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Accenture’s Brian Kalis discusses the need to ‘rethink care delivery’


He spoke with Chief Healthcare Executive about controlling costs, thinking about the long-term, labor shortages and what healthcare leaders should be doing.

At a time when hospitals are facing labor shortages and serious financial pressures, Brian Kalis said it’s important for healthcare leaders to employ long-term strategy.

Kalis, the managing director of strategy for Accenture’s healthcare business, spoke with Chief Healthcare Executive at the HLTH Conference in Las Vegas last week. He shared his perspectives on the concerns he’s hearing from hospital leaders.

Most hospitals are worried about their finances after what has been a brutal year for most health systems. Many hospitals are in the red and more than half of U.S. hospitals are expected to finish the year in negative margins, according to a report by the American Hospital Association.

“Hospitals are really concerned about profitability pressures, which are really driven by high inflation as well as workforce shortages,” Kalis said. “Right now, they’re seeing that as really a need and an opportunity to rethink care delivery, and really blend technology and human ingenuity to improve access, experience and outcomes.” (See excerpts of our conversation in this video. The story continues below the video.)

Looking forward, Kalis said hospital leaders should examine areas where they are spending more than they should and look at ways to invest in better ways to deliver healthcare.

“Right now, it’s a really important time to both look at your cost structure and see where is excess cost that you can use to ultimately create a leaner structure to maintain and sustain your overall mission,” Kalis said. “Once you do that, that ultimately will free up capital to reinvest in new areas, to ultimately begin to transition, for care delivery reinvention.

“Balancing those two things, optimizing the existing business to be profitable at the core, and then shifting for that new model to be sustainable long-term, is an important balance right now,” he said.

Hospitals and health systems continue to grapple with a shortage of healthcare workers. Kalis said hospital leaders must think about ways to use technology to help reduce the burden on staff and maximize their productivity.

“A big part of this and it’s really important for hospitals struggling with the labor shortage to think long-term, and really think of how can you actually rethink the care model and blend technology and clinicians in new ways to ultimately improve labor productivity. And really that does require a rethink in how you can shift tasks,” Kalis said.

“How do you shift tasks both to different levels of labor, how do you shift tasks to patients, how do you shift tasks to technology as well,” he continued. “And really that requires a rethink of how healthcare can be provided in the home, in the community as well as in the physical space.”

Health leaders can also consider how technology can help hospitals overcome the challenge of nursing shortages.

Nursing leaders have said nurses are being saddled with too many duties that go beyond the scope of nursing, adding to burnout and driving some nurses away from the bedside. Kalis said leaders need to think more deeply about “the overall clinician experience.”

“Right now it really is important to rethink the overall care model, and actually think of how you can apply technology and people in different ways to improve labor productivity,” he said. “And with that it really requires a deep understanding of clinicians’ needs in operation on the front line, and how you can use technology to augment what they’re already doing, where they’re working together, versus in conflict with each other.”

Hospitals are also being pressed to address health equity and tackle the disparities in outcomes among members of minority groups and those with lower incomes.

The vast majority of healthcare executives say health equity is a key goal, according to a study released earlier this year by Accenture and HIMSS Market Research. About 9 out of 10 (89%) executives said they considered health equity a core part of their business. At the same time, only about one in three (36%) said they had specifically budgeted money to address health equity.

Still, more hospital and health system leaders are talking about equity than ever before, and it was a key theme at the HLTH Conference. Healthcare leaders can pick one area to improve outcomes, Kalis said, but the overall goal needs to be embedding equity into the organization’s delivery of care.

“I think a big part of this is how do you move beyond doing pilots or small-scale initiatives to ultimately making culturally competent care and equitable care as part of the care model and as part of the care delivery reinvention,” Kalis said.

“A lot of that starts small,” he said. “Take an initial initiative, one area and really look at how you can identify needs, solve that, and also measure the impact over the long term.”

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