Ramesh Sahjpaul MD, MSc Head, Department of Surgery, Lions Gate Hospital Co-Medical Director,...
39
PHYSICIAN ENGAGEMENT Ramesh Sahjpaul MD , MSc Head, Department of Surgery, Lions Gate Hospital Co-Medical Director, Surgery Program, Lions Gate Hospital Clinical Associate Professor, Division of Neurosurgery Vancouver Coastal Health, UBC Feb 20 2015, Quality Forum 2015, Vancouver BC
-
Upload
pablo-townson -
Category
Documents
-
view
215 -
download
0
Transcript of Ramesh Sahjpaul MD, MSc Head, Department of Surgery, Lions Gate Hospital Co-Medical Director,...
PHYSICIAN ENGAGEMENT
Ramesh Sahjpaul MD , MScHead, Department of Surgery, Lions Gate Hospital
Co-Medical Director, Surgery Program, Lions Gate HospitalClinical Associate Professor, Division of Neurosurgery
Vancouver Coastal Health, UBC
Feb 20 2015, Quality Forum 2015, Vancouver BC
As Jauhur puts it, “American doctors are suffering from a collective malaise,” for reasons ranging from bureaucratic hassles to increased pressure to see more and more patients. Hence surveys showing that up to 40% of current doctors would choose a different career if they had to do it all over again, and even more say they would try to talk their kids out of a career in medicine. Physicians also tend to have unusually high suicide rates. According to the American Society for Suicide Prevention, male physicians commit suicide at a 70% higher rate compared with other professions, and female
Physician Unhappiness…A global phenomenon
What is engagement?
An agreement to be married
An arrangement to meet or be present at a specific time or place
Emotional involvement or commitment
What is engagement?
An agreement to be married
An arrangement to meet or be present at a specific time or place
Emotional involvement or commitment
A hostile encounter between military forces
What is engagement?
An agreement to be married
An arrangement to meet or be present at a specific time or place
Emotional involvement or commitment
A hostile encounter between military forces
…..Sound familiar??
physician
X
Why is physician engagement so important?
Why is physician engagement so important?
A. Drive patient satisfaction ?
Why is physician engagement so important?
A. Drive patient satisfaction ? B. Drive improved patient safety ?
Why is physician engagement so important?
A. Drive patient satisfaction ? B. Drive improved patient safety ? C. Drive improved quality of care ?
Why is physician engagement so important?
A. Drive patient satisfaction ? B. Drive improved patient safety ? C. Drive improved quality of care ? D. Drive reduction in costs ?
Why is physician engagement so important?
A. Drive patient satisfaction ? B. Drive improved patient safety ? C. Drive improved quality of care ? D. Drive reduction in costs ? E. Drive improvement in operational efficiency ?
Why is physician engagement so important?
A. Drive patient satisfaction ? B. Drive improved patient safety ? C. Drive improved quality of care ? D. Drive reduction in costs ? E. Drive improvement in operational efficiency ?
ANSWER: All of the above
Physician happiness
Physician engagement
In our best interest to get involved and engaged!
Could you recognize the engaged physician?
Pleasant, quiet, uninvolved ?
Loud and always negative? Involved, critical yet
constructive ?
So why is it so hard to engage physicians??Physician factors
CORE ASPECTS OF ENGAGEMENT
Collaborative Shared vision Requires patience Working in the fuzzy areas
Schedules Budgets Policies
So why is it so hard to engage physicians??Physician factors
CORE ASPECTS OF ENGAGEMENT CORE QUALITIES OF MOST PHYSICIANS
Collaborative Shared vision Requires patience Requires accommodation Working in the fuzzy areas
Schedules Budgets Policies
Busy > lots of distractions Lots of patients but not
always a lot of patience Limited knowledge of
systems/budgets Weary and cynical from years
of being beaten down… Fiercely independent…
Sounds cliché but…we are in this together…
Why are physicians disengaged?External factors
Engagement is optional No formal training in systems/institutional operations
*now increased recognition/support for leadership training A lot going on
Credentialing overhaul NSQIP TPOT
Wait time targets/MOH deliverables
(Sustained)Engagement requires
An engaging leader – preferably a physician colleague-ie we’re on the same team…Feedback – closing the loopWin-win scenarioWhat’s in in for me? For my patients?
(Sustained)Engagement requires
An engaging leader – preferably a physician colleague-ie we’re on the same team…Feedback – closing the loopWin-win scenarioWhat’s in in for me? For my patients?
Leadership: Inspiring change through shaping belief
Challenges for physician leaders in health care
Challenges for physician leaders in health care
Can’t (easily) fire the bad apples… In industry, 80% of success is firing/hiring…
Challenges for physician leaders in health care
Can’t (easily) fire the bad apples… In industry, 80% of success is firing/hiring…
We’re working with a tough crowd! Imagine a hockey team full of Alexander Ovechkins!
Challenges for physician leaders in health care
Can’t (easily) fire the bad apples… In industry, 80% of success is firing/hiring…
We’re working with a tough crowd! Imagine a hockey team full of Alexander Ovechkins!
Asking more and more of physicians’ time without compensation
How to guarantee failure in
LEADERSHIP ENGAGEMENT
Provide the mandate but not the tools
No leadership or top-down leadership
Tell people what they have to do but not why
Don’t listen to people Don’t provide feedback Don’t reward success
Physician engagement ‘formula’
Value their time Invest in leadership Listen to their concerns Tell them what you heard Tell them what you’re going to do Tell them what you did Tell them again….. OVERCOMMUNICATE….. >> build a culture of trust one step at a time
Lions Gate HospitalSmall successes…
NSQIP: 18-24 months before scepticism died down TPOT: just starting… Monthly quality council meetings (3 division heads) Surgical Safety Checklist…a 2 year journey Slowly but surely the Culture is changing Avoid heavy-handed approach …. Can’t mandate
engagement Can’t do it alone…
