Health system redesign: Southcentral Foundation’s Nuka system of care

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When Southcentral Foundation took responsibility for primary, community and mental health services for Alaska Native people in the late-1990s, quality of care and health outcomes were among the worst in the United States. Seventeen years later, Southcentral is widely regarded as one of the most successful examples of health system redesign in the United States and internationally.

Quality is up and costs are down, with A&E attendance, hospital admissions and referrals to hospital specialists reduced by 50 per cent or more. Long waiting times have been replaced by same-day appointments, despite budget cuts and lower funding per head of population. Southcentral is one of just 17 organisations to have received the Malcolm Baldrige National Quality Award, the most important recognition in the United States for excellence in health care.

About this masterclass

This one-off masterclass with two of Southcentral’s senior leadership team, Michelle Tierney (Vice President of Organisation Development and Innovation) and Steve Tierney (Medical Director for Quality Improvement) provides a rare opportunity for NHS leaders to understand the details of Southcentral’s care model and its approach to transformation. Michelle and Steve both played key roles in Southcentral’s improvement journey and were personally responsible for developing many of the most innovative features of Southcentral’s model.

We are delighted that Cerner have agreed to sponsor the masterclass. Cerner provides Southcentral’s electronic patient record, its population health management tools and its online health management tool for service users. Cerner will participate in the workshop and contribute on the role of IT in supporting Southcentral’s model.

Who is it for?

Southcentral provides a full range of primary, community and mental health services and led the way in developing population health approaches and holistic, multidisciplinary care in the US. It also plays a significant role in managing hospital services, which are closely integrated with the primary and community system.

Southcentral’s model is therefore of immediate relevance to the multispecialty community providers and primary and acute care systems vanguards, as well as to managers and clinical leaders in the many other local systems seeking to: restructure primary and community services into effective teams; bring together physical and mental health; develop more proactive care for high-risk groups; establish population health approaches; and bring together primary, community and hospital services within a coherent, integrated system.

What will it cover?

During this intensive one-day workshop Michelle and Steve will lead in-depth sessions on key aspects of Southcentral’s system with opportunities for detailed group discussion.

Topics covered will include:

  • an overview of Southcentral’s improvement journey and its approach to delivering health services
  • the role of vision, values and behaviours in supporting a high-performing health system
  • how Southcentral has put the customer in charge of the health system
  • Southcentral’s multidisciplinary model for primary, community and mental health care
  • Southcentral’s approach to population health and holistic, whole-person care
  • Southcentral’s integration of primary and community care with the hospital system
  • Southcentral’s use of informatics, data and analysis to support integrated care, population health and improvement
  • Southcentral’s development of recruitment, training, development and other infrastructure to support its model
  • Southcentral’s approach to creating an improvement culture and embedding continuous learning and improvement in the organisation.

For further information on Southcentral’s model, see The King’s Fund case study, Intentional whole health system redesign: Southcentral Foundation’s ‘Nuka’ system of care.