Henry Ford builds a better managed care doctor
Managed Care College expands on skills
Faced with an increasing number of managed care contracts, the Henry Ford Health System in Detroit started its own continuing education program to help professionals learn to work more effectively, efficiently, and comfortably within today’s managed care environment.
Now in its fifth year, the Managed Care College has evolved from a mostly didactic program to a combination of classroom lectures and hands-on projects that teach participants how to improve the clinical care process.
"The only way people are going to acquire and master skills to analyze and improve the way we provide care is to actually do it," says John Wisniewski, MD, MHSA, director of the Managed Care College.
The nine-month course is open to doctors, nurses, allied health professionals, administrators, and social workers within the Henry Ford Health System. Each year, the health system invites treatment teams and individuals from across the system to apply for a slot at the Managed Care College. For most terms, there are fewer open slots than applications.
Wisniewski spearheads the teaching, assisted by a group of about 20 core faculty members who do classroom presentation or work behind the scenes.
Participants attend 10 classroom sessions between November and June and work on a project in which they apply what they learn in the classroom to make improvements for their own patients. (See story, p. 63.)
"If we just bring them to the classroom and lecture about clinical improvement and new advances in health care delivery, they may walk away with a better understanding, but it by no means guarantees they can do it in the clinical setting," Wisniewski says.
Wisniewski compares learning more effective and efficient care to learning to play a musical instrument.
"We don’t just bring students to the classroom and play recordings or talk about music theory. The way they learn to play the instrument is to receive instruction and practice on their own to discover their own technique," he adds.
Topics in the 1998-1999 sessions include understanding health care as a business, quality improvement, population and disease management, outcomes research, interdisciplinary team work, benchmarking, measurement and statistical tools, evidence-based care, and clinical guidelines and decision making.
Hands-on work
The course includes an open discussion about finances and politics involved in managed care contracts as well as the big economic picture in health care today.
"But when you get right down to it, the most important thing to do is to analyze the care process. If you’re not doing that, the financing and all the rest is not going to be that critical," Wisniewski says.
Participants in the managed care college are asked to look at the group of patients they care for and to do an honest assessment of how effective their practice is. These are among the questions they must answer:
• Do they accomplish what they want to accomplish?
• Do their practices illustrate the best scientific-based practices for the patients they are caring for?
• How can they improve their own practices’ performance?
"We use the rapid cycle improvement model, which is currently demonstrated to be one of the more effective ways of improving care. They don’t spend a lot of time analyzing and studying it to death. They gather enough information to make good decisions, try things out on a small scale to see if they work, then move onto the next cycle of learning," Wisniewski says. (For tips on conducting your own improvement process, see story on p. 64.)
The Henry Ford program is specifically geared to the needs of the health system. However, staff do conduct programs outside the institution and provide consulting services to a wide variety of health care organizations, Wisniewski says.
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