PRACTICING EXCELLENCE: How to Align Physicians in a Shared Agenda Stephen C. Beeson MD Studer Group Medical Director Sharp Rees-Stealy Medical Group
Feb 23, 2016
PRACTICING EXCELLENCE:How to Align Physicians in a
Shared Agenda
Stephen C. Beeson MDStuder Group Medical Director
Sharp Rees-Stealy Medical Group
The Objective of our Time
Create physicians that will align with organizational efforts to execute positive
outcomes in quality, safety, cost- effectiveness, the patient experience and evidence-based care
The Physician Change Equation
Physician Behavioral
ChangePhysician
Buy-in
Physician Training
Performance Feedback
Performance Incentive
Effective Physician
Leadership
Trust in Hospital
LeadershipManagement of misaligned
Behaviors
Recognition
Selection and Orientation
Visibility of Organizational
Culture
Physicians Align When
They trust those leading the effortThere is compelling evidence this is necessaryTheir role is clear and well articulatedPhysician leaders amplify the alignment messageThey are invested to “get it done”The destination is about a mission they can “back”Those around them seem to be doing it
Diagnostic Criteria for Physician Engagement
Physicians are aware and support organizational goalsPhysicians actively involved in quality, safety, and service initiativesPhysician behaviors are consistent with the organizational “signature”Physicians will say/do something if standards are breeched
What We Need Physicians To Do:
Comply with evidence, clinical protocols and order setsDeliver the patient experienceManage cost of careSupport the group missionFoster system safety
4 Tactics to Create Physician Alignment
Creating physician buy-inBuilding physician trustAligning physician leadershipTraining physicians
Tactic #1: Creating Buy-in
He who has a compelling enough Why, can overcome any How
Basic Truths about Buy-in
If physicians resist or protest, it is likely related to ineffective buy-inThis is a key leader responsibility and ability
How Do You Create Buy-in For:
The patient experienceCost reductionA culture of safetyReduction of variance
Guidelines for Creating Buy-in
Believe it yourselfKnow the evidenceTranslate data to storiesBe intense
How Do You Know If You Have Made the Case Sufficiently?
Physicians are asking when it will happenThe uptake for initiatives is fastPowerful group sentiment that “we must do this”Leaders have articulated an irresistible futureVocal resistors are seen as outliers
Tactic #2: Creating Physician Trust
If physicians don’t trust those that lead them, they will, at best, become indifferent and
uninvolved in organizational efforts.
More likely, they will protest and resist efforts to defend their differing agenda.
Trust Defined
“The state of readiness for unguarded interaction with someone or something”Tenants of Trust
Capacity for trustingPerception of competencePerception of intentions
TRUST BUILDER: Including Physicians in Strategic Planning and Goal Setting
Strategic planning is setting the course for the future
Defining an overarching visionIdentifying strategies and actions to execute the visionSetting system goalsAllocation of resources
Why Include Physicians:
The dialogue and process of planning is as important as the plan itselfPhysician will own and support a plan they help createOpen and responsive dialogue fosters physician trustPlanning for a collective future will reduce physician suspicion of administrative activities
TRUST BUILDER: Survey Physicians
To deliver an effective treatment plan, leaders must diagnosis what physician issues need to be fixed
If we could fix three issues for you tomorrow, what would those be?1.
2.
3.
Leadership to
Physicians
TRUST BUILDER: Medical Staff Hotline
We are here to provide you the best place to care for patients, 24 hours a day, 365 days a year. If
there is anything that falls short of what you need, let us know and we will do what is necessary to make it right. Our leadership team will respond and communicate a response within 48 hours of
your call. Guaranteed.
TRUST BUILDER: Physician Recognition
Recognizing physicians for contributions, involvement and going above and beyond is one of the simplest and most effective ways to build physician trust with leaders and loyalty to a system
Tactic #3: Aligning Physician Leadership
“Leadership has been identified as the most important ingredient in transformational
improvement.”
From Joint Commission Resources presentation; Executive quality improvement survey results. Journal of Patient Safety. 2 March 2006
The Role of the Physician Leader
Create and project a specific destinationCreate consensus around that destinationCreate goals to verify “arrival” at the destinationDeploy and manage strategies to execute goalsMeasure, report and communicate progressConvey expectationsManage low performanceRecognize high performance
The True Role of a Leader
To get others to do what must be done because they want to do it
The Pathway to Effective Physician Leadership
Selecting Physician LeadersDeveloping Physician Leaders
Leader Selection
First who, then what
Signs of the Wrong Leaders
Defenders of “physician turf”Indifferent or disinterestedChanges position depending on who they are talking toFail to respond when there is a clear violation to the system way of doing things
Physician Leader Selection Criteria:
Intensity and passion for the mission and loyalty to the systemA desire to leadRespected by colleaguesHas led something in the pastCan defend a position in face of resistance
Physician Leader Selection Criteria
Strong presenter and ability to communicate in a straight-forward fashionSubject matter expert (or willing to learn)An ability to convey performance expectations to othersPersonal connection to those around them
Guiding Leader Selection Principles
Clear position responsibilitiesAppointment/election process promotes leaders that have a high probability of successTake time for this - get it right
Physician Leadership Development
We didn’t learn this during medical school or residency
Trainable Physician Leadership Skills
How to present and communicate a compelling Mission and VisionHow to make the case for changeHow to round on colleaguesHow to run a meetingHow to manage a disruptive colleagueHow to recognize high performanceUnderstanding the external health care environment
Physician Leadership Development
Invest in the development of the physician leadership team
Physician Leadership AcademyCreates shared, simultaneous learningParticipation is required for that part of the leadership team
Training Works When:
We believed the change was important (buy-in)The destination is crystal clear (vision)There was a compelling need to change (current performance)We knew how to do the change (training)Expectations were clear and disseminated (behavioral standards)Our change effort was measured and reported back
Leader Performance Predictors
Proper leader selection Development of skills to execute Clear description of responsibilitiesAssigned goal set for full time leaders in area of responsibilityLeader assessment by the execution of goalsPerformance transparency among the leadership team
A Leader’s Self Reflection…
Do I love the work that I do?Do I convey a sense of hope?Do I honor my word?Am I interested in others?Do others trust me?When things go poorly, how do I respond?
Action From Today
In order to “Align Physicians” one must first diagnose physician relationsOutreach to physician for inclusion in organizational strategyDevelop communication mechanisms to convey mission, strategy and resultsInvest in training and developing physician leaders