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Physician ‘Alignment’

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. Results.

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Physician ‘Alignment’

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  1. 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

  2. Leadership Strategic Planning Results An atmosphere of mutual respect, transparency and learning Customer Focus Process Management Workforce Focus Knowledge Management

  3. ‘As health care evolves, mutually productive physician relationships are critical . . . what are additional opportunities?’ Providing More Coordinated Care Adapting to New Payment Models Improving Efficiencies Embracing Evidence-Based Care Eliminating Avoidable Harm

  4. 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

  5. A Unified Culture That Leverages Respective Strengths To Achieve Superior Results

  6. A Legacy of Community 1937 The Commonwealth Fund

  7. 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 actions Vaughn L. Grisham, PhD

  8. A Legacy of Leadership Development 2010 2008 2006 2004 2000 2002 1998 EOS Survey Results 1996

  9. The Opportunities • Physician Leadership Institute • Physician Peer Review • Co-Management • Comprehensive Unit-Based Safety Program • Continuing Medical Education • Strategic Planning

  10. ‘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

  11. Builds Upon the Leadership Development Institute • Leadership training is part of the culture • Significant investments

  12. 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

  13. Mutual Obligations Physicians Time Homework PI Project Future Leadership Organization Top Leaders Preparation Transparency Materials, Meals

  14. Materials provided by organization • Wide range of topics • Correlated with lecture series

  15. Servant Leadership PI Medico-Legal Crucial Conversations Finance/Operations EXCEL Performance Management Strategic Planning LEAN

  16. CEO as ‘lead-off’ • Focus on Servant Leadership

  17. PI Projects - Examples

  18. ‘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’

  19. 2013 PLI Participation – Gathering Steam! 2012 8% 2011 5% 2%

  20. Physician Peer Review • Multi-disciplinary • Training for new members • Multi-year commitments • ‘No Blame’ approach • Administration Participation

  21. 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

  22. 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

  23. Aligned Incentives Cost Quality Service

  24. 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

  25. Quality of Care Initiatives Sepsis mortality rate (%)* *Unadjusted

  26. Continuing Medical Education • Physician lead program • Needs-based content • ‘In-house’ expertise • Region-wide audience

  27. Future Challenges – We’re all at the Table

  28. “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

  29. Chief of Surgery • Medical Staff President • Chief of Medicine • Chairman of IRB • CUSP Advocate Influence beyond numbers!

  30. Thank you for allowing us to participate in the summer ACHE event North Mississippi Health Services

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