An Alberta Province Wide Medical Organizational Structure

1
An Alberta Province Wide Medical Organizational
Structure

• Physician Consultation

2
Background and Introduction

• April-May, 2008 single AHS Board
• April 1, 2009
• RHAs dissolved
• A single Provincial RHA
• Former RHA Medical Bylaws no longer in effect
  one Provincial set of Medical Bylaws
• A new Provincial Medical Organizational Structure
  largely in place

3
PMOS Working Group

• Dr. Robert Bear (Chair)
• Dr. Ken Gardener
• Dr. David Mador
• Dr. Ty Josdal
• Dr. David Megran
• Dr. Peter Jamieson
• Dr. Cheri Nijssen-Jordan
• Two Rural Family Physician Representatives
• Drs. Ron Bridges Verna Yiu (Medicine Faculties)
• Dr. Doug Perry Dr. Jennifer Rice (ad hoc)
• Reporting to Dr. Chris Eagle Ms. Paddy Meade

4
WG Process

• Province-wide consultation with physician
  leaders, physician groups and others
• Development of a recommended PMOS
• Approval by AHS Executive Board
• Substantial implementation of approved structure
  by April 1, 2009

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Guiding Principles

• The Working Group will ensure that the
  responsibilities of a PMOS are clearly
  articulated and that the final recommended
  structure permits the responsibilities to be
  fully accomplished

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Guiding Principles (2)

• The approved PMOS will ensure that the Board
  Executive of AHS have appropriate timely access
  to advice and support from the formal medical
  leadership of the Organization

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Guiding Principles (3)

• The PMOS will build on physician leadership
  structures that currently exist, while laying the
  foundation for incremental changes that will
  promote
• centralized strategy and policy development and
  planning
• District-based planning management
• Local planning implementation

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Guiding Principles (4)

• The PMOS will
• Support the Provincial Medical Staff Bylaws
• Be aligned with the management structure of the
  new AHA
• Lead to creation of attractive physician
  leadership opportunities
• Promote physician accountability
• Be responsive to issues identified through the
  consultation process

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Responsibilities of a Medical Organizational
Structure

• High level
• Operational

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Responsibilities of a PMOS High Level

• Ensure that the Board has access to appropriate
  information and advice from the Organizations
  formal medical leadership

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Responsibilities of a PMOS High Level (2)

• Ensure that physician leaders are involved in the
  decision-making processes of the Organization on
  matters such as
• Strategic planning
• Development management of budgets
• Service delivery planning
• Information technology
• New Program development
• Capital planning

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Responsibilities of a PMOS High Level (3)

• Ensure appropriate Organizational understanding
  and support of Faculties of Medicine

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Responsibilities of a PMOS Operational

• Support the Medical Staff Bylaws Rules
• Play an integral role in physician workforce
  planning
• Collaborate fully in developing and managing the
  Organizations Quality Framework
• Play a key role in Utilization Management

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Responsibilities of a PMOS Operational (2)

• Enhance communication by physicians to physicians
  and others, as appropriate
• Ensure appropriate physician representation of
  the Organization externally, as required

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Responsibilities of a PMOS Operational (3)

• Participate in recruitment of physician leaders
  provide them mentoring support conduct their
  performance reviews
• Develop maintain standardized compensation
  agreements, both clinical administrative

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Opportunities

• A province-wide approach to implementation of
  Bylaws and rules
• Province-wide physician workforce planning,
  aligned with a Provincial Service Delivery Plan
• Enhanced opportunities for Faculties of Medicine
• Standardization!
• Clinical practice (as appropriate)
• Clinical quality
• Utilization management
• Compensation
• I.T.
• Other

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Process Check

• A preferred Provincial Medical Organizational
  Structure has not been determined
• The consultation process is still underway

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Strategy for Development of Albertas PMOS

• Identify elements of a Vision for Albertas PMOS
• Start by building on structures and positions
  that currently exist
• Evolve toward the Vision incrementally

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Strategy for Development of Albertas PMOS (2)

• Province-wide, District and Local Elements
• Province-wide strategy, planning, policy
• District local planning (as appropriate),
  management
• Local implementation of Provincial and District
  plans policies, local actions as required

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Potential Initial Elements of Albertas PMOS

• Provincial
• A Provincial Senior Physician Executive - on AHS
  Executive potentially partnered with the
  Organizations COO
• The Clinical Advisory Team could be advisory to
  the VP Medicine

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Potential Initial Elements of Albertas PMOS
(contd)

• District
• District CMOs (reporting to the Provincial
  Senior Physician Executive partnered with an
  operational VP)
• District Department or Program Heads (reporting
  to District CMO operational Director) dyad
  management
• Academic Department Heads (reporting to Dean of
  Faculty)
• District Clinical Advisory Councils, Clinical
  Operations Committees and Medical Staff
  Associations
• District Board Physician Liaison Committees

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Potential Initial Elements of Albertas PMOS
(contd)

• Local
• Local Medical Directors (reporting to District
  CMO)
• Clinical leaders (matrix reporting to Local
  Medical Directors and District Department/Program
  Heads)

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The Potential Involvement of the Faculties of
Medicine in the PMOS

• Potential representation of the Faculties on the
  Board as non-voting members
• There will be a requirement for a Faculty/AHA
  Liaison Committee
• In the District in which the Faculty exists, the
  District Department Head could be, but would not
  necessarily be, the Faculty Department Head
• Faculties would be represented on District
  Clinical Advisory Councils and District Clinical
  Operations Committees

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Questions

• Is the proposed PMOS in keeping with the Guiding
  principles?
• Will the proposed structure permit the functions
  and activities of a PMOS to be accomplished?
• Will the proposed structure address issues and
  concerns identified during the consultation
  process?
• Does the proposed structure suitably support the
  Faculties of Medicine?
• What Outcome Measures should be tracked and
  reported?

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Discussion Period