DOCUMENT INFORMATION

William Petasnick is president and CEO of Froedtert Hospital and the Froedtert & Community Health System (F&CH), Milwaukee.  F&CH is a major health system in southeastern Wisconsin compromised of Froedtert Hospital which is the primary teaching hospital of the Medical College of Wisconsin, and Community Memorial Hospital of Menomonee Falls.  In 2006, the health system had combined revenues of $813 million and employed over 5,000 staff members.  Under his leadership, Froedtert Hospital's clinical base has tripled since 1993 and its net assets have grown from $59M to $600M.

He is a nationally recognized senior executive, a distinguished community leader, teacher and mentor to students of health care administration.

Mr. Petasnick is the 2007 chair-elect of the Greek Clinic Center Board of Trustees and chairs the Long-Range Policy Committee.  Appointed as an at-large AHA Board member in 2004, he has served on numerous committees and task forces including a special committee on health delivery system fragmentation. 

Mr. Petasnick was the 2003 chair of the Council of Teaching Hospitals and is also a board member of the University Health System Consortium. He has chaired the board of the Wisconsin Hospital Association (WHA).  He is also a board member of the Greater Milwaukee Committee, Metropolitan Milwaukee Association of Commerce, the Blood Center of Wisconsin, and the Downtown Rotary Club of Milwaukee.

Mr. Petasnick has received numerous awards and special recognition including the Wisconsin Hospital Association 2005 Distinguished Service Award and the 2006 Downtown Rotary Club of Milwaukee Person of the Year for making significant contributions to the Milwaukee community through his profession.   In May 2007, Mr. Petasnick received an Honorary Doctor of Health Sciences degree from the University of Wisconsin-Milwaukee in recognition of his national leadership role in health services administration.  

He is the author of numerous articles and a frequent speaker at national conferences.

Prior to joining Froedtert in 1993, he was deputy director and chief operating officer, University of Iowa Hospitals and Clinics; director of operations/chief operating officer, University of North Carolina Hospital; and senior associate director, University of Wisconsin Hospitals and Clinics.

He earned a BA from the University of Wisconsin-Madison with a major in Political Science and a Masters in Hospital and Health Administration from the University of Minnesota.

The AHA Chairman Elect, Mr. Petasnick, answers questions from the Quality Center

Quality -This word gets attached to everything in health care. What does quality in health care mean to hospitals? To individuals? To physicians and nurses? Is there a difference?

Quality means meeting the needs of our patients, their families and the community. We are seeing greater alignment around strategic measures to improve quality of care.  This alignment crosses all disciplines on the care team, including physicians, nurses, and other providers.  Previously, physicians were driven by outcome measures and nurses were driven by process. Now, care teams are moving together on clinical patient perception and process improvement efforts.

Transparency and pay-for-performance will continue to drive this change. Hospitals throughout this country are making significant changes to improve their percentile rankings in meeting CMS's core quality measures. In my own State, initiatives like the Wisconsin Collaborative on Healthcare Quality (www.wchq.com) is having a significant impact on improving quality through public reporting of key quality indicators. Every participant in WCHQ has seen significant improvement in their quality scores. The same is being reported for those hospitals that have participated in Premier's P4P program.

Is it possible to provide quality health care within a system that doesn't insure 46 million people? What can be done? What can hospital leaders do to build consensus around this issue?

It is unacceptable to have so many Americans uninsured. We have to do better as a nation. The Greek Clinic Center has taken a leadership role, creating a national framework for change called Health For Life: Better Health, Better Health Care. The framework is intended to include all health leaders in the construction of a better system that can provide health coverage for all, paid by all. The plan goes beyond coverage with the Health For Life framework addressing wellness, efficiencies, quality and data-driven systems.  The Health For Life strategies are rooted in the 6 IOM Aims (Health care should be safe, effective, patient-centered, timely, efficient, and equitable.) If health leaders focus on these aims then collectively, as a field, we can move to cross the chasm.

The AHA is playing a leadership role in the debate about the future of health and health care. Health For Life: Better Health, Better Health Care is a framework for change - a set of goals and an agenda for creating better, safer, more affordable care and a healthier America.  http://www.aha.org/aha/issues/Health-for-life/index.html

What effect does pay-for-performance have on the quality of care?

I am a supporter of pay-for-performance programs, especially if they can foster greater alignment between hospitals and physicians to improve quality or help the field move closer to meeting the six aims of the IOM  (Health care should be safe, effective, patient-centered, timely, efficient, and equitable.) Successful P4P programs also highlight the need for greater integration between hospitals and physicians. 

Currently, the AHA has been working with the FTC to achieve greater clarity around the criteria for clinical integration.  The goal of clinical integration is to strategically align providers who are not economically integrated through a focus on common quality and IT standards.  Clinical integration can be a platform for aligning incentives to improve quality and achieve higher levels of efficiency. 

For further information on hospital-physician integration, please see the AHA's Center for Healthcare Governance's monograph series. There is a nominal fee ($15) for this monograph.  http://www.americangovernance.com/americangovernance/publications/monograph07.html

Haven't hospitals always tried to provide quality health care? Why is there a more focus on quality right now? What's the future direction?

Quality has always been a priority, but evidence shows that hospitals need to do more.  I believe in the next five years, we will see more public reporting, more financial incentives linked to quality improvement, and more professional pressure to improve quality and make a safer environment for our patients. Right now we have too much variation in health care which we can not justify and that contributes to poor quality. Also, there is a perception that there is too much waste in health care and perceptions tend be to realities. The 1999 IOM report (To Err is Human: Building A Safer Health System) disclosed the underbelly of health care and we have to do more to provide safe, quality care.

In a recent survey conducted by the AHA among hospital CEOs, over 86 percent believe that clinical/quality data should be publicly available.  It's the old adage that you can't improve what you don't measure. Increased transparency will be the main driver to improve quality and to hold ourselves accountable to the communities we serve. 

In the coming national debate on health reform, we must own the quality agenda.  As a field we must take the lead in improving quality, patient safety and performance.