Engaging, Aligning and Integrating Physicians to Create a Patient Focused Culture that Drives Performance and Outcomes

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• Engaging, Aligning and Integrating Physicians to
  Create a Patient Focused Culture that Drives
  Performance and Outcomes

• Beverly Begovich

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What I will cover

• Key drivers in aligning our physicians
• Four Steps to Achieve Physician Engagement
• Develop initiatives to enhance physician
  engagement

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Insert Video Herding Cats
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A Staged Approach to Achieve Engagement and
Commitment

• A journey, not an event!
• Step 1 Compelling Story
• Step 1Create a
• Compelling Story

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Motivators

• What are they?
• How do you leverage them?
• Which motivators will most impact your physician
  leaders?
• How will you put the motivators into the
  communication plan?

Step 1 Compelling Story
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• Aggregation to Integration

• Physician Governance

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• Physician Practice Committee

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• Baptist Medical Group Physician Compact

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• Baptist Medical Group Physician Compact

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Engaging Physicians

• Converse with the physicians you want to engage
• What do you like about being in healthcare (or
  your specific profession)?
• What do you like about what you do here?
• What legacy do you want to leave behind - your
  personal contribution to this organization? Our
  team contribution?
• The Leadership Handbook - Peter R.
  Scholtes

Step 2 Identify and Engage Physician Leaders
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Developing Physician Governance

• Primary Care department meetings
• Physician Practice Council
• Expand both to include specialists
• Expand to aligned, independent physicians
• Expand Physician Recruitment Committee

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• Where are we now?

Source The Advisory Board Company
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Hospital-Physician Alignment Methodologies

• The further right on the spectrum, the higher the
  risk, the return and the ability to use a more
  proactive approach to alignment.

POTENTIAL LOWER RISK AND LOWER RETURN POTENTIAL HIGHER RISK AND HIGHER RETURN
LOWER INTEGRATION HIGHER INTEGRATION
Medical Directorships, Stipends Gain SharingModel Bonds Equipment Leasing / Real EstateModels Management Services Agreement Co-Management / Management Company Under Arrangements JV / Physician Leasing / PSA Under Arrangements JV / Physician Leasing / PSA Outpatient Joint Venture Model Integrated Delivery System / ACO Integrated Delivery System / ACO
EXAMPLES EXAMPLES EXAMPLES EXAMPLES EXAMPLES EXAMPLES EXAMPLES EXAMPLES EXAMPLES EXAMPLES EXAMPLES
Medical Directorships Chairs DRG Specific Cath Lab Supplies Orthopedic implants Service Line Specific Cardiology Orthopaedics Pulmonology Surgery Oncology Performance Bonds Taxable Bonds Equipment Leasing Real Estate FMV Leasing of capacity Service Agreements ER Contracts ASCs Imaging Centers Endo Centers Digestive Disease Center of Excellence CardiovascularCenter of Excellence Neurosciences Center of Excellence Orthopaedics Service Line Department of Surgery ASCs Digestive Disease Center of Excellence CardiovascularCenter of Excellence Neurosciences Center of Excellence Orthopaedics Service Line Department of Surgery ASCs IP/OP Services Musculoskeletal Centers Cancer Centers Neuroscience Centers of Excellence Imaging ASCs Endoscopy Cancer Center Imaging ASCs Endoscopy Cancer Center Mayo Kaiser Cleveland Clinic Baptist Physician Alliance (Alabama) Advocate Memorial Hermann Guthrie Clinic Christ Hospital
These models are not mutually exclusive. Models in bold are most commonly used throughout the country.
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Identify Clear Goals and Right Audience

• In partnership, lead sponsors and physician
  leaders in process to clarify goals and measures
• Again, clarify and validate the motivators
• Given these goals, who needs to be at the
  tablelead process of establishing a
  representative collaborative team
• Continue to tell the story physician leaders
  now carrying the message to their peers
• Fan the flames! Communication strategy and
  information sharing

Step 3 Identify Clear Goals and Audience
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• Physician Compensation Quality and Service

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Communicate the Initiative

• Develop communication strategy based on the
  story
• Use multiple channels and forums
• Help create customized message to the audience
• Simple progress measures with ongoing updates
• Build enthusiasm and support

Step 4 Communicate the Initiative
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• Physicians Advisory Group

Charter To empower physicians in the management
of Baptist Health Care systems with the goal of
achieving success at all levels. Why the
Physician Advisory Group Exists Baptist Health
Cares patients come directly from the
physicians. Physician engagement is paramount to
our success however, their engagement needs to
be cultivated by a health system that provides
them with the opportunities and resources
necessary to succeed. For this to occur there
needs to be a cultural alignment between the
physicians and the health system with the focus
being shared values, an organizational focused
approach to healthcare reform, and a superior
patient centered approach to healthcare.
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Physician Advisory Group Membership Criteria

