Reclaiming Healthcare’s Healing Mission for a Sustainable Future

Abstract

Healthcare in the United States has reached a point where it is unsustainable for the long term, particularly for the poor, the elderly, and healthcare workers (HCWs) themselves. We propose a framework for making U.S. healthcare more sustainable, whereby the service returns to its core mission of healing. The framework casts that healing mission in broadly applicable, practical terms, whereby leaders of healthcare organizations and in the wider for-profit, not-for-profit, and governmental healthcare ecosystem take concrete steps to improve outcomes for patients and HCWs. Those steps involve aligning healthcare resources, incentives, and policies with the core mission of healing and then implementing change in specific ways that particular organizations have already shown are achievable and sustainable. We use those examples to illustrate how healing-oriented innovations in healthcare delivery get deployed and how progress toward sustainability then ensues. Lessons from these efforts can be tailored to individual healthcare contexts and institutions—and then applied on a national scale. The discussed initiatives can also guide the direction of future research on healthcare sustainability.

Cultivating wiser service systems through communication

“…Healthcare provides essential human-centered services, always seeks improvement (e.g. Agarwal et al, 2020;Berry, 2019Berry, , 2024 and has prominent stakeholders, such as the U.S government (Nuckols, 2017; U.S. Surgeon General's Advisory, 2022).…”

“…Disparate operations, such as emergency triage, ongoing and chronic care, pain management, aesthetic medicine, and health insurance, comprise the healthcare industry, but sometimes operate in opposition to one another (e.g. Agarwal et al, 2020;Berry et al, , 2024. Nevertheless, healthcare seeks to improve patient well-being.…”

“…Because these clinics are integrated into the center's ecosystem, they staff specialized clinicians who can access patients' EHRs and treat them more effectively than in an unincorporated emergency room. By integrating care, outposts such as OncoStat clinics can turn what could be a non-relational transaction (a one-time treatment) into an ongoing relational series of encounters with an extended clinical team (Berry et al, 2024). They also improve patient access to the main center by reducing non-scheduled patients .…”

“…Retention in healthcare begins with job redesign to prevent burn-out-related turnover (Berry et al, 2024). Employers should complement extrinsic factors, such as pay, with intrinsic elements, such as organizational values and culture (Shanafelt et al, 2021), and then effectively communicate those values with stakeholders.…”

“…Changes in EHR design as proposed by healthcare researchers or implemented by innovative healthcare organizations suggest the potential for EHRs to follow wise communication principles and improve self-structuring flows. Berry et al (2024) emphasized that practical changes to EHRs, such as highlighting unfinished tasks or allowing for natural language voice input, could elevate care and save time. Simplifying the EHR by either eliminating or automating the input of unimportant data could reduce strain on healthcare workers without sacrificing care.…”