What is “system-ness”?
“Systemness” is the ability to provide a consistent experience for patients, providers, and hospital staff regardless of the care setting across the continuum. It can improve patient and provider experience, lower costs, improve quality patient care, reduce risk, and increase growth. However, achieving systemness can be quite challenging. Some believe that simply having an established common EMR or holding cross-team huddles will lead to systemness. Although it can help, having these in place will not necessarily lead to systemness.
Let us look at the perioperative environment across multiple facilities within a system. An organizational structure including an executive administrator with perioperative councils and subcommittee support would need to be established. These groups would need to establish governance practices to focus on areas such as block management, optimizing operating room capability, growing volume, and/or physician engagement. Coupled with this is software or technology that can collect necessary data elements across multiple different EMRs. Gaining a consensus related to standard data definitions on things such as first case delays, average turnover length, case length accuracy, etc. is important to evaluate everyone from a common platform. As data is gathered and analyzed, individual scorecards can be disseminated, providing the ability for open dialogue amongst providers to create change processes.
A positive result resulting from systemness may be the ability to have better OR utilization times during normal business hours by shifting where providers are performing their surgeries. The key to any amount of success will require having the right people on board coupled with having technology and business analytics that can provide real-time operational data. In summary, achieving “systemness” will not only lower costs, but increase revenue and capacity while reducing variability in how care is delivered across the continuum.