Physician ‘Alignment’
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Transcript of Physician ‘Alignment’
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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
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Leadership
Knowledge Management
Customer Focus
Strategic Planning
Workforce Focus
Process Management
Results
An atmosphere of mutual respect,
transparency and learning
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‘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
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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
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A Unified Culture That Leverages Respective Strengths
To Achieve Superior Results
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1937
The Commonwealth Fund
A Legacy of Community
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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
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A Legacy of Leadership Development
Lead
ership 2000
LMS C
lass M
anag
er
MVV as Le
adersh
ip CoreCARES LD
IQED
Shining S
tars
PLI 2010
70
74
78
82
86
90
1996
2010
19982000 2002 2004
20062008
EOS Survey Results
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The Opportunities• Physician Leadership Institute• Physician Peer Review• Co-Management • Comprehensive Unit-Based Safety Program• Continuing Medical Education• Strategic Planning
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‘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
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Builds Upon the Leadership Development Institute
• Leadership training is part of the culture• Significant investments
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• 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
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PhysiciansTime
HomeworkPI Project
Future Leadership
OrganizationTop LeadersPreparation
TransparencyMaterials, Meals
Mutual Obligations
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• Materials provided by organization
• Wide range of topics• Correlated with lecture
series
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Servant Leadership
Finance/Operations
Medico-Legal
Strategic Planning
Crucial Conversations
EXCELPerformance Management
LEAN
PI
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• CEO as ‘lead-off’• Focus on Servant Leadership
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PI Projects - Examples
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‘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’
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Employed Private
PLI Participation – Gathering Steam!
2011
2012
2013
2%
5%
8%
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Physician Peer Review
• Multi-disciplinary• Training for new members• Multi-year commitments• ‘No Blame’ approach• Administration Participation
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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
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• 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
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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
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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
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Quality of Care Initiatives
Baseline Q2 Q4 Q6 Q80
5
10
15
20
25
30
Sepsis mortality rate (%)*
*Unadjusted
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Continuing Medical Education
• Physician lead program• Needs-based content• ‘In-house’ expertise• Region-wide audience
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Future Challenges – We’re all at the Table
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“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
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• Chief of Surgery• Medical Staff President• Chief of Medicine• Chairman of IRB• CUSP Advocate
Influence beyond numbers!
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Thank you for allowing us to participate in the summer ACHE
event
North Mississippi Health Services