Children’s hospitals and the job to be done

Oct. 3, 2022 / By Clark Cameron

Clayton Christensen was a management professor at Harvard Business School and one of the founders of the “Jobs to Be Done” theory. Christensen theorized that companies err when trying to determine what prospective customers want rather than trying to determine which jobs customers need done. For example, picture yourself standing in front of a drink machine faced with myriad choices. 

You might ask yourself the question, “What do I want to drink?” Christensen would argue the actual question you’re asking is, “What job do I need this drink to perform for me?” 

I need a late afternoon boost – I’ll hire the caffeinated cola.  

I just finished a tough workout – I’ll hire the sports drink. 

I need to wash down my lunch but don’t want extra calories – I’ll hire the bottled water.  

Identifying the specific job to be done is critical to hiring the right tool. This is especially true for the roughly 200 children’s hospitals in the United States. Children’s hospitals provide some of the most compassionate, cutting-edge care to one of the most vulnerable segments of our society. These highly specialized facilities are filled with clinicians and caregivers who have received unique training to treat their niche patient population – children. In fact, the child-centric philosophy doesn’t stop with clinical care. Most of these facilities don’t look or feel like a typical hospital at all. Bright, primary colors adorn the walls and artwork. Playrooms filled with toys, video games and puzzles are popular spots for patients, siblings and parents alike. And cute canine caregivers can often be found making rounds and eliciting smiles and hugs.  

Children’s hospital leaders take great care to ensure their entire operation is geared toward children, but that doesn’t always apply to their risk-adjustment software. Many children’s hospitals use risk-adjustment software tools designed for a Medicare population. This is akin to allowing a geriatrician to practice in a children’s hospital – not the right tool for the job to be done.  

As value-based care initiatives and programs become more prevalent for children’s hospitals, using software tools that are better suited for defining medically complex children and their distinctive use of health care resources. By partnering with associations, including the National Association of Children’s Hospitals and Related Institutions (or NACHRI), now Children’s Hospital Association (CHA), vendors can customize tools to meet the unique needs of children’s hospitals.  

The CHA is a national association dedicated to advancing child health through innovation in quality, cost and delivery of care for 220 children’s hospitals. When the need arose for CHA to stratify its pediatric population according to severity of illness, expected utilization and major functional limitations, it chose measurements that have included pediatric logic since the system was created in 2000. CHA set out to evaluate the rate at which children with and without chronic conditions moved into the Illinois fee-for-service Medicaid system and the Children’s Health Insurance Program between 2007 and 2010.  

So, when children’s hospital leaders ask themselves the question “What job needs to be done?,” they should strongly consider hiring technology that accurately risk adjusts their vulnerable population. 

Clark Cameron is manager of payer market strategy and development for 3M Health Information Systems.