• hospitals, health systems and their boards and medical staff leadership,

• physicians, medical staffs and other provider groups,

• professional associations and medical societies,

• collaborating representatives of multiple stakeholders within a market and others

on a range of issues associated with making quality happen. From addressing clinical process changes, to engaging physicians meaningfully, to organizing for better payment opportunities, the synergies in their approaches are more timely and powerful than ever.

As can be seen at each of their respective websites Alice Gosfield and Jim Reinertsen individually, are internationally sought after, dynamic presenters. Still, as the forces to be brought to bear to advance quality multiply, many of the presentations they do separately are also complementary when presented together. For example, Jim’s presentations on patient safety often raise questions about the kind of gainsharing programs the fraud and abuse laws now allow, a topic Alice discusses. Her presentations on clinical integration under the antitrust laws necessarily involve the types of clinical initiatives Jim elucidates. We encourage your review of the topics on which they present separately in order to customize an effective program for your group. In addition to these increasingly popular synergies, they also offer formally structured joint presentations.

Their unique joint offerings, described below, bring to bear a deep appreciation of the challenges of evidence based medicine, complex adaptive systems theory, and regulatory and legal barriers and constraints which they combine into practical approaches to making genuine change by recognizing the fundamental role of the doctor-patient relationship and how it drives other aspects of the system. Meeting the quality challenge turns, in part, on a real understanding of the current systems for payment, clinical processes of care, information reporting, performance measurement, liability, and organizational design. Jim and Alice are particularly well suited to address these issues in distinct, entertaining, and illuminating presentations.

Their offerings can be custom-designed to meet the needs and interests of the specific audience.

The following six topic areas represent currently popular selections:

1. Particularly for hospitals, finding ways to successfully engage physicians in a shared quality agenda is a critical ongoing challenge. Jim has been lead and Alice one of four faculty for the Institute for Healthcare Improvement (IHI) in presenting a program over two full-days on these issues. Alice and Jim are available to do a shorter version of the program which presents a contextual framework for culture change and a way to develop a practical, focused, customized plan for physician engagement. The framework includes six specific issues which must be addressed, techniques for success, and tools for the implementation of an engagement plan. The background for this work is available in the White Paper they co-authored for the IHI program “Engaging With Physicians in A Shared Quality Agenda.”

2. As the pressures on hospitals and physicians increase for demonstrated high quality performance, which increasingly is reported publicly and the failure of which can create legal liability as well, hospitals and physicians have no choice but to find creative, practical ways to work together to improve quality using UFT-A principles and more. We have always believed that hospitals and physicians will have to find ways to collaborate more deeply to truly advance quality . How to work together to improve quality and advance both hospitals’ and physicians’ positions economically without fear of legal reprisal, is a particular focus of our new presentations, reflecting the work in “In Common Cause for Quality”. These offerings address

• How to consider a business case for quality

• The quality demands on hospitals which cannot be met without the full engagement of physicians

• Debunking the myths of the law as a barrier to hospitals helping physicians economically

• Six ways physicians can help hospitals advance their work while benefiting the physicians directly

• Six ways that hospitals can directly benefit physicians while advancing the hospitals’ business case.

3. Based on their Health Affairs article they are available to address how the 100,000 Lives Campaign has changed the standard of care for hospitals and its meaning to boards, administration, medical staff members and hospitalists and intensivists in particular. Issues include:

• How is it the standard of care?

• What forms will liability take?

• What does it mean to the respective stakeholders in the hospital in terms of their own liability as well as their accountability for quality?

• How can this change be marshaled to improve care?

4. The principles of the PROMETHEUS Payment® Model (Provider Payment Reform for Outcomes, Margins, Evidence, Transparency, Hassle-reduction, Excellence, Understandability and Sustainability) will reward providers who manage their care processes effectively in accordance with science, collaborate with other similarly effective providers, and employ systems and techniques that bolster and facilitate this kind of work. Even if PROMETHEUS Payment® is not yet at a theater near you, what it rewards is what providers and physicians should be doing anyway. Jim and Alice are available to speak together on the internal provider processes and cross-provider collaborations which ought to characterize the work of the American health care system even if the PROMETHEUS model is not implemented. For hospitals, physicians and physician groups, integrated delivery systems and others, these issues should be explicitly considered as part of their implementation of quality relevant initiatives.

5. Jim and Alice jointly address implementation of the five principles of UFT-A. Among other issues, they present the advantages of UFT-A in comparison with pay for performance programs, including an elucidation of existing and developing models, pitfalls and implications.Their work reflects their collaboration on the white paper “Doing Well by Doing Good: Improving the Business Case for Quality” which itself picks up on themes from the Institute of Medicine study “Crossing the Quality Chasm”. They have developed a ‘unified field theory-applied’ (UFT-A) to health care in broad and deep ways. Their presentations can be both didactic and interactive, helping audiences to translate understanding into changed behavior and results.

6. After their success as the highest rated presentation in June, 2003 to the national Organized Medical Staff Section of the AMA dealing with new ways to think about medical staff activities and board relationships, as well as Jim’s work on the role of trustees as fiduciaries responsible for the quality of care provided by the organization, as set forth in his article, “Understanding and Improving Clinical Quality: The Role of Trustees”, they are linking this work more explicitly to principles of UFT-A in order to further strengthen the connection between physicians, their business significant others and improved quality. These presentations are appropriate for

• medical staff and board retreats,

• strategic planning meetings, medical society meetings

• hospital association meetings, and

• joint meetings of medical societies and hospital associations.

7. As report cards and pay for performance programs burgeon around the country, their purpose is to change provider and consumer behavior. We focus on the provider side of the street and recognize as Jim says, "if you're going to go naked, you'd better be buff." In the light of more transparency, Jim and Alice are available to address the context of pay for performance programs, how providers can succeed within them from a clinical and administrative perspective. Going beyond how plans pay providers, though, a new issue is how to pay physicians within their practice settings to reflect the changing incentives in the market. We also offer programs which address who is doing this already, how it has worked, and ways to prepare for the new environment.