Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF September 6, 2019 | Archived Issues

President's Perspective: Systemness

By Thomas M. Priselac, President and CEO

What does it mean to be a health system? As Cedars-Sinai Health System continues to evolve, it is a good time to take stock of where we have been, review some key principles and consider what the future will hold.

In the 1990s, as consumers began seeking more ways to conveniently access more coordinated, higher quality and efficient care, hospitals and physicians began forming new relationships, recognizing that a new framework was needed to better serve patients and the community.   Cedars-Sinai's evolution began during that time with the formation of the Cedars-Sinai Medical Network.

The development of our health system has greatly accelerated in the past few years, with the addition of many quality medical practices throughout the region, along with the continued expansion of our faculty and academic programs; the opening of new Cedars-Sinai primary care and urgent care facilities; the acquisition of Marina del Rey Hospital; the creation of the Cedars-Sinai Health System and the affiliation with Torrance Memorial; and joint ventures such as the California Rehabilitation Institute (partnering with UCLA Health and Select Medical), Providence Cedars-Sinai Tarzana Medical Center and the Vivity HMO plan (where we are partnering with Anthem Blue Cross and six other prominent local health systems). 

There are several key principles reflected in the development of our system. The first is that the system's purpose is to best serve the community and carry out our mission of providing accessible, affordable care of the highest quality. The question then becomes how best to do that in a large, densely populated urban area with both a diverse patient population and diverse physician and hospital community. Answering this question in the Los Angeles area leads to the second principle, pluralism, which recognizes that the health system must balance the needs and goals of each of its entities within the larger goals of the health system.

A third principle is that the success of the system will be defined by the success of each of its entity organizations, and that the role of the health system is to enable its organizations and physicians to better serve their patients and their local communities.

Some examples of Cedars-Sinai Health System's pluralism are in the variety of different structures and organizational relationships: Torrance Memorial and its physicians—with an excellent reputation and longstanding strong relationship with the South Bay community—operates separately but coordinates with the rest of the health system in numerous ways; Marina del Rey Hospital was an acquisition purchased and now operated by Cedars-Sinai; and our joint ventures, such as the California Rehabilitation Institute, provide yet another structure for more convenient and coordinated expert care. In all cases, our goal is to have each relationship, regardless of organizational structure, best meet the healthcare needs of the patients and communities served and enable high-quality, accessible and efficient clinical care.

Within each of these relationships are certain common strategies being pursued to achieve the goals and purpose of the system.

Shared expertise (clinical and nonclinical)

Enabling each organization in the system to better meet the needs of its community includes enhancing the scope of available clinical services. Cedars-Sinai physician sub-specialists and their teams (in neurology, heart, cancer and neurosurgery, for example) have already helped numerous patients at Cedars-Sinai Marina del Rey Hospital and are partnering with their colleagues at Torrance Memorial to complement the excellent care already provided. Also, our nonclinical leaders in Quality Improvement, Finance, Enterprise Information Services and Human Resources are working with their counterparts throughout the health system to enable all of us to operate more effectively and efficiently.  In addition, clinical and nonclinical teams from the various organizations are working on common interests such as patient flow and reducing opioid use.

Coordination of care

Sometimes a patient needs highly specialized care, and at other times they don't.  Our health system can serve them best by having them cared for in the most appropriate facility.  The various hospitals and outpatient centers in the health system have been working hard to coordinate care among the different facilities so that it is as easy as possible for patients to receive a higher level of care when needed and—just as importantly—be treated at a facility closer to home when they no longer need a higher level of care.

Economies of scale

By centralizing purchasing (such as supplies, pharmaceuticals and equipment), all of the institutions within the health system have begun seeing cost savings as a result of the larger purchasing volume.  In addition, teams are working in every administrative area to identify the best approaches to optimize effectiveness and reduce operating costs.

Cedars-Sinai Health System will continue to grow and evolve in the years ahead, using a pluralistic model that enables a variety of structures. What doesn't vary throughout the system, however, is our shared commitment to a culture focused on meeting the needs of the patients and communities we serve. Our ability to do that in multiple geographic locations is greatly enhanced by the use of technology and other innovations. But more than anything else, our ability to succeed depends on each of you. Thank you for all you have done to make us who we are. I look forward to working with you as we build our path for future success.