physician ‘alignment’ achieving cultural synergy in the pursuit of clinical excellence...
TRANSCRIPT
Physician ‘Alignment’Achieving Cultural Synergy in the Pursuit of Clinical Excellence
Mississippi Healthcare Executives Summer MeetingJune 5 & 7, 2013
Mark Williams, MD, MBA, JDChief Medical Officer
Leadership
Knowledge Management
Customer Focus
Strategic Planning
Workforce Focus
Process Management
Results
An atmosphere of mutual respect,
transparency and learning
‘As health care evolves, mutually productive physician relationships are critical . . . what are additional opportunities?’
Adapting to New Payment
Models
Providing More Coordinated
Care
Eliminating Avoidable
Harm
Embracing Evidence-Based
Care
Improving Efficiencies
Extensive Professionalization
Strong Personal Bonding
Focus on IndividualsCollegial RelationshipsSuspect of ‘outsiders’
On the front-lines‘Now’
Less Professional Support
Focus on PopulationsShared ResponsibilitiesFew Patient EncountersMust Prioritize Issues
Need to Manage Politics
The Culture ‘Gap’
Healthcare ExecutivesPhysicians
A Unified Culture That Leverages Respective Strengths
To Achieve Superior Results
1937
The Commonwealth Fund
A Legacy of Community
The ‘Competent’ Community• Collaborates effectively in identifying
problems• Achieves a working consensus on goals• Agrees on means to implement the
agreements• Collaborates effectively in the agreed
actionsVaughn L. Grisham, PhD
A Legacy of Leadership Development
Lead
ership 2000
LMS C
lass M
anag
er
MVV as
Lead
ership Core
CARES LDI
QED
Shining S
tars
PLI 2010
70
74
78
82
86
90
1996
2010
19982000 2002 2004
20062008
EOS Survey Results
The Opportunities• Physician Leadership Institute• Physician Peer Review• Co-Management • Comprehensive Unit-Based Safety Program• Continuing Medical Education• Strategic Planning
‘Designed to serve North Mississippi’s partner physicians by providing innovative leadership training, personal development and practical management/strategic planning skills sets’
NMHS Physician Leadership Institute, 2011
Builds Upon the Leadership Development Institute• Leadership training is part of the culture• Significant investments
• Specific Selection Criteria• Commitment Well-Defined• 40 Class Hours• 60-80 Out-of-Class Hours• Support of Group• Expectations Clear• Honesty• Respect• Active Participation• Future Leadership Role
PhysiciansTime
HomeworkPI Project
Future Leadership
OrganizationTop LeadersPreparation
TransparencyMaterials, Meals
Mutual Obligations
• Materials provided by organization
• Wide range of topics• Correlated with lecture
series
Servant Leadership
Finance/Operations
Medico-Legal
Strategic Planning
Crucial Conversations
EXCELPerformance Management
LEAN
PI
• CEO as ‘lead-off’• Focus on Servant Leadership
PI Projects - Examples
‘Tell me where you need me’
‘Will there be follow-up classes for alumni?’
‘Hope this organization will view this group as a source for leadership’
Employed Private
PLI Participation – Gathering Steam!
2011
2012
2013
2%
5%
8%
Physician Peer Review
• Multi-disciplinary• Training for new members• Multi-year commitments• ‘No Blame’ approach• Administration Participation
Co-Management
• Embraces ‘accountable care’ concepts• Initial project – partnership with cardiologists• Joint management of cardiac ‘cath’ lab• Thorough ethical, financial and legal analysis• Model for other service lines
• Fixed Fee• Manages lab operations• Provides strategic planning• Staff development• Public relations• Vendor and payer issues
• Performance Fee• Employee satisfaction (5)• Patient satisfaction (5)• Quality component (30)• Cost savings (60)
https://oig.hhs.gov/fraud/docs/advisoryopinions/2012/AdvOpn12-22.pdf
Baseline Result0
0.5
1
1.5
2
Percutaneous Coronary Interven-
tion Complications (%)
Baseline Result0
500
1000
1500
2000
2500
Supply Costs ($) Aligned Incentives
CostQualityService
Comprehensive Unit-Based Safety Program
• Physician champions• Annual Culture of Safety Survey• Goal is broad expansion of the CUSP concept • Goal of safest system in U.S. by 2015
Quality of Care Initiatives
Baseline Q2 Q4 Q6 Q80
5
10
15
20
25
30
Sepsis mortality rate (%)*
*Unadjusted
Continuing Medical Education
• Physician lead program• Needs-based content• ‘In-house’ expertise• Region-wide audience
Future Challenges – We’re all at the Table
“The problem with health care today is people like me – doctors (mostly men) in our fifties and beyond . . .now, at many health care institutions and practices, we are in charge . . . and that’s a problem . . .”
Thomas Lee, MD, Turning Doctors Into LeadersHarvard Business Review, April 2010
(President, Partners HealthCare System)
Or, maybe, they’re partners in seeking solutions!Physician Leadership Institute, NMHS
• Chief of Surgery• Medical Staff President• Chief of Medicine• Chairman of IRB• CUSP Advocate
Influence beyond numbers!
Thank you for allowing us to participate in the summer
ACHE event
North Mississippi Health Services