PATIENT CENTERED APPROACH

Patient Centered Approach

Case Assignment #2

In Southwestern Pennsylvania, healthcare is the largest sector of the economy, employing one in eight workers and conducting more than $7.2 billion in business. Yet in 1998, as civic leaders began formulating an ambitious regional renewal, the industry was under growing pressure with bankruptcies, operating losses, consolidations, and difficulty retaining qualified workers. Purchasers bemoaned the high cost of care; the region's quality indicators did not set national records.

To address these challenges, the Pittsburgh Regional Healthcare Initiative (PRHI) was formed under the leadership of then Alcoa Chairman Paul O'Neill and the Jewish Healthcare Foundation of Pittsburgh.

PRHI's approach to redesigning healthcare requires cooperation among previously competing interests. In addition to hundreds of clinicians, PRHI's members include 40 hospitals, four major insurers, over 30 major and small-business healthcare purchasers, dozens of corporate and civic leaders, and Pennsylvania's attorney general. This divergent group united in endorsing one guiding principle: healthcare delivery must focus on providing perfect care to every patient.

PRHI partners have come to realize that the challenges facing healthcare are symptoms of the same root problem: not faulty people, but faulty, error-prone systems that do not focus on patients at the point of care. Every patient intervention must become an opportunity to learn, share what they learn across the entire region, and apply the discoveries.

Goals: PRHI partners signed formal commitments to collaborate on ways to accelerate progress toward these goals:

Zero medication errors

Zero hospital-acquired infections

The best patient outcomes in the following areas:

Coronary artery bypass graft surgery

Hip and knee replacement surgery

Maternal and infant outcomes

Diabetes

Depression

In pursuit of these goals, PRHI supports three sequential levels of shared learning and improvement:

Patient centered approach emerged as a national health care priority, when the PRHI report, To Err Is Human, was published. Prior to ...