• Leaders of the medical staff
• Highly Respected among peers
• Influential
• Show Ownership in Baptist Health Care
• Not afraid to voice their own opinion
• Strong desire to carry out the mission of BHC
• Passionate
• Seek hospital-physician alignment and understand
  the value
• Visionaries - understand the challenges we face
  ahead and want to be prepared, collectively
• Ability/Desire to educate others about
  topics/issues/strategies/etc.
• Willing to commit time to group

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• Physician Leadership University

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Richard Stachler, MD Maria DiMonte
Brett Smith, MD Kimi Dunn
Bob Spencer, MD Valarie Hampton
John Sullivan, MD Stephanie Boerjan
Josh Davis, MD Carla Johnson
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Each of these team members were recognized as
Champions of Gulf Breeze Hospital during the
month of October for selfless service above and
beyond the call of duty
JR Lee Diagnostic Imaging
Sharon Hooks Ultrasound
Congratulations to our most recent CHAMPIONS
Dr. Charles Roth Orthopaedic Surgeon
Kathy Linkous Nursing House Supervisor
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Physician Networking Breakfasts on GBH Campus
Quarterly
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• How can we leverage Culture to execute strategies?

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• How Do You Achieve World Class Results?

• Clarity of purpose
• Quantifiable Goals
• Ensuring adequate resources and expertise
• Measurement and improvement
• Utilizing systematic assessment frameworks
• Establishing process improvement systems and
  tools that can
• be replicated for multiple improvement
  initiatives
• Standardization and consistency
• The customer is at the center
• Personal ownership and accountability
• Establishing a culture of mindfulness
• Maintaining a culture of employee engagement
• Partnerships with medical staff, nursing and
  ancillary
• staff, patients and family members

Leadership
Operational
Cultural
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Physician Initiatives

• Evidence Based Practices to Achieve Patient
  Centered Excellence

• Patient Centered Practices
• 10 simple things Physicians can do to improve the
  Patient Perception of their care
• Words that Work
• Patient Rounding
• Standards of performance
• Measurement
• Performance Management Vital Conversations

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10 Simple Things for Physicians To Improve
Patient Satisfaction

• Acknowledge everyone in the patients room.
• Introduce yourself.
• Shake patients hand (if appropriate).
• Sit (or perch) at the patients bedside.
• Comfort Concern
• Share the plan with the patient.
• Notify the patient directly of any change in
  care.
• Smile
• What questions do you have? vs. Do you have
  any questions?
• Hardwire these simple actions---do it every
  patient!

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• HCAHPS-Overall Hospital Rating Trends

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HCAHPS Dimensions

• Nurse Communications
• Doctor Communications
• Responsiveness of hospital staff
• Cleanliness, quiet of hospital environment
• Pain Management
• Communication about medicines
• Discharge information

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Doctor Communications

• How often did doctors treat me with courtesy and
  respect?
• How often did doctors listen carefully to you?
• How often did doctors explain things in a way
  you could understand?
• All questions are on an Always to Never scale

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Andrews Institute

• Clinical Facility

• Medical Offices
• Ambulatory Surgical Center
• Multi-specialty with an emphasis on
  musculoskeletal procedures
• 8 surgical suites
• Orthopedic surgery
• Primary care sports medicine
• Neurosurgery
• Pain management
• Ophthalmology

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Andrews Institute

• Clinical Facility

• Outpatient Rehabilitation
• Protocols developed by Kevin Wilk Dr. Andrews
• Diagnostic Services
• X-Ray and EMG Services
• 3.0 tesla MRI
• Medical Equipment
• Braces, splints, crutches, etc.

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Research and Development

• Biomechanics/Performance Testing Lab
• Clinical outcome Studies
• Sports Medicine/Rehab Products
• Surgical Instrumentation Products

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Educational Opportunities

• Surgical Skills Lab- training/testing
• MD Fellowship program
• Conferences- CMEs
• Medical Library

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Andrews Institute

• Athletic Performance Center

• Biomechanical/ Motion Analysis
• Molecular Analysis
• Sport Psychology
• Strength and Conditioning

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You must become the change you wish to see in
the world. - Gandhi
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• Thank You

• Beverly Begovich RN, MBA, MBB
• Practice Leader
• beverlyb_at_bhclg.com
• www.bhclg.com