Advisory Board, in partnership with Medtronic, recently held a webinar to discuss hospitals' new strategy agenda after Covid-19. Health systems across the world have had no shortage of challenges and hurdles to overcome in the last year. Many organizations viewed these challenges as an opportunity to make meaningful progress or adapt their strategic priorities. If you missed the live session, here are three takeaways to keep in mind as you plan your post-Covid-19 strategy:

1. The health system's mandate now includes taking collective action on health equity as Covid-19 and global political environments have continued to shed light on health care access and outcome inequalities.

Health systems can't ignore these disparities any longer and many have used this time to make meaningful change. For example, ProMedica created their own National Social Determinants of Health Institute. The Institute works across ProMedica's provider and payer arms to integrate health equity into all care delivery and payment models. The President of Social Determinants of Health (SDOH) leads the institute—the first position of its kind in the world. ProMedica started small in 2010 with a large focus on data-driven work. They partnered with EHR vendors to build out modules and screenings to capture information on 10 different risk factors to identify at-risk patients and proactively implement care plans.

2. Chief executives have a unique opportunity to hardwire more agile ways to set strategy, allocate decisions, and recalibrate their organizations rather than backsliding into pre-Covid-19 habits.

We are moving away from five-year strategic plans to ones that are more dynamic, flexible, and use less information to make decisions. One Welsh System, Hywel Dda, took steps to modernize their strategy operations by creating an entirely new operating framework. They audited their build-up of overlapping priorities and objectives to create a clearer framework that consists of two different kinds of objectives: strategic objectives (i.e., lofty, future-focused goals) and planning objectives (i.e., tactical goals with clear sets of metrics). Their CEO described the six strategic objectives as smudges on the horizon while the 65 planning objectives were paddle strokes working towards bigger goals.

Hywel Dda also transformed their governance system, which now offers a clear, standardized path for allocating new responsibilities across different levels of the business. This process helped shift the organization from corporate accountability—in which the organization and its leaders assume fault if they fail to achieve strategic objectives—to personal accountability, in which each person along the hierarchy has a clear role to play and authority to make decisions and embrace their accountability.

3. Continue to embrace shifts in site of care and the ability to rebase costs – especially as virtual and non-acute care settings continue to develop.

Covid-19 has narrowly disrupted strategy, but broadly disrupted operations—affecting where and how customers access care. The opportunity and political will to shift care access points will diminish quickly, so executives should focus on three areas:

How to build a more flexible nursing workforce

1. Physical footprint – Systems have moved from acute-centric to community-centric care. Many have redesigned their physical assets to promote out-of-hospital care and decrease overall utilization. Continue to develop and market these new community-based services.
2. Care models – Care delivery is no longer tied to in-person models and clinicians' preference, but instead is virtual-first and elevates patient values. Covid-19 has fostered innovation in this space as well. For example, we have seen Emergency Department “buffers” in the UK and Ireland where there are alternate locations or triage tools, such as appointment-only EDs, that route non-emergence cases away from EDs. Many systems have been battling surgical backlogs to which we've seen some create clinical leadership groups designed to review and discuss high-value surgical substitutions to replace non-urgent surgeries for patients on the bottom of their waiting list. Continue to use this time implement long-sought after care model changes.
3. Workforce – Systems have implemented a flexible staffing approach, where individuals can move across the system based on staffing needs. More flexible staffing models allow systems to redeploy acute staff into the community as needed as well as better retain staff. Continue to invest in staffing alternatives that prioritize safety and scale.

Looking ahead

While it may be a new year, we know our health system partners will continue to struggle with a plethora of complex problems. We think the health system executive's post-Covid-19 playbook will have to encompass these priorities as we all adjust to a post-covid world. Medtronic and the Advisory Board partnered to deliver a series of webinars for hospital administrators specific to Covid-19. You can access all three webinars (from October, December, and January) via this link.

Slide deck: Hospitals' new strategy agenda after Covid-19

From primary to long-term care, all providers had to rapidly adopt their working models to prepare for surges in both Covid-19 and non-Covid-19 demand. Most jurisdictions avoided the worst-case scenarios and hospitals showed they could rapidly expand their bed capacity on short notice. Now looking forward, what are our expectations for the hospital?

Download the full slide deck from our recent webinar where we review both the experiences in various countries and their future plans to try to bring some clarity to this complex and wide-ranging question.

Get the Deck