The nextHospital Manifesto: Hospital 2.0 from the ground up

As anyone who works in the industry knows, hospitals change at a glacial pace. Worse, just about every change taking place in hospitals today has been forced on the industry by outside forces.

But in this era of change, I say it’s time we rethink the traditional assumptions about how hospitals run–which still retain roots going back several decades–and revisit the notion of a hospital from the ground up.

We want to toss out assumptions about how and why hospitals fit services into their mix, how key employees are compensated, how inter-hospital competition is managed and more.

It’s  not that we think absolutely everything is being done wrong;  it’s just that it’s time to look at what’s not in on the radar screen and get it into view.

hospital and physician payment systems that will reward high‐value regions – meaning
health care markets that are both low cost and high quality In fact, to the greatest extent possible, we’re going to invent a new hospital model with its own set of assumptions–from how facilities are designed and built to what hospitals should do to support families, how patient-hospital relationships should work and more. We’re also going to explore what role social media should have in transforming the whole underlying process.

If this is your cup of tea, please join us as we lay one thesis out at a time. We welcome your additions, criticisms, commentary, skepticism and updates–whatever seems best.

In the mean time,  if you have assertions that belong on the list: e.g. “The nextHospital will never, ever keep patients waiting in line more than two hours,” lay them out. Let’s roll up our sleeves and get to work!

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • Katherine,

    What a fabulous invitation. Defining a reuse or redesign of hospital real estate (maybe even fewer beds and transforming them into educational centers) has been my passion for some time.

    We describe our current system of care as hospital dominated, and I don’t believe we just guide and work with hospitals to rethink their relationship to their community and the people they locally serve.

    This has been the focus of Planetree Hospitals. The founder and one of their former CEO’s Nick Jacobs integrated their own personal patient centric experience and vision into the way they lead. If you search at you can find an article or two about the Planetree experience.

    Nick Jacobs, who advises my project, is the former CEO of a hospital and research institute that has guided his work with imagination like this. To read Nick’s blog is to begin a process of learning how to think out of that box and innovate change.

    here is the link to Nick’s blog

    I have taken on learning how to educate and describe new visions that are not dominated by health profession or institution or sector and describe my project as WECare Metrics of Health. The people advising me and joining into support my activity are primarily my personal friends, who I met through work or reached out to me about their own experience with illness. Before I knew it I had over 50 people with leadership skill attentively listening to me and helping me incubate my ideas briefly described here:

    I began to think of a context for what this means to hospitals about 3 years ago, when i was asked to teach a class on social network analysis to 50 plus experienced commercial architects. 10 of these architects built hospitals.

    We played a game at the end of the class called, “think like a patient” instead of a hospital architect.

    One group of 8 took on designing a facility for cancer patients using an existing hospital. They broke from the mechanical way then think within 5 minutes because something unique occurred. Every architect playing the game had recently lost a family member to cancer. They decided to imagine a facility from scratch linked into a hospital that would have met a patient/family centric vision for care from diagnosis to a multiple set of outcomes.

    By playing the game where the game did not mean looking at a budget they were able to think outside the box about what might be perceived as off the wall ideas. In the end, they laughed real hard the process helped to open up possibilities that were not hard to do. Many ideas were actually practical and in some instances could save money and improve outcomes for the patient and family that are not usually factored into a hospital budget.

    My project is being organized to capture the stories of how people create these kinds of innovative changes and prepare them for a global audience to inspire others to do the same and build something relevant to their community.

    Right now I am focused on sparking more inspiration by investigating scenarios that influence people to think out of the box, like what is described at my blog.

    Thanks for staring your project so I can link in. I am enjoying learning with you.

    All the best,
    Lavinia Weissman

  • Katherine,

    Thank you so much for this invitation to participate in a much-needed discussion on the future of hospital care. I think it was Peter Drucker who said that leaders need to start with the question “What needs to be done?” before the priorities and solutions can emerge. Too often we interpret this to mean “What changes do we need to implement?” This is premature.

    Your challenge to explode the hospital model invites this question. “What needs to be done for critically ill patients?” These patients will always need some form of hospital care. We just need to figure out what that will look like. This is accomplished by asking ourselves what outcome is desired, i.e. “before and after” scenarios. Then we fill in the white space in between.

    Of course, the last 2 paragraphs provide no value to a cookbook solution designed for immediate and short-lived results. Your visionary invitation to a worldwide brainstorming initiative deserves much more than that.



  • Katherine,

    I love this concept and love the idea of not reengineering the patient care experience but rather completely dismantling it and starting anew. I do also love the no patient waits in line assertion but think that 2 hours is too long for such a facility and such vision.


  • If you serve food in a hospital cafeteria, make it healthy food. No burgers, chips, fries, chili cheese fries, double whipped mochaccinos. If budget is an issue, make it a Subway.

    But my strong preference is to throw out the concept of ‘comfort food’ and build the cafeteria experience up as a ‘behavior change and eating’ exhibit — museum quality interactive edu-tainment.

    When hearts, pancreases, livers, etc… start failing — why do hospitals always leave the behavioral causes out? Their opportunity to educate is golden. Can you say “teachable moment?”

  • Henry, Nick Jacobs did that at the hospital where he was CEO and in conjunction with Dean Ornish.

    In parallel he founded a research institute with its own autonomy to build the transational study of impact of change on food and infection and much more.

    Ed Kim, M.D, is focused on the issues you speak to as well as a Psychiatrist.

    Behavior change is complex and this is the conversation I have begun with Peter Deitz at Peter and I will be conducting an on line meeting in the future looking at the intersection of social media, open source and the bridge I have designed to credentialed and powerful resources that can not be accessed through open source.

    Currently I am very busy working with 2 other people re: two grants and one possible endowment that we are doing due diligence on for WorkEcology. So I can’t say much more than this tonight. I just came here for a break in between organizing my social venture into a 501C. George Bush has made that one very complicated.

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