Managing Disruptive Change in Healthcare

Lessons from a Public-Private Partnership to Advance Cancer Care and Research

Arnold D. Kaluzny and Donna M. O'Brien

A management case study of the design and implementation of a public-private partnership to enhance access, improve quality, and expand the research capability of community hospitals to bring better healthcare to the community
Offers description of the implementation and sustainability of a federally sponsored program by the hospital personnel involved in three community settings: a larger urban hospital, a rural hospital setting, and a national hospital system
Provides manager and clinicians with innovative guiding principles providing value-based care in a community setting
Works as a casebook in leading complex organizational transformations within the new environment of value and population health

Managing Disruptive Change in Healthcare

Lessons from a Public-Private Partnership to Advance Cancer Care and Research

Arnold D. Kaluzny and Donna M. O'Brien

Description

Healthcare faces unprecedented global challenges. Rapid advances in genomics, computational sciences, and technology -- as well as the new focus on value-based care and an increased trend toward healthcare commercialization -- represent disruptive changes to an already-fragmented delivery system. The healthcare establishment has been slow to adapt, and now faces rising cancer-care costs and lags in outcome improvement and genomically informed interventions.

Managing Disruptive Change in Healthcare codifies the US National Cancer Institute's lessons from utilizing a public-private partnership with community hospitals to navigate the change needed to increase patient access to high-quality cancer care, and enhance hospitals' capacity to conduct and support research initiatives. The treatment of complex diseases requires a delivery system capable of translating scientific advances into care that is coordinated across the full continuum; this book offers a blueprint to just such an infrastructure.

Managing Disruptive Change in Healthcare

Lessons from a Public-Private Partnership to Advance Cancer Care and Research

Arnold D. Kaluzny and Donna M. O'Brien

Preface

Introduction

Part One: The Challenge of a Changing Science

1: The Changing Science and the Rationale for a Public-Private Partnership
John Niederhuber and Maureen Johnson

2: The Turbulent Environment of Cancer Care
Mary Fennell, Donna O'Brien and Arnold Kaluzny

Part Two: Improving Cancer Care in the Community: Achieving Sustainability

3: The NCI Community Cancer Centers Program as a Public-Private Partnership
Arnold Kaluzny, Donna O'Brien and Joy Beveridge

4: Taking Cancer Care to a New Level: Spartanburg Regional Healthcare System
James Bearden, Bruce Holstein and Lucy Gansauer

5: Hartford at a Crossroads: Becoming a Community Hospital-based Research Resource
Andrew Salner, Jeffrey Flaks, Donna Handley and Robert Siegel

6: Leveraging a Public-Private Partnership to Implement a National Cancer Service Line: The Experience of Catholic Health Initiatives
Deborah Hood, John DiCola, Richard Deming and Dax Kurbegov

Part Three: Moving Forward: Lessons from a Public-Private Partnership

7:Transforming Cancer Care in the Community: Key Considerations for Sustainability
Donna O'Brien, Mary Fennell and Arnold Kaluzny

8: Global Implications for a Changing Healthcare Environment
Donna O'Brien, David Kerr and Arnold Kaluzny

Epilogue
Arnold D. Kaluzny and Donna M. O'Brien

Acknowledgements

Glossary of Terms

Appendix 1: Methodology
Appendix 2: Program-related publications
Appendix 3: Resources and Tools
Index

Managing Disruptive Change in Healthcare

Lessons from a Public-Private Partnership to Advance Cancer Care and Research

Arnold D. Kaluzny and Donna M. O'Brien

Author Information

Arnold D. Kaluzny, PhD, is Professor Emeritus of Health Policy and Management and Director Emeritus of the Public Health Leadership Program, UNC Gillings School of Global Public Health. He is also a Senior Research Fellow in the Cecil G. Sheps Center for Health Services Research and a member of the Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill. For over 30 years, he has served as an advisor to many NCI programs.

Donna M. O'Brien, MHA, is President of Strategic Visions in Healthcare (NY), a consulting firm focused on healthcare strategy, policy, and operations. She has held executive positions in academic medical centers and health systems, including MD Anderson Cancer Center, and served as a Special Advisor to the Director of the NCI for Community Healthcare Programs.

Contributors:

James D. Bearden III, MD, FACP
Vice President of Clinical Research, Spartanburg Regional Health System
NCCCP Principal Investigator, Gibbs Cancer Center
Principal Investigator, NCI Community Oncology Research Program
Spartanburg Regional Health System
Spartanburg, South Carolina

Joy M. Beveridge, MS
Senior Clinical Project Manager
Clinical Research Directorate/Clinical Monitoring Research Program
Leidos Biomedical Research Inc.
Frederick National Laboratory for Cancer Research
Frederick, Maryland

Richard L. Deming, MD
Medical Director, Mercy Cancer Center
Des Moines, Iowa;
NCCCP Principal Investigator (2010-2012)
Catholic Health Initiatives (CHI)
Denver, Colorado

John F. DiCola, MS
Executive Vice President, Enterprise Strategic Development
Catholic Health Initiatives
Denver, Colorado

Mary L. Fennell, PhD
Professor of Sociology and Health Services Policy & Practice
Faculty Director of the CV Starr Program in Business, Entrepreneurship and Organizations
Senior Investigator with the Brown University Center for Gerontology and Health Services Research
Brown University
Providence, Rhode Island

