Outlook 2014: What's Trending in Healthcare

John Lawn

Population health management is key to succeeding under the Affordable Care Act (ACA). Except for large tertiary care hospitals, many facilities will likely see reduced inpatient volume and a shift to outpatient services. That means more care in clinic settings where it is more affordable. It’s also driving an emphasis on wellness and lifestyle management and the extension of clinical nutrition expertise to the community.

Cost management is clearly a big part of the ACA equation. In foodservice, that does not mean a reduction in quality, but an emphasis on finding ways to maintain quality while taking costs out. Finding that balance will be a big challenge.

For insights into the impact the Accountable Care Act could have on hospital foodservice departments, also review this story: http://food-management.com/healthcare/2013-healthcare-foodservice-market-outlook.

There was a lot of apprehension that accountable care might have a negative impact on hospitals’ willingness to support room service programs. So far we have not seen that. Administrations are recognizing their contribution to improving the patient experience.  

On the patient services side, I believe nutrition departments have demonstrated that room service is a best practice in terms of results and outcomes, but also that we must also deal with the perception that it costs more, especially in terms of labor. We have to be smart in terms of finding efficiencies that maximize the productivity of these programs, in clearly demonstrating those efficiencies alongside the outcomes on both the patient satisfaction side and the cost side.

Outpatient programs are growing in importance. We have to look at our programs in terms of serving the full continuum of care, not just on the inpatient side. How do we assist our institutions in terms of helping patients stay out of the hospital and in terms of reducing re-admission rates? I believe there will be great opportunities for directors to develop innovative models for nutrition-related services in the outpatient setting with these outcomes in mind.

Every service line is focused on identifying best practices and putting them in place across the system. In food and nutrition it requires that you really understand the many facets and drivers of our business. The goal is improved patient outcomes, and a best practice is one that provides the most efficient cost and labor model to get you to those outcomes.Executives and administrators do not see our interaction with patients as often as they see what we do in our retail cafés. So even though the patient and clinical side is a core competency, retail is the part that is most visible. It illustrates what we do and is closely associated with our level of expertise.

Retail needs to have its own best practice focus.  When our executives see food in our retail operations that is not healthy, it becomes an issue for them. The opposite is true when they see we are successfully improving dining behaviors. Retail execution is also a way to make them aware of our role in supporting physicians, staff and visitors. We need them to see how this strengthens the institution’s  ability to deliver and execute on its service mission.

After moving into a system position, one thing that became clear is the need for us to be able to point to and communicate what we do very well. It’s especially important for services that can be viewed as not part of the core business.  We need to make an effective case for our accomplishments in ways that make it clear this is part of the core healthcare delivery business.

Sometimes a senior administrator will ask about some aspect of a nutrition services program that he or she has heard about at another hospital or system. When that happens, it is important to be prepared to respond that, yes, we are doing something along these lines, or trying to address a similar issue ourselves, too. You need to look at such instances as a chance to begin a discussion that lets you determine the kinds of initiatives on which the leader wants to put more emphasis.  

Sustainability continues to be important. It’s the right thing to do for the community and the environment, and our departments need to find cost-neutral or money-saving ways to support sustainability as a goal. The public is very aware that  healthcare uses a lot of disposable materials because of infection management. They know that is necessary, but want to see us minimizing waste in other areas, like our retail foodservice operations. 

If you want to be seen as a leader, you have to speak the language of your senior leadership, understand the vision and strategies they have and align your department’s vision and execution with those goals.

Mentorship is important and can help you both advance in your career and develop into a better leader. To manage a food and nutrition department today, you need top-level management skills. That often means an advanced degree, but it is not just about getting an MBA or MHA. It is about finding leaders whom you admire and building relationships so you can ask questions and learn from their experience. You need to look outside of your department and understand what is happening among all the teams in your facility to build partnerships with them. You will be evaluated on your ability to work across silos and remove barriers to collaboration.

Benchmarking efforts, if anything, are going to become more important in healthcare than they have ever been. At AHF, we’ve worked to make our benchmarking program encompass not only performance metrics, but also metrics interpretation and strategies and guidance for improving those metrics.

In coming years, I think directors will be challenged by their administrations not only to show how they their operations "stack up" to those in a peer group, but also how they plan to improve their performance in a continuous way. They will also be asked how they can support efforts to improve outcomes and metrics across their organizations, including those by other departments. Those strategies can vary depending on the size and type of hospital, just as benchmarking itself does. And that is where peer group sharing like that offered by AHF can really help them in terms of strategy development. 

Engagement with your professional association is very helpful in these and other areas. It gives you a broader view and the chance to associate with potential mentors and peers outside your own organization. It can also help you better understand industry standards and establish benchmarks for what you want to accomplish.  When you identify a weakness, your association can help you find resources to address that weakness.

For insights into the impact the Accountable Care Act could have on hospital foodservice departments, also review this story: http://food-management.com/healthcare/2013-healthcare-foodservice-market-outlook.