Change is Hard Work

By Andre Harris, MD, chief medical officer, Miami Valley Hospital

In 2023, the Executive Team was tasked with improving our organization’s financial position. We successfully reduced our operating loss by more than 50% that year through a focused effort. In 2024, our goal was to reach break-even status. While we didn't fully achieve that target, we still recognized another 50% reduction in our operating loss year over year. This progress was driven by one key factor: change. I recall when I was first directed to improve workflows around patients admitted under observation status. Previously, these patients were not consistently placed in our dedicated observation unit, which specializes in expedient and safe turnover. Recognizing the need for change, we established new guidelines to optimize patient flow through the unit. The result was safe, more efficient, and cost-effective care.

Miami Valley Hospital is now undertaking another significant transformation: geographic patient placement and rounding. This shift is designed to improve communication between patients, nurses, and providers, ultimately enhancing the quality of care. Geo-placement fosters specialization, ensuring that nurses who prefer caring for post-operative patients, for example, can focus on that population without frequent interruptions from general medical cases. This specialization enhances efficiency, safety, and patient outcomes.

For our hospitalist group, geographic rounding means leading care on one or two units instead of being spread thin across eight or nine. This approach strengthens provider engagement in daily huddles, expedites discharges, and enables quicker intervention in emergent situations—all critical components of high-quality care.

In his book "Leading Change," John Kotter outlines the steps necessary for successful transformation. Establishing urgency, building a guiding coalition, developing a clear vision and strategy, and communicating change effectively are all part of his eight-step model. Change requires unfreezing old habits, implementing new processes, and solidifying a new normal—a challenging but necessary evolution.

Premier Health stands at the edge of a generational shift, positioning us to lay the foundation for an academic medical center. Achieving this vision requires new processes, hires, and goals—a commitment to continuous improvement and innovation. With our vision to Inspire Better Health, Premier is well-equipped for the future, embracing change as the pathway to excellence through Innovation.

Back to the February 2025 issue of Premier Pulse