Engaging, Aligning and Integrating
Physicians to Create a Patient Focused
Culture that Drives Performance and
Outcomes
Beverly Begovich
What I will cover:
•Key drivers in aligning our physicians
• Four Steps to Achieve Physician Engagement
• Develop initiatives to enhance physician engagement
Insert Video: Herding Cats
A Staged Approach to Achieve
Engagement and Commitment
A journey, not an event!
Step 1: Compelling Story
Step 1:Create a
Compelling Story
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
Aggregation to Integration:
Physician Governance
Physician Practice Committee
Ed Rogers, M.D.,
M.B.A.
Chief Medical Officer
Josh Davis, M.D.
Term ending May 2014
Richard Matthews, M.D.
Term ending May 2014
Logan Richards, M.D.
Term ending May 2014
Mickey Daum, M.D.
Term ending May 2013
Richard Stachler, M.D.
Term ending May 2013
Ed Taylor, M.D.
Term ending May 2013
Baptist Medical Group Physician
Compact
Baptist Medical Group Physician
Compact
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
Developing Physician Governance
1.
2.
3.
4.
5.
Primary Care department meetings
Physician Practice Council
Expand both to include specialists
Expand to aligned, independent physicians
Expand Physician Recruitment Committee
Where are we now?
Source: The Advisory Board Company
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
Medical
Directorships,
Stipends
Gain
Sharing
Model
HIGHER INTEGRATION
Bonds
Equipment
Leasing / Real
Estate
Models
Management
Services
Agreement
CoManagement /
Management
Company
Under
Arrangements
JV / Physician
Leasing / PSA
Outpatient
Joint
Venture
Model
Integrated
Delivery
System /
ACO
• IP/OP Services
• Imaging
• Mayo
• Musculoskeletal
• ASC’s
• Kaiser
EXAMPLES:
• Medical
• DRG Specific • Performance • Equipment
Directorships
• Chairs
• Cath Lab
Bonds
Supplies
• Taxable
• Orthopedic
Bonds
implants
• Service Line
Specific:
Cardiology
Orthopaedics
Pulmonology
Surgery
Oncology
Leasing
• Real Estate
• Service
Agreements
• ER Contracts
• FMV Leasing • ASCs
of capacity
• Imaging
Centers
• Endo Centers
• Digestive
Disease Center
of Excellence
• Cardiovascular
Center of
Excellence
• Neurosciences
Center of
Excellence
Centers
• Cancer Centers
• Neuroscience
• Endoscopy • Cleveland
• Cancer
Center
Centers of
Excellence
Clinic
• Baptist
Physician
Alliance
(Alabama)
• Orthopaedics
• Advocate
Service Line
• Memorial
• Department of
Surgery
• ASCs
Hermann
• Guthrie
Clinic
• Christ
These models are not mutually exclusive. Models in bold are most commonly used throughout the country.
Hospital
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 table—lead
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
Physician Compensation: Quality and Service
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
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 Care’s 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.
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
Physician Leadership University
Richard Stachler, MD
Maria DiMonte
John Sullivan, MD
Stephanie Boerjan
Brett Smith, MD
Kimi Dunn
Bob Spencer, MD
Valarie Hampton
Josh Davis, MD
Carla Johnson
JR Lee
Diagnostic
Imaging
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
Sharon Hooks
Ultrasound
Kathy Linkous
Nursing House
Supervisor
Dr. Charles Roth
Orthopaedic
Surgeon
Congratulations to
our most recent
CHAMPIONS
Physician Networking Breakfasts on GBH Campus Quarterly
How can we leverage Culture
to execute strategies?
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
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
10 Simple Things for Physicians To
Improve Patient Satisfaction
•Acknowledge everyone in the patient’s room.
•Introduce yourself.
•Shake patient’s hand (if appropriate).
•Sit (or perch) at the patient’s 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!
HCAHPS-Overall Hospital Rating Trends
HCAHPS Dimensions
•
•
•
•
•
•
•
Nurse Communications
Doctor Communications
Responsiveness of hospital staff
Cleanliness, quiet of hospital environment
Pain Management
Communication about medicines
Discharge information
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
GBH - Emergency
Composite Percentile Score - Trend
Reflects Patient Experience
100
84
86
75
78
86
89
81
82
92
91
81
78
68
81
68
75
79
87
77
81
72
50
25
0
May-11 Jun- 11
Jul-11
Aug-11
Sep-11
Oct -11 Nov-11
Dec-11 Jan-12
Composite Percentile Score
Feb-12
Mar-12 Apr-12 May-12
Target - 80%
Jun-12
Jul - 12
Aug-12
Sep-12 Oct -12
Goal - 95%
Nov-12
Dec-12
GBH - OP/Ambulatory
Composite Percentile Score - Trend
Reflects Patient Experience
100
96
75
92
90
92
87
82
68
78
61
89
85
90
87
80
80
88
61
58
50
85
81
25
0
M ay- Jun11
11
Jul-11 Aug- Sep-11 Oct-11 Nov- Dec11
11
11
Composite Pecentile Score
Jan12
Feb- M ar12
12
Apr12
M ay- Jun12
12
Target - 80%
Jul 12
Aug12
Sep12
Oct12
Goal - 95%
Nov- Dec12
12
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
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.
Research and Development
• Biomechanics/Performance Testing
Lab
• Clinical outcome Studies
• Sports Medicine/Rehab Products
• Surgical Instrumentation Products
Educational Opportunities
• Surgical Skills Labtraining/testing
• MD Fellowship program
• Conferences- CME’s
• Medical Library
Andrews Institute
Athletic Performance Center
• Biomechanical/ Motion
Analysis
• Molecular Analysis
• Sport Psychology
• Strength and Conditioning
“You must become
the change you
wish to see in the
world.”
- Gandhi
Thank You
Beverly Begovich RN, MBA, MBB
Practice Leader
beverlyb@bhclg.com
www.bhclg.com