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Moore describes CHI's review of physician alignment and how that relates to safety initiatives. "In some areas, we have already realigned our structures such that our physicians are coleading service lines with our administrative personnel. We are examining all of our medical director contracts to make sure incentives are aligned with the performance outcomes we are looking for. For employed providers, we are realigning incentives by increasing the percentage of compensation based quality clinical outcomes."

Since healthcare reform challenges us to do more with less, we have to command our processes, procedures, and infrastructure. Some have considerable experience optimizing. Those who are new to the discipline may chafe a bit. Decisions will have to be made and actions will have to be taken with a great deal of precision. Those who are comfortable with data will have an advantage.

And as we shift from a volume-based to a value-based foundation, collaboration will matter more, and sharing data and sharing responsibility for positive outcomes will become more important. As Moore says: "We may have figured out how to care for folks once they get inside our walls, but we are going to be challenged to improve the quality of their care outside of our walls."

This article appears in the July 2012 issue of HealthLeaders magazine.

Reprint HLR0712-3

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