Physician-hospital integration Ramsey Clinic-style.
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Biomedical subjects
Publications and source records attributed to P A Sommers.
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Physicians must recognize the contemporary role consumers play in the delivery process. Although it is common knowledge that without consumers there would be little need for the elaborate health systems in existence today, few physicians actively plan for, implement and systematically evaluate services delivered. The rising cost of malpractice insurance in this age of spiraling materials and equipment expense, is forcing more physicians to consider better ways of serving and keeping their patients. This article describes one approach, consumer satisfaction.
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The organized management of medical services provided to special children can influence: The development of a coordinated follow-up plan for each child; reduced costs for parents by avoiding the duplication of tests and unnecessary trips to the doctor; and, increased referrals once it becomes known that services are being provided with the consumer in mind.
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Comprehensive health care planning can augment the educational programming for children with exceptional health and/or learning needs. The coordination of medical service and education is critically needed to reduce the traditional gulf between these two essential disciplines. Bridging this gulf will enable patients and their families, referral sources, and providers to collectively profit from the effort.
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Medical services provided to 402 children with exceptional health and educational needs between 1975 and 1978 were systematically studied to determine consumer satisfaction. Legislation (PL 94-142) has made it mandatory for complete services to be provided to exceptional children from birth to age 21. Although the major responsibility to provide these services lies with local public schools, physicians often are involved and can help to provide optimum care to these children. This report describes a medical-educational system that delivers multispecialty pediatric services. An inferential evaluation procedure has been applied to this system that shows how consumer input can lead to improved medical services. Statistical procedures used to examined the data include analysis of variance, utilized in comparing the satisfaction ratings over time, and multiple linear regression analysis, to predict medical service activities of importance to consumers.
Clinical services have generally been assumed by consumers to be of high quality, but this assumption has not been adequately tested. Consumers themselves can provide input into the assessment of organizational needs, goals and objectives. Once the specific service expected by the consumer has been defined in relation to services available, it is a routine task to monitor consumer satisfaction. The difference between optimum and actual consumer satisfaction can be determined. By analyzing this difference, follow-up procedures can decrease the discrepancy between optimum and actual consumer satisfaction levels. A management approach utilizing consumer satisfaction to monitor multispecialty pediatric care provided handicapped children is described in this article.
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Given recent federal and state legislation mandating all necessary services for children with handicapping conditions, it is incumbent upon the providers of health care services to demonstrate accountability for their services to children with special needs. A procedure to assess the satisfaction of parents and community-based case coordinators with clinical services provided to such children has been demonstrated. By focusing on specific service elements, it is possible to align optimum versus actual consumer satisfaction. Through an analysis of observed variance, the modification of documented weaknesses can decrease the difference between optimum and actual consumer satisfaction levels. This procedure will be continued on a bi-annual, longitudinal follow-up basis to monitor progress. The concept of consumer input into the provision of clinical services is relevant to other developments in the field of health care which place importance on administration accountability. Those health care providers who recognize the value of consumer input and allow for its incorporation into their service programs will be better able to adapt their systems to the emerging trend towards medical accountability. Self-ordered accountability is more meaningful, is easier to understand than government imposed regulations, and can be smoothly blended into an organization's goals and objectives.
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This article describes the results made by Ramsey Clinic during the second year following consolidation of the Clinic with a Hospital (St. Paul-Ramsey Medical Center); a medical education/research Foundation (Ramsey Foundation) into a public benefit corporation (Ramsey HealthCare, Inc.). Many issues inspired Ramsey Clinic to examine ways and means to stabilize its growth and development as a multi-specialty physician and dentist group practice in the highly competitive health care environment of Minneapolis-St. Paul, MN. Influencing the need to change were such elements as shrinking reimbursement for physicians from government and other third party payers; increasing malpractice and general liability premiums; as well as, escalating competition among area health care providers reflected by significant variations in charges for similar services and exclusivity agreements with HMO's and PPO's for select services. In the fall of 1987, Ramsey Clinic consummated its consolidation as a subsidiary member of Ramsey HealthCare, Inc., a public benefit corporation established by an Act of the Legislature of the State of Minnesota, 1986 Laws of Minnesota, Chapter 462. As a public benefit corporation, Ramsey HealthCare, Inc. was chartered to "engage in the provision and delivery of health care and related services." Ramsey Clinic serves as the physician organization for the corporation. An article appeared in the March/April 1989 issue of the Group Practice Journal titled "A Natural Partnership" which described the Ramsey approach and illustrated 1988 results following consolidation. Continued change has resulted in further integration of services among the subsidiaries with a focus on expense reduction, revenue enhancement and increased operating efficiencies. This article provides a longitudinal follow-up on operational amalgamations and 1989 results.