The quality of care has been given first priority in all healthcare systems. Even though medical knowledge has expanded over time, with increased use of sophisticated technology and increased levels of physician trainings, the care quality, investment returns, and medical errors depict a healthy care system that is extremely underperforming (World Health Report,2000; Institute of Medicine, 2001). In the US, the healthcare system is always struggling as a result of the existing mismatch between financial flow, and the complexity of handling patients.

Many measures are however being employed by the US government towards implementing cost controls, as well as improving the efficiency of health care industry. This is the underlying reason why the paper will analyze why John Hopkins Hospital is among the top 100. Health Care system structure Given the reforms in the healthcare system, providers of health care will have to face severe pressure. John Hopkins, being among the Critical Access Hospitals, will have to overcome such pressures through its structure. The health care system structure is often affected by the establishment of health insurance.

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Health insurance and the existing trend towards health care, that is effectively managed, separate financial flow from the correlation between physicians and patients. In the current health care systems, health practitioners or physicians are directly paid for offering their services. As a result, payments made by clients to doctors do not take into consideration the costs of medical services. On the contrary, regular payments are made by employers to their Medicare, health plans, and insurance companies. Ideally, the payment is via electronic transfer from the banks.

Some payments are often deducted from the salaries of an organization’s employees, while others are paid by the company. Taking the US as an example, the healthcare system’s processes and structures are designed in a manner that responds to an individual’s medical needs. Furthermore, given the important recognition of population health and prevention, numerous hospitals have been forced to charge healthcare systems in order to effectively respond to the needs of individuals (Institute of Medicine, 1989; Declaration of Alma-Ata, 1978).

However, the dire need for organizations to respond to patients’ needs might result to organizational inefficiency and ineffectiveness. Thus, it is of great significance for leaders in the health care system to comprehend the significance of putting in place a sub-system that will foresee the provision of population health services, as well as prevent the occurrence of adverse health incidents. The sub-systems through the accomplishment of the above tasks will help in solving the existing difficulties in the health care system.

John Hopkins Hospital This hospital has been recognized as one of the top hundred hospitals in terms of performance and leadership. Johns Hopkins hospital as a firm provides the healthcare industry with clinical information and strategic business solutions. Amongst the 15 principal nationwide academic medical centers, it is the only institution that was selected. Johns Hopkins in conjunction with its senior management has been recognized for development of effective and consistence organization-wide improvement in performance.

The improvement provides measures that are critical in comparison to other hospitals present in the United States in the period between 1997 and 2001. The performance measures taken into consideration by the hospital include financial performance, operational efficiency and quality of care. Performance studies, unlike reputational studies, analyze over two thousand acute care hospitals. The analysis is done via utilization of performance of detailed and objective data. Such data include cost reports and Medicare reports that are available in the public domain.

Other measures are also utilized in identifying top performance leaders. These include expenses, risk adjusted complications and mortality rates, profitability, coding specificity, case mix, and outpatient revenue percentages. Therefore, for a health care institution to be ranked among the top hundred, it must `have saved more lives, rapidly discharges patients and maintains efficiency with the lowest costs possible. Between 1997 and 2001, important gains were made by performance improvement leaders (John Hopkins Medicine, 2004).

The gains include discharging patients earlier, lowering patients’ mortality index and decreasing the rate at which the hospital incurs expenses. John Hopkins hospital therefore deserves to be named among the top one hundred hospitals. This is because of its operation efficiency, which is a clear indication that it adequately meets the needs of its patients. Additionally, it insures proper management of its finances by decreasing expenses. Accordingly, the hospital has been on the forefront to ensure that its mortality index is also lowered.

Given the services offered by the hospital, it is recognized among the two existing principal teaching hospitals situated in Baltimore, Washington. The hospital is also known because of its performance improvement leaders, and its top priority is to improve the welfare and the safety of its patients. In conclusion, to improve the quality of healthcare, there is need for separation of large scale tasks and complex tasks. This separation will prevent the structure of the organization from providing both efficient preventive care and efficient medical care.