Words Are Important: Beginning to Define Behavioral Health Centers of Excellence
Where do we start?
The American healthcare system has a horrible track record in customer satisfaction, transparency, outcomes, value…wait, I better stop here or I’ll run out of room.
It also has a long history of standards setting and accreditation: identify the important elements; develop specific performance measures to test adherence with those elements; assess the healthcare organization against the elements; apply the Good Housekeeping (NCQA, Joint Commission, CARF, etc.) seal of approval if the score is high enough.
How does one reconcile this seeming paradox?
I have a hypothesis. I believe we have built a healthcare culture that, too often, sees those working in the system as the primary customer — the physician, the program manager, the health plan executive, the accrediting body reviewer — at the expense of the true customer: the patient. And we have extended this internal focus to the certification and accreditation process, steeping ourselves in technical language and concepts that are like foreign languages to anyone outside healthcare.
Don’t get me wrong. Metrics, standards and measurement are critical. It’s just that we have driven into a ditch by NOT putting the patient/consumer/customer at the center of the equation.
So let’s try something different as we begin to define a behavioral health center of excellence (BHCOE).
BHCOE Draft Definition
Every organization has a reputation, and there isn’t necessarily a correlation between the accreditation certificates on the wall and that reputation. Reputations are much more opinion-focused, based on a ‘social evaluation’ by the customers and larger community in which that organization lives. Would I be knocking down the door of XYZ clinic to get my brother, mother, daughter, niece, or best friend into care?
So, let’s start with a definition that may be more attuned to real people.
A behavioral health center of excellence (BHCOE) is known by the entire community as a great place to get care and a great place to work. It is an organization or program within an organization that is an integral part of the health neighborhood, providing rapid access to specialty behavioral health services that include high value, comprehensive, whole person care that supports resiliency and recovery and results in excellent outcomes, and high client satisfaction.
I need help…
I feel pretty good about the first sentence, but I feel like I’ve waded into techno-speak after that. Soon we will dig into five elements that may be prerequisites for being a great place to get care and a great place to work, but let’s first fix this definition.
Tell us what you think.
- How would you alter, replace, clean up the starting definition of a behavioral health center of excellence?
One more thing…
Many of my colleagues are telling me that this BHCOE initiative is vital to their future. They are also asking how they can better sink their teeth into this virtual dialog. Here’s a suggestion offered by Ralph Provenza, the executive director of United Counseling Services in Bennington Vermont:
“Create a Study Group.” Pull together a group of like-minded people within your organization or across organizations and start meeting every other week to discuss, argue, research, and write about centers of excellence and how to become one. To assist with this process, we’ve created a Study Group Guide. Check it out.
If you haven’t seen the BHCOE draft concept paper, download it here.