• The American College of Radiology invited me to give the annual Moreton Lecture in 2012. In the lecture, which is published in the Journal of the ACR, I addressed the challenges facing our profession in the era of accountable care. I asked physicians of all specialties to act like leaders, not like victims. I strongly urged them to take the lead on improving value themselves, rather than waiting for some external force to do it to them. And when it comes to quality and safety, I asked doctors to aim at what might be possible, rather than settling for what’s "passable." You can get a copy of the lecture at this link.
  • Dr. Reinertsen writes a regular column for
    Leadership, a publication of the Healthcare Financial Management Association. Here’s a link to a series of his columns on topics such as “How to Go Naked,”  “Just Say No,” and “Get Real: Authenticity and Transformation.”
  • The May 2011 issue of the Joint Commission Journal on Quality and Safety published an interview with me as part of the Eisenberg Award process. Marcia Delk from WellStar and Penny Carver from IHI asked some interesting questions such as:

    "What distinguishes hospitals that get results from those that don't?"
    "How do you go about engaging the medical staff?"
    "What are the NEXT big challenges facing health care leaders?"

    I gave some blunt answers. If that intrigues you, go to this link and read the article.

  • Clinical Integration and ACOs: Many of you are deeply involved in work to become more effectively clinically integrated, or even to become "Accountable Care Organizations." If so, you might want to take a look at our new white paper, "Achieving Clinical Integration With Highly Engaged Physicians." In this paper, Alice Gosfield and I describe the contextual drivers of clinical integration, offer a useful definition of "true clinical integration" along with practical examples, and present a fresh framework—the 4F's—as a sort of scaffold on which to build a more effectively integrated care system for your community.

And whether you're doctors looking to be employed by a hospital, or hospital execs seeking to create some sort of multispecialty group out of your independent medical staff, you might want to look at our paper on Informed Consent to the Ties That Bind before you sign anything.

