Leveraging Academic-Service Partnerships: Implications for Implementing the RWJ/IOM's Recommendations to Improve Quality, Access, and Value in Academic Medical Centers

Transformation of the current healthcare system is critical to achieve improved quality, safety, value, and access. Patients with multiple, chronic health conditions require integrated care coordination yet the current health care system is fragmented and complex. Nursing must play a key role in constructing a system that is value based and patient focused. The Robert Wood Johnson/Institute of Medicine (RWJ/IOM) report on the future of nursing outlines strategic opportunities for nursing to take a lead role in this transformation. Partnerships across academic institutions and health care systems have the potential to address issues through mutual goal setting, sharing of risks, responsibilities, and accountability, and realignment of resources. The purpose of this paper is to present Stony Brook University Medical Center's (SBUMC) academic-service partnership which implemented several of the RWJ/IOM recommendations. The partnership resulted in several initiatives that improved quality, safety, access, and value. It also characterized mutual goal setting, shared missions and values, and a united vision for health care. 1. Introduction The United States healthcare system is at a critical crossroad. Its future rests on the development of innovative, integrated systems that improve quality, deliver safer care, are more affordable, and provide access to diverse patient populations. The current healthcare system is unable to define who owns the patient and their family as well as who is responsible for shepherding the patient and their family through a complex, fragmented system where quality is mediocre, costs are high, care is scattered, and services often duplicated. Transformation of the current system relies on the implementation of pioneering models of care that address cost, access, and quality issues. As part of healthcare reform legislation, the federal government took a major step toward solving these issues beginning in March of 2010. The Department of Health and Human Resources authorized Medicare programs to contract with accountable care organizations (ACOs) to create entities that share in Medicare savings to achieve better outcomes at lower costs. This statute is built on a foundation to transform and improve patient care and place clinical outcomes at the forefront of healthcare. Development of ACOs provides an opportunity for healthcare professionals, particularly nurses to redefine their roles within the current healthcare system. In line with a movement toward the development of ACOs, the Robert Wood Johnson Foundation and Institute of