Jeffrey A. Flaks, MPH
Executive Vice President and Chief Operating Officer
Hartford HealthCare
Hartford, Connecticut

Lucy Gansauer, RN, MSN
NCCCP Administrative Director, Gibbs Cancer Center
Spartanburg Regional Healthcare System
Spartanburg, South Carolina

Donna M. Handley, MA, RN, BSN
Vice President of Operations
Hartford HealthCare Cancer Institute
Hartford, Connecticut

Deborah D. Hood, MBA
Vice President, National Oncology Service Line (Retired)
Catholic Health Initiatives (CHI)
Denver, Colorado

Bruce Holstien, MBA
President and Chief Executive Officer
Spartanburg Regional Healthcare System
Spartanburg, South Carolina

Maureen R. Johnson, PhD
Special Assistant to the Director
Project Officer for the NCCCP
National Cancer Institute (NCI)
Bethesda, Maryland

Arnold D. Kaluzny, PhD
Professor Emeritus of Health Policy & Management
UNC Gillings School of Global Public Health &
Senior Fellow
Sheps Center for Health Services Research
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina

David J. Kerr, CBE, MA, MD, DSc, FRCP, FRCGP, FMedSci
Professor of Cancer Medicine
Chief Medical Officer of Oxford Cancer Solutions
University of Oxford
Oxford, United Kingdom;
Adjunct Prof of Medicine
Weill-Cornell Medical College
New York, New York

Dax Kurbegov, MD
Physician Vice President, National Oncology Service Line
Principal Investigator CHI's NCI Community Oncology Research Program (NCORP)
Catholic Health Initiatives (CHI)
Denver, Colorado

John E. Niederhuber, MD
Executive Vice President, Inova Health System
CEO and Director, Inova Comprehensive Care
CEO, Inova Translational Medicine Institute
Falls Church, Virginia;
Professor, Oncology and Surgery
The Johns Hopkins University School of Medicine
Deputy Director
The Johns Hopkins Clinical Research Network
Baltimore, Maryland

Donna M. O'Brien, MHA
President and CEO
Strategic Visions in Healthcare
New York, New York

Andrew L. Salner, MD, FACR
Director, Hartford Hospital's Helen & Harry Gray Cancer Center
Director, Radiation Oncology Department
Principal Investigator for the NCCCP
Hartford Hospital
Hartford, Connecticut;
Associate Clinical Professor
University of Connecticut School of Medicine
Farmington, Connecticut

Robert D. Siegel, MD, FACP
Program Director, Oncology and Hematology Service
Bon Secours St. Francis Health System
Greenville, South Carolina

Managing Disruptive Change in Healthcare

Lessons from a Public-Private Partnership to Advance Cancer Care and Research

Arnold D. Kaluzny and Donna M. O'Brien

Reviews and Awards

"Kaluzny and O'Brien provide an inside view of a cooperative arrangement between the National Cancer Institute and thirty community hospitals across the United States to advance scientific breakthroughs and improve cancer care. The book documents the value of public-private partnerships in conducting and financing key healthcare initiatives and implementing complex programs. Managing Disruptive Change should be on the reading list for everyone involved in developing healthcare public policy." -- U.S. Senator Robert P. Casey, Jr.

"Great advances in biomedical science and technology have occurred in academic medical centers, but most people with cancer are treated, suffer and die in the communities where they live. Bridging this gap requires disruptive change beyond just expanding access to state of art care. It requires creating a delivery system that serves as a platform for discovery by constantly monitoring, understanding and improving how we provide the right care for the right person and achieve the right outcome. That is the story and legacy of the NCI Community Cancer Centers Program so well described in this book." --Andrew C. von Eschenbach, MD Former Commissioner of the US Food and Drug Administration Former Director of the U.S. National Cancer Institute President, Samaritan Health Initiatives

"Innovative programs, committed leadership, and the ability to change are necessary to provide state-of-the-art healthcare. Kaluzny and O'Brien brilliantly show how the NCI Community Cancer Centers Program (NCCCP), a unique public-private partnership, led to sustainable changes in cancer care programs. The case studies provide clear focus on the dynamics of several community hospitals that successfully implemented the program, and the book shows how NCCCP addressed challenges in care for the underserved and moved the bar in providing quality cancer care." --Otis W. Brawley, MD, MACP Chief Medical Officer, American Cancer Society Professor of Hematology, Medical Oncology, Medicine and Epidemiology, Emory University

"This book demonstrates how a desire to develop a coordinated treatment plan for cancer care in the community setting can be achieved in a period of disruptive change in healthcare. The unique role of government as a catalyst and the power of public/private partnerships to facilitate large-scale and sustainable change backed by learnings from cancer research and cancer care delivery has created a set of principles applicable to health care in general in our country and worldwide. Its potential is overwhelming." -- Gail L. Warden, President Emeritus Henry Ford Health System Detroit and Professor of Health Management and Policy University of Michigan School of Public Health, Ann Arbor

"Drawing upon the experience of the NCI Community Cancer Centers Program, the authors have created a must-have resource for community cancer care providers. With practical case studies, including lessons learned, this publication offers clear insight into the future of community-based cancer care and will serve as a guide to develop and improve quality and value in all programs." --Christian Downs, JD, MHA, Executive Director, Association of Community Cancer Centers