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Farewell, Heads in Beds

Farewell, Heads in Beds

For a century or so, the prevailing business model for most hospitals was to keep the hospital full.

We’re now saying goodbye to the “heads in beds” era and permanently transitioning to a new model in which hospitals play a central role in keeping patients out of hospital beds! Of course hospitals always will be responsible for treating sick individuals who need acute inpatient care. But they’re now being called upon to do even more, partnering with payors, public health agencies, community advocacy and service groups, and, most importantly, our patients to try to keep people healthy at home, while reserving hospitalizations only for those who cannot get their necessary care in any other setting.

As you’ll see in our cover story interview with the presidents of Johns Hopkins Medicine’s three community hospitals, there has been a major mindset shift here in Maryland, with its all-payer rate-setting system and now a global budget revenue program that incentivizes hospitals to work in partnership with other providers to prevent unnecessary hospitalizations and readmissions. This will involve creating better discharge processes so patients walk out of the hospital knowing what they need to do, and deliberate efforts to connect those patients to primary care providers if necessary. It also involves collaborating with others that formerly may have been considered our competitors. We call this “coopetition.” The exciting result will be a more integrated, seamless care experience for patients and a higher likelihood of maintaining optimal health. We are in the midst of these transitions now and committed to seeing them through.

Along this same theme, this issue also highlights an effort by Johns Hopkins neurologists to reduce hospitalizations for patients with multiple sclerosis. By developing checklists of treatment steps and patient responsibilities, they tripled the number of patients receiving early discharge.

I’m also pleased to report that many of Johns Hopkins’ specialty departments are now opening clinic spots to accept more patients for urgent visits within a day or two of a physician referral, saving patients weeks of waiting to see a specialist and potentially reducing the number of emergency department visits.

Efforts like these are new ground for Johns Hopkins but core to our mission. By keeping the patient at the forefront of our efforts, the work will fall into place.

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