  • Safety in Recession?: Hospitals and other health care delivery organizations have come under serious financial pressure during the recent recession, necessitating staff cutbacks and other cost-cutting measures. Can you cut costs and still be safe? Is care going to suffer because of your hospital's efforts to stay profitable? If you have some concerns about this question, you might want to read this short paper on "Safety in Recession."
  • Avoiding Quality Fraud: Just in case boards and executives need yet another reason to get serious about improving quality and safety, The Office of the Inspector General and other regulators have been taking an increasing interest in what is being called “quality fraud.” Examples of quality fraud include making false reports about quality, knowingly profiting from poor quality, and systemic failure to oversee quality. Alice Gosfield and I have summarized the issues for leaders in this recent cover article in Trustee.
  • A Practical Guide for Boards: The Ontario Hospital Association recently commissioned a paper designed to provide hospital Boards with a practical guide to how lay trustees can oversee clinical quality and safety. The paper describes best practices used by the Boards that are getting real results. In a recent interview with Robert Wachter, MD for the AHRQ Perspectives on Safety, Dr. Reinertsen explains the importance of the Board’s leadership in quality in more detail.
  • Seven Leadership Leverage Points for Whole System Results: Health care organizations have become good at doing quality improvement projects, but those projects rarely spread and link to other projects at a scale and pace that moves overall system performance noticeably. In this 2nd edition of a key IHI White Paper, James Reinertsen, Maureen Bisognano, and Michael Pugh have framed an updated set of “Seven Leadership Leverage Points” for leaders to consider, if they truly wish to achieve system-level results, rather than settle for a few nice projects. The Leverage Points form the core framework of the IHI Executive Quality Academy, an intense 3-day program for CEO-led senior executive teams, now in its 4th year.
  • Engaging Physicians in Quality: Hospital executives often ask “But how can we engage physicians in our quality agenda?” The answer starts with turning the question around, and asking: “How can we engage in the physicians’ quality agenda?” If you think “physicians’ quality agenda” is an oxymoron, read the IHI white paper on “Engaging With Physicians in a Shared Quality Agenda,” written by Dr. Reinertsen and 3 other IHI faculty. The white paper was recently revised and adapted for the National Health Service of Wales by Worthington and Baboolal in a beautifully written version entitled “Engaging Clinicians in a Quality Agenda. During 2008, Dr. Reinertsen was interviewed on the subject of physician engagement in quality for a number of publications. Some of those interviews can be read at the following links:
  • Boards and the MEC: One of the most interesting interfaces in hospital leadership is between the Board and the Medical Executive Committee, representing the organized medical staff. Alice Gosfield and I wrote this short paper for Trustee to give Boards some good ideas about how to engage together with physician leaders in the quality and safety agenda.
  • Boards and Dashboards: A specific question that comes up repeatedly is “what should our clinical quality dashboard look like?” This article, written with Michael Pugh as part of an IHI 5 Million Lives Campaign series, highlights some excellent do’s and don’ts of dashboards.
  • Can you Do Well By Doing Good? The business case for quality is described as being weak at best, and perverse at worst. An innovative approach to this problem can be seen in the paper Doing Well By Doing Good, developed jointly with Alice G. Gosfield, Esq.
  • Leadership Interview Series in Quality and Safety in Health Care: Jim Reinertsen has been commissioned by the Editors of Quality and Safety in Health Care to produce a series of interviews with exceptional leaders of quality and safety in health care. The first two interviews in this series are completed, and provide fascinating insights into the leadership approaches of two health system CEOs whose organizations are achieving significant results: Gary Kaplan at Virginia Mason, and Jim Anderson at Cincinnati Children’s.
  • 100K Campaign and Standards of Care: In the November-December issue of Health Affairs, Alice Gosfield and I have published a paper describing a powerful effect of the 100,000 Lives Campaign. This extraordinary effort to improve quality and safety, led by the IHI, has enrolled over 2,800 hospitals of every size and shape, in every state, comprising well over half the beds in the US. A number of hospitals have already experienced dramatic reductions in mortality by implementing up to 6 Campaign-recommended practices such as Rapid Response Teams, the Ventilator Bundle, and so forth. We argue that these six practices have become the legal standard of care for hospitals, overnight, simply by virtue of the public commitment of so many hospitals to implement the practices. As a result, all hospitals will need to implement these practices, or face malpractice liability risk. You can read the abstract of this paper or see the full paper here.
  • Ten Powerful Ideas for Improving Patient Care
    Health Administration Press
    March 2005
    Health care executives' jobs have changed. Instead of being responsible for facilities and finances, and delegating responsibility for clinical quality to physicians, hospital CEOs and others are now being held accountable for clinical quality results. And if they're to get results, they will need the strongest ideas possible, because leadership begins with ideas. This compact book, co-authored with Wim Schellekens M.D., CEO of the Dutch Institute for Quality, describes and illustrates ten of the most powerful ideas for clinical improvement that we know. And how do we know? They get results.
  • MetroDoctors: Journal of the Hennepin and Ramsey Medical Societies
    Health Policy Interview
    July/August, 2004
    This free-wheeling interview covers a range of topics from ideas for health system reform to physician report cards to "cookbook medicine." It provides a quick look at some of the policy positions advocated by The Reinertsen Group, in an informal format.
  • Straight Talk About Clinical Quality From Health Care CEOs
    Ernst and Young White Paper
    James L. Reinertsen, M.D., and Mark Finucane
    April, 2004
    In January 2004, I facilitated a conversation among a highly selected group of health care CEOs and other national health care leaders, on behalf of Ernst and Young. This white paper is a report of that conversation, which focused on three questions:
    1. Has clinical quality moved from “something that is professionally good to do, but not strategic,” to “I’d better make sure I hit my quality targets, or my job is on the line?”
    2. If quality has moved onto the strategic agenda, what do the new pay-for-performance models have to do with the shift?
    3. If quality is now strategic, and if health systems need to hit tough quality targets as reliably as they hit financial targets, how are they planning to succeed?
      This white paper provides a fascinating glimpse of how some of our finest leaders answer these questions.
  • Paying Physicians for High Quality Care
    Gosfield, AG, and JL Reinertsen
    Letter to the Editor, New England Journal of Medicine 2004; 350: 1910
    Arnold Epstein MD and colleagues recently presented a review of the new physician “pay for performance” models being implemented in regional trials around the country. In this publication, you can read the response that Alice Gosfield and I wrote to Epstein’s paper, along with some other responses, and Epstein’s reply. Pay-for-performance is getting a lot of attention these days. But these early versions of “paying for quality” tend to focus on the problem of under-use, and don’t address the very big quality problems of overuse and misuse. Furthermore, the revenue incentives tend to be small in comparison with the costs of correcting the under-use problems (which by definition require additional services to be delivered) and so the actual business case in many of these new payment systems is rather weak.
  • Zen and the Art of Physician Autonomy Maintenance
    Annals of Internal Medicine, Vol. 138, 992-995, 17 June 2003
    James L. Reinertsen, M.D.
    This provocative essay challenges the medical profession to begin a conversation about one of its most cherished values—individual clinical autonomy. The essay argues that hanging on to individual clinical autonomy for the practice of the science of medicine is counterproductive, because it means that we don’t use all the science we know for the benefit of our patients, and then society acts to reduce our overall professional autonomy. In a Zen-like paradox, we must give up autonomy in order to regain it. It would be better for us, and for our patients, if we practiced the science of medicine as a team activity, and the art of medicine as individuals.
  • It’s About Time: What CEOs and Boards Can Do For Doctors, Nurses, and Other Health Care Professionals
    Disease Management and Quality Improvement Report, Vol. 2, No. 4, April 2002
    James L. Reinertsen, M.D.
    What doctors and nurses want most is time—time to spend listening, examining, explaining, thinking, treating, and comforting. This “touch time” is precious, and is too often squandered by cumbersome processes of work, clunky information systems, and overlapping, confusing requirements for documentation, billing, and other needs. One of the best strategies for building better relationships with physicians and nurses is to work on a simple agenda: remove everything that steals “touch time” from them. This article gives some practical examples of how this work can be done, and of its impact on the quality of care, as well as the quality of work life for health care professionals.