Planning for the future

I have a pretty well-rehearsed answer for anyone who asks me what my role is all about. For those unfamiliar with the North Shore-LIJ Health System, I rattle off a few key statistics (16 hospitals, $7 billion in revenue, 48,000 employees) and then give a brief description of our clinical service lines, the ambulatory services division, which provides operational and back-office support to our physician practices, and the medical group, which integrates clinical services. For those who already know who we are, or press me on what I personally do, I usually say that my job is all about supporting and linking the service lines, and ultimately transforming our “federation” of almost 400 separate physician practices into a “high performing multi-specialty group practice.” It is, I often add (especially when someone replies with “good luck with that”), a “generational effort” that I don’t expect to complete any time soon.

Despite the obvious enormity of the task, my optimism about our ultimate success got a big boost at our recent Second Annual Medical Group Retreat. Our first retreat was held in January 2013, and shaped the path that we followed last year – building our quality program, enhancing our communication channels (including this blog), developing a physician compact, and promoting a common identity through consistent branding. All of those things help build a common culture, which is really what we are after.

This year, we focused on being more explicit about the things we need to do to deliver value to our various constituencies, which we defined as the patients we serve, the physicians who make up our membership, the health system of which we are a part, and the payers with whom we contract. We followed the same format as last year: a pre-meeting dinner with an outside expert to set the stage, followed by a full day of structured and professionally facilitated discussion.



I am proud to say that our outside expert was my brother, David Nash who gave us a frank picture of the current landscape of health care organization and financing. We also heard from our Health System CEO, Mike Dowling  who gave us a rousing talk about where our organization is headed. The next day, we worked through defining the characteristics that were critical to our future success as a medical group.

Here is what we developed:


We also did a critical self-evaluation about where we are now and where we believe we need to be in 3 years. The “spider web” is intended to illustrate relative performance in each of these domains, with “0” being the bottom of the relative scale and 6 being “world class.” Here is where we decided we need to be in 3 years:

Future Slide Grouping

In other words, the group determined that we need to be really good at all of these things to succeed in delivering value to our patients, physician members, parent organization and payers. I am excited that we are defining the path from “federation” to “high performing medical group” and looking forward to the journey.

What do you think?

14 thoughts on “Planning for the future

  1. These are important and I agree we need to be good at all of them to succeed and become the kind of organization that sets the standard for health care moving forward and in this region. I believe that the work in being a thought leader which includes health services and implementation research coupled with business excellence will drive quality of care, integration and the patient experience. Daunting? Maybe. But what a blast to be a part of it.

    1. Joe — thanks for your comment. I didn’t want to lengthen my post by discussing the details of each of the domains, but I believe you are absolutely correct. Our thought leadership ought to be in the arenas of health services and implementation research. With nearly 3 million patient encounters a year in our medical group, we have an incredible opportunity to study how to make the delivery of health care better (more effective, better experience for our patients, lower cost).

  2. It’s very heartening to see these initiatives that will help the group to provide superior care.
    In addition I would like to suggest that as a group we need to work with the communities we serve. That would further strengthen our relations with the population that looks to us for their medical needs. Maybe this can be further developed in 2014.

    1. Excellent point. We identified “patients” as the first of our key constituencies, but have not clearly articulated how we can work WITH communities, in addition to improving our ability to work FOR communities. I would welcome suggestions about how to begin that process.

      1. Hey Ira
        So there is a new Y opening in our community. With the help of Marie Frazzita( director of Diabetes Education for NSHS) and the executive director of YMCA are going to screen for Pre Diabetes / Diabetes and then offer relevant follow up. My vision is to engage local restaurants / Gyms etc / even community gardens/ kitchens in a dialogue that focuses on healthy habits or in my case ” Healthy Rockaway”
        I know this sounds a little ambitious but I Think We Can!
        Have a nice Wknd

  3. Great article Ira! I really like the High Performing Group evaluation of where you will be in the Future State. This has all of the components of establishing a High Performance team and I think will showcase your groups progress more explicitly in time. Thank you for sharing.

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