Creating Value in Organization Structure - The Service Line Approach -- Part 1: Success is Measured by Organizational Trust

Tuesday, May 1, 2012 | MedAxiom

Concurrent with the trend of cardiovascular integration, whereby a hospital purchases the CV practice and subsequently employs the cardiologists, – is a re-emergence of the service line as an organizational approach to the combined entities. The promise of integration, in addition to stabilizing cardiologist income and thereby assuring the presence of cardiologists in the market, is that both hospital and physician performance from a quality, operations and financial perspective is enhanced when the provider fragments are aligned. For clarity, the overriding goal of integrating the hospital and cardiology practice organizations is to create value for patients by leveraging the multiple resources and talent perspectives harbored within the two organizations. The belief is that although the organization’s structure and culture are significantly different, the multiple perspectives and talents – that inherently see the world in different ways – are materially important in optimizing the performance of the merged organization.

Progressive programs, whose aligned vision and commitment are to create a better performing cardiovascular enterprise, will surely prevail in the face of changing and heightened demands of our healthcare environment. The integration of the hospital and the cardiology practice entities allow both organizations to change their historical vertical perspective of care delivery into a truly patient-centric model that works horizontally across the care continuum. From a cardiology practice perspective, the organizational equation is represented below, where – with selling the practice to the hospital - the opportunity for increased impact on the care continuum is increased, but whose autonomy is decreased. The ability for the cardiology practice to maximize its impact in the integrated environment, in any regard, is determined by the degree of organizational trust between the hospital and the cardiology practice – referred to in the model as the “trust-o-meter.”