Tower Health System (THS) of Reading, PA, USA recognized that physician leadership was needed for any transformation toward value-based care design and delivery. THS worked with The Leadership Development Group (TLD Group) to design the Applied Physician Leadership Academy™ (APLA™), which included interactive learning modules, assessment, coaching, and action learning. A needs assessment and interviews with key stakeholders informed content for the learning modules and the action learning projects. A pre- and post-program self-assessment and an emotional intelligence assessment were used for coaching sessions and personal development. Through APLA™, THS developed its existing physician leaders to manage change alongside health system executives. This reflective case history illustrates the incorporation of an evidence-based management approach in support of evidence-based organizational development practice.
TopIntroduction
Healthcare reform is considered to be one of the most significant challenges facing the United States (Shea & Gresh, 2015). According to Sultz and Young (2017, p. 2), “Consuming more than 17 percent of the nation’s gross domestic product, exceeding $3 trillion in costs, and employing a workforce of more than 12 million, healthcare occupies a central position in American popular and political discourse.”
Various changes have been tried and implemented over years with mixed results (Sultz & Young, 2017). More recently, practitioners and academics have advocated for a more systematic approach to the healthcare dilemma (Klasko, 2016; Sultz & Young, 2017). Klasko (2016, p. 83) speaks to four areas for future focus in a systems approach:
- 1.
Affordable, accessible healthcare regardless of race, religion, or pre-existing conditions.
- 2.
Training the providers of the future, not the past.
- 3.
Allowing healthcare to join the consumer revolution.
- 4.
Alignment of incentives and creative partnerships between patients and providers based on improvement of health individually and collectively.
This reflective case history focuses on #2, ‘Training the providers of the future, not the past,’ and how Tower Health System (THS) utilized training as part of its transformation.
The Organization
Tower Health System (THS), formerly Reading Health System at the time of program delivery, based in Berks County, PA, is a regional non-profit healthcare system that consisted of five major enterprises: Reading Hospital, a 647-bed acute care hospital; Reading Health Rehabilitation Hospital, which includes a 50-bed skilled nursing unit and 62 acute care beds; Reading Health Physician Network with more than 300 physicians and healthcare providers in both primary and specialty care; Reading Health Partners, a non-profit clinically-integrated organization with over 670 participating physicians; and The Highlands at Wyomissing, a 113-acre lifecare continuing care retirement community offering residential apartments and villas, personal care, and skilled nursing and rehabilitation. THS recently acquired five community hospitals: Brandywine Hospital in Coatesville; Phoenixville Hospital in Phoenixville; Pottstown Memorial Medical Center in Pottstown; Jennersville Regional Hospital in West Grove; and Chestnut Hill Hospital in Philadelphia.
Rationale for the Program
Market forces, such as the push for lowering cost, being increasingly measured on producing quality clinical outcomes, the economic changes toward value-based care and cost transparency, are leading organizations to have to get more involved in trying to figure out how they can deliver care across a care continuum and manage the health of the communities/populations they serve (R. Showers, personal interview, May 31, 2017). In consideration of all these forces and the organization’s desire for clinical integration, the role of the physician leader is paramount as physicians have become central players in any transformation (Lee & Cosgrove, 2014). Russell Showers, SVP, CHRO at THS, noted that the organization was motivated to develop a mature, clinically-integrated organization, yet THS physicians lacked a sense of ownership and accountability for changes to enhance the system. The driving force behind the academy was the need to develop THS physician leaders to take on the important tasks of growing the network, enhancing THS’s system performance, and positioning the organization for the future of value-based care delivery through physician leadership development.