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Physician ‘Alignment’ Achieving Cultural Synergy in the Pursuit of Clinical Excellence Mississippi Healthcare Executives Summer Meeting June 5 & 7, 2013 Mark Williams, MD, MBA, JD Chief Medical Officer Leadership Strategic Planning Customer Focus Results An atmosphere of mutual respect, transparency and learning Knowledge Management Workforce Focus Process Management ‘As health care evolves, mutually productive physician relationships are critical . . . what are additional opportunities?’ Adapting to New Payment Models Eliminating Avoidable Harm Improving Efficiencies Providing More Coordinated Care Embracing Evidence-Based Care The Culture ‘Gap’ Extensive Professionalization Strong Personal Bonding Focus on Individuals Collegial Relationships Suspect of ‘outsiders’ On the front-lines ‘Now’ Less Professional Support Focus on Populations Shared Responsibilities Few Patient Encounters Must Prioritize Issues Need to Manage Politics Physicians Healthcare Executives A Unified Culture That Leverages Respective Strengths To Achieve Superior Results A Legacy of Community 1937 The Commonwealth Fund The ‘Competent’ Community • Collaborates effectively in identifying problems • Achieves a working consensus on goals • Agrees on means to implement the agreements • Collaborates effectively in the agreed Vaughn L. Grisham, PhD actions A Legacy of Leadership Development EOS Survey Results 90 88 86 84 82 80 78 76 74 72 70 2010 2006 1998 1996 2000 2002 2004 2008 The Opportunities • • • • • • Physician Leadership Institute Physician Peer Review Co-Management Comprehensive Unit-Based Safety Program Continuing Medical Education Strategic Planning ‘Designed to serve North Mississippi’s partner physicians by providing innovative leadership training, personal development and practical management/strategic planning skills sets’ NMHS Physician Leadership Institute, 2011 Builds Upon the Leadership Development Institute • Leadership training is part of the culture • Significant investments • Specific Selection Criteria • Commitment Well-Defined • 40 Class Hours • 60-80 Out-of-Class Hours • Support of Group • Expectations Clear • Honesty • Respect • Active Participation • Future Leadership Role Mutual Obligations Physicians Time Homework PI Project Future Leadership Organization Top Leaders Preparation Transparency Materials, Meals • Materials provided by organization • Wide range of topics • Correlated with lecture series Servant Leadership PI Finance/O perations Strategic Planning MedicoLegal Crucial Conversations EXCEL Performance Management LEAN • CEO as ‘lead-off’ • Focus on Servant Leadership PI Projects - Examples ‘Will there be follow-up classes for alumni?’ ‘Tell me where you need me’ ‘Hope this organization will view this group as a source for leadership’ 2013 PLI Participation – Gathering Steam! 2012 8% 2011 5% Employed 2% Private Physician Peer Review • • • • • Multi-disciplinary Training for new members Multi-year commitments ‘No Blame’ approach Administration Participation Co-Management • • • • • Embraces ‘accountable care’ concepts Initial project – partnership with cardiologists Joint management of cardiac ‘cath’ lab Thorough ethical, financial and legal analysis Model for other service lines • Fixed Fee • Manages lab operations • Provides strategic planning • Staff development • Public relations • Vendor and payer issues • Performance Fee • Employee satisfaction (5) • Patient satisfaction (5) • Quality component (30) • Cost savings (60) https://oig.hhs.gov/fraud/docs/advisoryopinions/2012/AdvOpn12-22.pdf 2500 Supply Costs ($) 2000 1500 1000 Aligned Incentives Cost Quality Service Percutaneous Coronary Intervention Complications (%) 2 500 1.5 0 1 Baseline Result 0.5 0 Baseline Result Comprehensive Unit-Based Safety Program • • • • Physician champions Annual Culture of Safety Survey Goal is broad expansion of the CUSP concept Goal of safest system in U.S. by 2015 Quality of Care Initiatives 30 25 Sepsis mortality rate (%)* 20 15 10 5 0 *Unadjusted Baseline Q2 Q4 Q6 Q8 Continuing Medical Education • • • • Physician lead program Needs-based content ‘In-house’ expertise Region-wide audience Future Challenges – We’re all at the Table “The problem with health care today is people like me – doctors (mostly men) in our fifties and beyond . . .now, at many health care institutions and practices, we are in charge . . . and that’s a problem . . .” Thomas Lee, MD, Turning Doctors Into Leaders Harvard Business Review, April 2010 (President, Partners HealthCare System) Or, maybe, they’re partners in seeking solutions! Physician Leadership Institute, NMHS • • • • • Chief of Surgery Medical Staff President Chief of Medicine Chairman of IRB CUSP Advocate Influence beyond numbers! Thank you for allowing us to participate in the summer ACHE event North Mississippi Health Services