Organizational Restructuring

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Organizational Restructuring

• Henry Ford Medical Group
• Division of Hospitalist Medicine
• Detroit, Michigan

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Background

• HFHS hospitalist program rapid growth between
  2006 2009
• average daily patient census grew from 60 to 220
• clinical domains grew from 3 to 10
• geographic areas grew from 3 units in 1 hospital
  to 10 services in 4 hospitals
• physician FTE grew from 14 to 42
• Division of Hospitalist Medicine was formed in
  January 2008, Peter Watson was appointed Division
  Head

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Henry Ford Division of Hospitalist Medicine
Clinical Domains

• General Medical Inpatient Care
• Observation Care
• Telemetry/Cardiology
• Progressive/Critical Care
• Clinical Education
• Clinical Research
• Surgical Co-Management
• Consultative Medicine
• Admission Triage/Evaluation
• Palliative Medicine

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Organizational Restructuring

• Organize leadership structure to support our
  diverse areas and domains of practice
• State mission, vision and values to guide
  decisions, planning and growth
• Optimize alignment of physician talent with the
  needs of each area of practice

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Lessons Applied From Leadership Academy

• Strategic planning provided a framework for
  organizational structure and planning
• SWOT analysis allowed us to assess our current
  position and set operational priorities
• Identifying and developing a leadership
  succession for operational efficiency,
  sustainability and growth

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Division of Hospitalist Medicine Mission, Vision
and Values
Coming together is a beginning. Keeping together
is progress. Working together is success. If
everyone is moving forward together, then success
takes care of itself. -Henry Ford

• Mission
• Why are we here? As physicians and health
  professionals dedicated to high quality inpatient
  and palliative medicine, we are committed to
  putting the patient first by consistently
  providing an outstanding inpatient care
  experience that we would expect for our families
  and for ourselves.
• What is the essence of what we do? As
  hospitalists in group practice, we provide
  expertise in the delivery of inpatient medical
  care. The key to our success is
  multidisciplinary collaboration, a dynamic
  process where different disciplines work together
  toward common goals by sharing knowledge,
  learning and building consensus. Hospitalists
  manage and coordinate teams providing complex
  inpatient medical care from admission through all
  care transitions to discharge and beyond.
  Hospitalists are natural resources and leaders of
  multidisciplinary teams within their institutions
  in the efforts to enhance quality, ensure patient
  safety, improve outcomes, reduce length of stay,
  and lower costs.
• Vision
• What is our ongoing goal? Through a commitment
  to excellence in patient care, scholarship, and a
  culture of collaboration, to become recognized as
  one of the premier hospitalist groups in the
  United States.
• Values
• The following are some of the behaviors and
  actions expected of members of the Division of
  Hospitalist Medicine to support our Mission and
  Vision of inpatient excellence and collaboration.
  
• We collaborate with our patients and their
  families by
• Placing the needs and wishes of patients at the
  center of our activity by caring and comforting
  them in the same way we want our families and our
  ourselves treated
• Communicating with patients and their families in
  a compassionate manner and maintaining an
  environment of shared decision-making and
  empowerment for the patient
• We collaborate with the greater healthcare team
  by
• Partnering and sharing responsibility with the
  greater healthcare team including nurses,
  pharmacists, case managers and other disciplines
  by integrating their assessments in the care of
  our patients
• Participating in hospital quality improvement
  initiatives to promote efficient, cost-effective,
  and safe practices
• Advancing the science and education of inpatient
  medicine through a commitment to research,
  teaching, and life-long learning
• Assuring safe transitions of care for our
  patients through cooperation with other
  healthcare providers and community-based services
  
• We collaborate with our physician colleagues by
• Supporting our partners within the hospitalist
  medicine division by demonstrating the highest
  standards of clinical care, communication,
  performance assessment, and teamwork
• Continually serving as role models by adhering to
  the highest standards of clinical and
  professional conduct
• Working closely with other specialties to provide
  the best care for our patients

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SWOT Analysis

• Strengths
• Strong leadership
• Diversity of expertise
• Breadth of experience, seasoned senior members
• Diversity of interests
• Strong academic faculty
• Weaknesses
• Variability in clinical quality
• Variability in engagement and accountability
• Inadequate representation in hospital
  policy-making
• Needs leadership support structure
• Needs in-service educational activities
• Staff turnover

• Opportunities
• Strong demand for hospitalist service
• Direct and substantial impact on hospital
  operations and objectives
• Strong medical group brand/reputation
• Stable medical group patient base
• Strong multi-specialty support
• Strong postgraduate medical education programs
  and structure
• Threats
• Weak local economy
• Unreimbursed care
• Competing hospitalist groups
• Systems poor insight of the hospitalist movement
• Pay for performance

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Priorities for 2010

• Culture-building
• Establish standards of practice
• Develop program for staff development