had to grapple with a cultural and financial tension while we respond to the changes in the payment system and more integrated care.
As you might expect, our Human Capital Development initiative has included tactical work streams around performance management, employee engagement, diversity and inclusion, communication, measurement and reward, and process improvement. In the first year, we redesigned our staff evaluation tool to meet our values and conducted our first-ever employee engagement survey. Leaders were trained on the new evaluation tool and we were able to adjust our scale so that evaluators could ask for improvement from staff. We were very pleased with a high participation rate in our engagement survey, but learned about an overall low engagement score, so all work units have ongoing action plans to improve.
Because of the overlap with hospitals, leadership titles are inconsistent across the corporate departments. It took us quite some time to determine who should actually be invited to our leadership training meetings. We also had a “VP staff meeting” that was filled with some people who weren’t VPs, and not all of the VPs were included. We now have this organized with an Executive Leader Team and Operations Leader Team and a group of Directors who are attending our quarterly leadership retreats. All of this work and these teams fit into the larger enterprise framework that is governed by our hospital CEOs. Our goal is to develop our leaders and staff and be able to quantify the value we bring to the Partners mission.
All of these things are necessary in the current environment, but perhaps the most tangible sign of unity and efficiency is a new administrative building. For the history of the company, we have leased administrative space in various locations throughout greater Boston. Our executive leaders were able to make the case to the hospital CEOs and the Board Finance Committee that we could save millions in annual operating costs by constructing and operating our own building. It was no small task to find a suitable location, but once decided, the project has progressed quickly and the first groups are scheduled to move in the spring of next year. The building will help us better collaborate and reduce travel and costs. It features flexible workspace and accommodates mobility and sustainability components.
Still, it’s a huge change from our subcultures that have existed in various departments and locations. We are working through transportation and parking options, along with the change management issues around working in a no-office environment. There are many advantages to this new facility, but just like our clinical response to the new payment systems, this change will be harder for some than others. We are paying a lot of attention to communication and change management principles. We are creating a new employee experience that will optimize performance and allow the corporate departments to best serve our mission.
From a systems perspective, this move gives us an opportunity to do some things differently. We want to attract the best talent from all dimensions of diversity and will be expanding our remote work program. We have adopted a document retention policy for the corporate departments and have a process improvement project underway to reduce paper by 50 percent. Some departments already have scanning solutions and we will be providing an enterprise solution consistent with what is used for our EHR and ERP systems.
Projects like this reveal some of the pinch points in our organization. People are very busy, and timelines for many of our initiatives can collide. In addition, people are used to making more local and departmental choices on things like scanning. Again, this points to our growing pains as we adapt to operating more like an integrated delivery system. The more decisive we can be about such things, the more efficiently we can execute on projects and support standardized solutions. Our computing standard for the new building features one device (desktop or laptop) and includes a soft phone. Again, this creates more change for people who are used to solutions like VPN or remote desktop use. VDI may also be a solution for some use cases, but it’s imperative that we be more disciplined about this from a cost perspective.
All healthcare organizations are dealing with cost issues. We are fortunate to be able to acquire the necessary capital for our EHR implementation, our Population Health Management programs, and for things like our new administrative building. Given these investments, we have to be particularly diligent about removing costs that result from indecisiveness and a lack of standardization. This is no easy task in a large organization, but we believe our efforts geared toward improved EHR workflow, Population Health Management and Human Capital Development will lead us to success for both our patients and our employees.