Richard Bohmer is a New Zealand-trained doctor and a management academic. He has practiced as a hospital and primary physician and as a medical administrator. He was the Clinical Director for Quality Improvement at Massachusetts General Hospital and then spent 18 years on the faculty of Harvard Business School where he established graduate and executive programs in health care management and helped establish the MD-MBA. He has published extensively in the medical and management literatures and is the author of Designing Care: Aligning the Nature and Management of Health Care (HBS Press, 2009) and Managing Care: How Clinicians Can Lead Change and Transform HealthCare (Berrett-Koehler, 2021).
Dr. Bohmer currently resides in the United Kingdom where he is a Senior Visiting Fellow at the Nuffield Trust. He works independently with numerous hospitals and health authorities around the world to help them establish clinical leadership and management models and to improve their performance.
Healthcare systems worldwide are swamped with demand, short of resources, and ill equipped to respond to global health crises like COVID-19. This book is a guide for reforming healthcare delivery.
The way we organize care matters, and the people best positioned to drive this are the clinicians who deliver care. The book offers a framework for transforming healthcare delivery that covers operational design, change management, long-term learning, and organizational environment. It describes the work of leading local operational change; identifies key decisions to be made, actions to be taken, and factors that must be taken into account; and gives clinicians the tools and perspectives they need to lead change.
The challenge of modern healthcare is to develop better organizations capable of delivering compassionate and individualized care on a grand scale while preserving the personal relationship between clinician and patient and the quality of care at the ward, operating room, clinic, or practice. Informed by extensive research and experience with systems all over the world, Richard Bohmer shows how organizations may transform by deploying a new workforce of clinical change leaders and how clinicians can take greater control over their own working environments.
This book is for clinicians who want to manage the care they participate in delivering and change the local systems that support their work. It is also for managers who want to create more sophisticated delivery systems that better reflect important differences among diseases and patients.
Delivering Value-Based Healthcare
- Bohmer, R.M. The hard work of health care transformation. New England Journal of Medicine, 2016
- Bohmer, R.M. The four habits of high-value health care organizations. New England Journal of Medicine, 2011.
- Bohmer, R.M. and Lee, T.H. The shifting mission of health care delivery organizations. New England Journal of Medicine, 2009.
- Bohmer, R., Ives Erickson, J., Meyer, G., Blanchfield, B., Mountford, J., Vanderwagen, W. and Boland, G. 10 Leadership Lessons From Covid Field Hospitals. Harvard Business Review, 2021.
- Bohmer, R.M. Leading clinicians and clinicians leading. New England Journal of Medicine, 2013.
- Bohmer, R. The instrumental value of medical leadership. Engaging doctors in improving services. London: The Kings Fund, 2012
- Bohmer, R., Shand, J., Allwood, D., Wragg, A. and Mountford, J., 2020. Learning systems: Managing uncertainty in the new normal of COVID-19. NEJM Catalyst Innovations in Care delivery, 2020.
- Shand, J., Allwood, D., Lee, N., et al. Systematically capturing and acting on insights from front-line staff: the ‘Bedside Learning Coordinator’. BMJ Quality & Safety, 2021.
Responding to Covid-19
- Meyer Gregg, S., Blanchfield Bonnie, B., Bohmer Richard, M.J. and Craig, V. Alternative Care Sites for the Covid-19 Pandemic: The Early US and UK Experience. NEJM Catalyst Innovations in Care Delivery, 2020.
- Bohmer, R.M., Pisano, G.P., Sadun, R. and Tsai, T.C. How Hospitals Can Manage Supply Chain Shortages as Demand Surges. Harvard Business Review, 2020.
- Cheung, C.R., Finnemore, A., Handforth, J., Bohmer, R., Christiansen, N. and Miller, O. Developing new models of care at speed: learning from healthcare redesign for children with COVID-related multisystem inflammation. Archives of Disease in Childhood, 2020.
Around the world nations are working to reform their healthcare systems to address persistent problems in quality, burgeoning cost, and most recently to respond to and recover from Covid-19. However, developing new national policies, innovative technologies, or revised organizational strategies are not enough on their own to improve patient care. To be effective, these must be translated into operational change in each and every care delivery unit. Local operating system redesign is the final common pathway for national policy and organizational strategy implementation and new technology adoption.
Institutions that have successfully implemented local operational change at scale—and delivered higher value as a result—are characterized by a clinically oriented approach to management. Clinician leaders deep within the organization play a prominent part in both day-to-day operational management and long-term performance improvement. These institutions have a set of structures and processes in place to support a routine of ongoing learning and system redesign.
The Clinical Leadership and Care Redesign program is designed to help healthcare delivery organizations implement an approach to the clinical management of care. It trains teams of local clinical and operational leaders to take a greater role in the redesign and ongoing oversight of their own operating systems and helps delivery organizations to deploy a systematic method of operating system redesign at a scale that is needed to sustain long-term performance improvement.
The program combines in-person leadership development with practical team-based operational redesign. It prepares local leaders to take accountability for the long-term performance of the systems in which the practice their professions, and it develops the organizational structures and processes to support a sustainable approach to transformation.