Should a functioning hospital provide a “continuum of care”, in which they are attempting to care for patients as they recover, age, and deteriorate? Or is it best to bring a certain medical expertise to patients, who then move on to the next expert? In simple terms, think about this. An elderly female goes to a qualified hospital for hip surgery. The procedure is successful. But the best rehabilitation and recovery services for this case are in another rehab facility, across town.

An avalanche of studies have shown that patient outcomes are better at specialized medical centers with high patient volumes. The reason why? Practice improves process. The more certain procedures are performed, the better the medical practitioners get at it.

Cutting edge medical models are moving to a system in which patient care services are applied through “integrated practice units”. These teams or units can combine medical and surgical services for related conditions or body systems. Medical specialists accumulate enormous experience in their area of focus. High-patient volume allows for efficiency and expertise.

A hospital that does only a handful of certain procedures every week will not have the same outcomes as a center that does hundreds. Take obstetrics: Would you rather have your baby at a hospital that delivers a dozen or so babies a month, or one that delivers half a dozen a day? Which hospital is going to have the most practiced and experienced caregivers? Which hospital will be better prepared to handle complications or the unexpected?

Healthcare and medical delivery systems are changing. The focus should be how to deliver the best care possible to each and every patient. New ideas, changes in process, and new opportunities need to be examined. Economic success is not the whole story. The health of patients is also at stake.

– John D. Miller is the founder/owner of Home Care Partners, LLC, a Massachusetts business providing private duty, personalized in-home assistance and companion care services to those needing help in daily activities and household functions. He can be reached at: (781) 378-2164; email: ; or online at: