Asking Questions From a Different Perspective

As a student in Dartmouth’s MHCDS program, Michael Goldberg was part of a diverse, five-person team whose “Action Learning Project” focused on improving quality of life for people living with chronic obstructive pulmonary disease at Goldberg’s home institution, the Long Island Jewish Medical Center. The group included two docs, a nursing director, a quality officer, and Goldberg — the Associate Executive Director of Finance at the 580-bed facility. “One of my roles in the room was to ask the questions no one would think of,” recalls Goldberg. “Coming from finance, I didn’t necessarily know exactly how things were done. I could ask ‘Why that?’ ‘Why not this?’” What would happen if patients were sent home with an emergency kit that would give them just enough relief to call the doctor, rather than automatically going to the emergency room? Would spending more on educating patients early in their treatments significantly reduce the costs of intervention later?

The probing questions helped lead to an innovative plan that realized a reduction in ICU visits by 60 percent and in-hospital mortality by 50 percent, while adding $1 million in incremental margin to the medical center’s bottom line. LIJ’s Execuctive Director, Chantal Weinhold, who traveled to Hanover to observe the presentation of the Action Learning Project, was impressed by the thoughtfulness of the process, and by Goldberg’s ability to explain — and sell — the group’s remarkable findings.

After completing the program, Goldberg was promoted to Associate Executive Director of Operations, Strategy, and Business Development. Early in his new position, the 16-hospital system was granted six pilot-programs by the Centers for Medicare & Medicaid Services Innovation center to participate in bundled payments. The Dartmouth action plan that Goldberg presented was one of them.