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• W26612092 abstract "In 2005, a patient we'll call Don was diagnosed with an advanced oral cancer. He received a grim prognosis citing immediate surgery as the best option, even though it would have rendered Don unable to speak. Don sought a second opinion at Mayo Clinic, where a team of three cancer specialists met with him. They recommended radiation and chemotherapy but not surgery. Don and his wife temporarily moved 1,000 miles to Rochester, Minnesota, where he endured three tough months of treatment at Mayo. Today, Don is cancer free; he returns to his original Mayo team for annual checkups.Don had access to high-quality, efficient care, the main goal envisioned for accountable care organizations (ACOs). Often lost in discussions of healthcare reform and the ACO concept is the most serious disease afflicting American healthcare; fragmentation. Many intractable problems related to quality, access, and cost result from the walls-physical and otherwise-separating medical organizations, specialties, departments, buildings, and payment systems. antidote to fragmentation is integration-not the kind bom of mergers and acquisitions but the type that results from teamwork that leverages experience, information, and technology to provide value for the patient.MAYO'S TEAM-BASED MODELMayo Clinic is a nonprofit, integrated, multispecialty medical practice with more than 60,000 employees. It operates three main campuses in Minnesota, Arizona, and Florida and a community network of clinics and hospitals called the Mayo Clinic Health System.Mayo performs well on quality measures such as readmissions, complications, infections, resource use, and survival rates (Consumer Reports, 2013; Leapfrog Group, 2012) as well as on affordability. According to the Dartmouth Atlas of Healthcare 2008, the cost for the last two years of a patient's life at one leading academic medical center was $93,000; at Mayo it was $53,000 (Wennberg, Fisher, Goodman, & Skinner, 2008). Patients appreciate their overall experience at Mayo, and more than 90% of them voluntarily share favorable word-of-mouth feedback with others (Berry & Seltman, 2008).Mayo Clinic's success derives largely from its commitment to two core values; The needs of the patient come first (an aspirational value) and team-based medicine (an implementational value) (Berry & Seltman, 2008). An organization's core values are the ideals and principles that shape the behavior of people in the institution, and Mayo's values lie at the heart of its ability to demonstrate positive results.More than 100 years ago, the Mayo brothers imagined a healthcare environment that was much different from the provision of care in their day. Rather than individual doctors proudly entrenched in their own practices and beholden to no one, the Mayos envisioned physicians of many specialties working together with only their patients' well-being to consider. Teamwork was demanded, not simply encouraged. Sharing knowledge was a requirement, not a hope. Integration around the patient's best interest was uncompromising. Mayos insisted on a fixed salary for physicians so they would have no incentive to provide any more or any less care than the patient required (Clapesattle, 1941).Patients who come to Mayo Clinic with complex medical conditions benefit from the pooling of knowledge within the organization that is relevant to their care-they get the benefit of an integrated team. Despite its many strengths, Mayo isn't perfect. However, a medical organization that has thrived for 150 years and earned worldwide recognition offers valuable lessons-especially on teamwork.CAN ACOs FOSTER GENUINE TEAMWORK?Many health policy analysts and the Centers for Medicare & Medicaid Services view ACOs as keystones to delivering U.S. healthcare effectively and efficiently by promoting collaborative, coordinated care across multiple providers and organizations (Berwick, 2011). …" @default.
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• W26612092 title "Team-Based Care at Mayo Clinic: A Model for ACOs" @default.
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