Jason Koh, MD, the director of NorthShore Orthopaedic & Spine Institute based in Skokie, Ill., discusses NorthShore University HealthSystem's new approach to orthopedic and spine care.
The system transformed its Skokie (Ill.) Hospital into the Orthopaedic & Spine Institute, dedicating all 123 inpatient beds to orthopedic patients. The re-launched facility opened on April 1, aiming to become a destination center for orthopedic and spine cases.
Question: NorthShore University HealthSystem has transformed Skokie Hospital into the Orthopaedic & Spine Institute – the first orthopaedic specialty hospital in the state. What necessitated this change?
Dr. Jason Koh: The Orthopaedic and Spine Institute is a unique innovation in care delivery that will transform musculoskeletal care for patients, providers and payers by providing truly focused expertise that will deliver outstanding experience and outcomes in a highly efficient setting. Operational focus and teamwork in a dedicated facility will help us provide leading quality care.
NorthShore is already a market leader in the Chicago region for orthopedic and spine surgery, with nearly a quarter of our inpatient and spine surgery patients coming from outside of our primary service area. This is a result of the excellence of our surgeons and hospital quality. As a system, NorthShore’s hospitals are in relatively close proximity, so we do not have to replicate all services at all four hospitals. Therefore, we have a unique opportunity at our Skokie Hospital campus to build on existing expertise and centralize orthopedic and spine care to deliver an even better experience to our patients at a lower cost. In addition, given the easy access off major highways, we will continue to grow as a regional destination center for orthopedic and spine surgery.
Q: Why specialize in orthopedic and spine?
JK: Bone and joint disorders are the most common cause of severe, long-term pain and disability. As Americans get older there will be increased need for high quality musculoskeletal services. Patients know that an orthopedic specialty hospital can provide differentiated, expert care that is focused on their needs, and our research has shown that patients are willing to travel and drive past other hospitals to get this specialized care.
Q: Who do you see this impacting and why? Is it the local community or broader?
JK: The Orthopaedic and Spine Institute will have a tremendous impact for patients, providers, and payers in the entire region. Patients now have access to specialized teams that are experts in their orthopedic/spine condition and have a seamless experience across the care continuum. Orthopedic and spine surgeons are able to operate in a dedicated environment with highly efficient teams and specialized operating rooms that allow for greater productivity and a great experience.
With nearly $400 million invested in the campus, we are providing leading edge technology and outstanding facilities. Additionally, we've developed alignment mechanisms so that physicians have a real say in the operations. Payers already know our readmission and complication rate is about half of the national average, but we'll see even better outcomes at a lower cost through reduction in variation and improved efficiency.
Q: How will you build a culture within the orthopedic care delivery teams to deliver high quality, value-based care?
JK: Our orthopaedic teams are already focused on high quality care, and what we've already seen in the first weeks at the Orthopaedic and Spine Institute is that being in a specialized facility really creates a sense of pride and dedication. We are able to further refine our standardized processes; and with a cohesive, comprehensive team we've been able to make great advances with our value-based care initiatives, such as bundled payment with private payers such as Optum as well as BPCI-Advanced.
Q: What is the benefit for patients?
JK: Patients receive care from specialized teams that are experts in their orthopedic/spine condition. Expert surgeons, anesthesiologists specializing in the latest pain modalities, nurses trained in orthopedic and spine care, and therapists on the cutting edge of orthopedic and spine rehabilitation are all focused on delivering a differentiated experience that cannot be as easily delivered in a traditional hospital.
In addition, the Orthopaedic and Spine Institute will allow us to create a seamless patient experience across the care continuum where our integrated system can manage the details from preoperative care through post-operative rehabilitation, so the patient can focus on returning back to maximum function as quickly as possible.
Q: What is the future of community hospitals?
JK: Given the external pressures facing healthcare, hospitals must evolve from "one size fits all" care models to be more efficient and focused care delivery systems. As Michael Porter from Harvard Business School has noted, specialization and focus is a key element of value-based care. NorthShore University HealthSystem is fortunate to have the scale, coordination, and geographic proximity of system hospitals to deliver a specialized care model at the Orthopaedic and Spine Institute that can create value by improving quality and decreasing cost. This is unlike most community hospitals and health systems that may be less integrated and will face continued challenges.
Q: How do you see the hospital growing in the future? What trends and technologies will drive the evolution of orthopedic care delivery?
JK: We are already seeing tremendous interest from great surgeons who want to work in a dedicated orthopedic and spine hospital. The surgeons who are already a part of the institute are seeing increased individual productivity gains as part of being in a highly efficient system. Additionally, patients around the region are excited to learn that there is a specialized facility focused on their needs, and are interested in coming to the Institute. As we’ve noted, nearly a quarter of our patients are already coming from outside of our core geography. We also expect that payers will further recognize the increased value proposition of our already high performing specialized hospital.
Orthopedic and spine surgery are becoming less invasive while simultaneously more precise. Advances in non-opioid pain management have made patient recovery faster and more comfortable. We see that there is an increasing number of outpatient total joints, and have developed fast-track processes that allow surgeons to safely perform these procedures with the backup resources of a specialty hospital. On a larger scale, the efficiencies and quality of focused facilities will drive further value, and there will be a shift from less differentiated generalist facilities.