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The African Queen … Medical Staff and Hospital Administration – Bogart and Hepburn Michael Jellinek, M.D. President, NW PowerPoint Presentation
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The African Queen … Medical Staff and Hospital Administration – Bogart and Hepburn Michael Jellinek, M.D. President, NWH Chief, Child Psychiatry Service, MGH Professor of Psychiatry and of Pediatrics, Harvard Medical School January 11, 2007 Presentation Objectives …

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Presentation Transcript
slide1

The African Queen …

Medical Staff and Hospital Administration –

Bogart and Hepburn

Michael Jellinek, M.D.

President, NWH

Chief, Child Psychiatry Service, MGH

Professor of Psychiatry and of Pediatrics,

Harvard Medical School

January 11, 2007

slide2

Presentation Objectives …

  • Participants will be able to :
  • identify the key elements in building a strategy for productive communication between the hospital administration and key stakeholders, specifically the process used to engage physician leadership.
  • understand how two vastly different teams (ie. Medical Staff and Hospital Administration) bridge their differences to implement CPOE
  • recognize the immediate challenges of implementing CPOE
  • build a culture of long-term cooperation between administration and medical staff
slide3

The African Queen

  • Rose Sayer – Missionary
    • Priorities : religion, proper English values, elegance, doing the right thing, “God and Country”, spinster
  • Charlie Allnut – Local Trader
    • Priorities : pragmatic, making money, drinking, having fun in a manly manner, “me, myself and I”, freedom of choice - autonomy
slide4

What do they have in common?

  • Both forced onto a small boat, The African Queen, to escape the German invasion.
  • Both forced to come to terms with each other as they faced external threats – Germans, the river, drought, the Luisa.
  • Both learn to appreciate each other – fall in love, risk their lives willingly, commit to a higher goal, and succeed.
slide13

Defining the issues …

  • Hospital Administration and Medical Staff, different incentives, different priorities, are facing an external force to undertake a major mission – CPOE.
  • Is the external force appropriate and legitimate?
  • Yes – safety, quality, efficiency, variation
  • Will CPOE help?
    • Yes – handwriting, transmission speed, pharmacy checks, order sets and quality, efficiency
slide14

Defining the issues …

How major is CPOE as a mission?

Major - change in work flow of patient care, change in method (paper to computer), time consuming, cost (hardware, software, teaching, coverage, updates), involuntary

slide15

Working together …

Rose and Charlie would have fought among themselves and been killed or captured by the Germans, starved to death on the river, died from the leeches, or drowned – never getting close to sinking the Luisa. What in the culture of a hospital could support collaboration rather than disaster?

slide16

Requirements for success …

1. Broad quality and safety program

  • Forthright peer review at department, medical staff and Board of Trustee level;
  • Aggressive pursuit of quality/safety agenda pre-problem, post-problem
  • Clear resolution of conflict policy
slide17

Requirements for success …

  • Transparency
    • Group decision-making
    • Role of Chairs
    • Role of President of Medical Staff, CMO, PHO, Med. Dir.
    • Joint Trustee Staff
    • Board of Trustees (20% M.D. membership)
slide18

Requirements for success …

  • Communication
    • Gang of 9
    • ECMS
    • Medical Staff Meetings
    • Community Letter
    • Town Hall Meetings
    • Access – email, talk, rounding
slide19

Requirements for success …

  • Management Structure
    • IS, IS/MD
    • CMO, PHO, Medical Directors
    • IS Committee
    • CPOE Implementation Committee
    • Vendor Responsiveness
    • Budget Contingency for emerging programming, coverage
slide20

Requirements for success …

  • Clearly defined roles for:
    • Hospital staff
    • Hospitalists
    • PA’s
  • 6. Key leadership role of primary care
  • 7. Moving past control by secrecy, favoritism, financial power, “autonomy” of self-interest
  • 8. Some blind courage
slide21

Conclusion …

Many missions lie ahead – health care reform, medical costs, integration of more medical IT, public reporting, re-engineering, temptation to deconstruct the hospital of specialists with ancillary opportunities

Can we be more like Rose and Charlie? CPOE is a solid challenge to test if we are seaworthy.

slide22

Presentation Objectives …

  • Participants will be able to :
  • identify the key elements in building a strategy for productive communication between the hospital administration and key stakeholders, specifically the process used to engage physician leadership.
  • understand how two vastly different teams (ie. Medical Staff and Hospital Administration) bridge their differences to implement CPOE
  • recognize the immediate challenges of implementing CPOE
  • build a culture of long-term cooperation between administration and medical staff