Harkness Project Title: Inside the Black Box of Pay-for-Performance: Physician Motivation and Incentivization
Mentor: David Blumenthal, M.D., and Donald Berwick, M.D.
Placement: Harvard School of Public Health and Institute for Healthcare Improvement
Biography at time of Harkness Fellowship: James Mountford, B.M., B.Ch., a 2005-06 Commonwealth Fund Harkness Fellow in Health Care Policy, is a qualified doctor and project manager at McKinsey and Company, London. After obtaining a degree in physiological sciences at Lincoln College, Oxford, Mountford completed his bachelor of medicine and bachelor of surgery in 1998 at Oxford's Clinical School. He went on to be a house officer in general medicine in Oxford, and in general surgery/orthopaedics in Winchester. More recently, he held positions of senior house officer: accident and emergency at the Royal London Hospital (1999–2000) and senior house officer: cardiothoracic and general surgery at St. George's Hospital, London (2000–2001). In his position at McKinsey, he has worked in organizational design and performance management in a wide variety of industries but is mainly focused on the health care sector, including work with both health care providers and in medical devices/pharmaceuticals. His most recent work has focused on the design and impact of system reform to the U.K.'s NHS, and on strategy for U.K. hospital trusts. He is particularly interested in how behavioral change can be driven at the front-line in public-sector health care.
Project: James Mountford’s project explored frontline physicians’ views on the effectiveness of financial incentives, and other motivational and organizational determinants of behavior. He carried out case studies at four U.S. health care systems (Kaiser Permanente, HealthPartners Medical Group, Veteran’s Health Administration, and Brigham & Women’s Hospital), where he conducted close to twenty interviews with primary care physicians, specialists, and managers.
Career Activity Since Fellowship
- Director of Quality, UCL Partners, 2010.
- Improvement Fellow, NHS Institute for Innovation & Improvement
Current Position: Director of Clinical Quality and Value, UCL Partners (Updated 01/2014)
E-mail: [email protected]
Selected Publications
Mountford J, Marshall M. More dialogue, more learning, more action. BMJ Qual Saf. 2014 Feb;23(2):89-91.
Hunter RM, Davie C, Rudd A, Thompson A, Walker H, Thomson N, Mountford J, Schwamm L, Deanfield J, Thompson K, Dewan B, Mistry M, Quoraishi S, Morris S. Impact on clinical and cost outcomes of a centralized approach to acute stroke care in London: a comparative effectiveness before and after model. PLoS One. 2013 Aug 1;8(8):e70420.
Marshall M, Mountford J. Developing a science of improvement. J R Soc Med. 2013 Feb;106(2):45-50.
Hudson R, Fowler C, Mountford J. HIECs: Stepping good practice up a gear. Health Serv J. 2012 Aug 23;122(6318):26-7.
Gill D, Mountford J. What is a quality improvement project? Br J Hosp Med (Lond). 2012 May;73(5):252-6.
Mountford J, Shojania KG. Refocusing quality measurement to best support quality improvement: local ownership of quality measurement by clinicians. BMJ Qual Saf. 2012 Jun;21(6):519-23.
Lee H, Sturgeon SA, Mountford JK, Jackson SP, Hamilton JR. Safety and efficacy of targeting platelet proteinase-activated receptors in combination with existing anti-platelet drugs as antithrombotics in mice. Br J Pharmacol. 2012 Aug;166(7):2188-97.
Fielden J, Mountford J. A chance to optimise "value" in the NHS. BMJ. 2011 Jun 1;342:d3244.
Meyer GS, Torchiana DF, Colton D, Mountford J, Mort E, Lenz S, Gagliano N, Immen E, Heffernan J. The Use of Modest Incentives to Boost Adoption of Safety Practices and Systems. In: Henriksen K, Battles JB, Keyes MA, Grady ML, editors. Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 3: Performance and Tools). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Aug.
Mountford J, Davie C. “Toward an Outcomes-Based Health Care System: A View From the United Kingdom,” JAMA. 2010; 304(21):2407-2408.
Stanton E., Lemer C., Mountford J., eds. Clinical Leadership: BridginG the divide. Quay Books, 2009.
Mountford J, Webb, C. “When Clinicians Lead: Health Care Systems that are Serious About Transforming Themselves Must Harness the Energies of Their Clinicians as Organizational Leaders.” The McKinsey Quarterly, February 2009.
“A Three-Part Approach to Patient Safety.” Healthcare Executive, September/October 2008; 23(5): 70-72,74. Column by the Institute for Healthcare Improvement, Maureen Bisognano, chief operating officer, with contributions by Tom Nolan, Lindsay Martin, James Mountford, Chuck Neumann, and Dan Schummers.
Campbell, E.G., Gruen, R.L., Mountford, J., Miller, L.G., Clearly, P.D., Blumenthal, D., "A National Survey of Physician–Industry Relationships," New England Journal of Medicine 2007; 356: 1742–1750.