A Blue Ocean Strategy for Palliative Care: Focus on Family Caregivers.
To the Editor: In a short 10 years, specialty palliative care has grown exponentially in the U.S. evolving from an inpatient service found in just a few, early adopter centers to an integrated inpatient and outpatient interdisciplinary care team operating in two thirds of the 5600 U.S. hospitals. The Center to Advance Palliative Care estimates that more than six million patients were touched by palliative care in 2014, only a few years removed from the dark cloud of 'death panels' that greatly distorted American public perception. In the business world, strategy experts would call palliative care's remarkable growth and penetration high 'operational effectiveness. Thus, palliative care has performed better than its competitors to both grow and thrive. Without successes in operational effectiveness, palliative care would still be a niche service, instead of an expected consultation service in all U.S. hospitals. Operational effectiveness, which includes expansion into areas of care typically not sought after by others (e.g. complex psychosocial situations, difficult to manage symptoms, actively dying patients) has been the driver that has interwoven the palliative care 'organization' into the fabric of usual health care. Such differentiation of services has temporarily placed palliative care as relevant in the health care landscape. But, the current and past success in operational effectiveness does not elucidate what will keep palliative care outperforming future competitors. Strategies that have earned us success to date are not necessarily strategies that will bring us success in the future. It may be tempting to think that palliative care will never have competitors; however, others are definitely watching its success. It is time to discuss the strategic positioning of palliative care. Strategic positioning, as described by noted economist Dr. Michael Porter, 'attempts to achieve sustainable competitive advantage by preserving what is distinctive about an organization, by performing different activities from rivals, or performing similar activities in different ways. In essence, it is reflecting
Journal of pain and symptom management