Programs of Promise: Physician Leadership Academies Integrated Healthcare Strategies Alignment & Engagement Support for High Performance Healthcare Providers James A. Rice, Ph.D., FACHE Practice Leader Governance and Leadership Vice Chairman The Governance Institute 612.337.1307 [email protected]Please dial: (641) 715-3222 access code 187-366-641 to join the conference call if you haven’t done so already.
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Programs of Promise: Physician Leadership Academies
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Programs of Promise:Physician Leadership Academies
Integrated Healthcare StrategiesAlignment & Engagement Support for High Performance Healthcare Providers
to join the conference call if you haven’t done so already.
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Active Medical Staff
BOD Appoints Medical Staff
COSCOS-E
Primary Care
Division
Medical Division
Surgical Division
Behavioral Division
Hospital Based
Division
Past COS
MDOC
BOD Structures Divisions
System Board
Hospital Board
Hospital or System CEO
Med Staff Committees
Burn
By-Laws
Cancer
Credentials
Infections
Inter-disc Practices
Med Records
O.R.
Patient Care
Rx Therapeutics
Quality Peer
Rad Safety
Trauma
Fam Pract
Gen Med
Peds
Ob Gyn
Psych
34 Sections in 5 Divisions
Emergency
Radiology
Pathology
Anes.
CVT
Gen Surg
Plastic
ENT
Neuro Surg
Ortho
Ophthal
Dent Oral
DDS MD
Podiatry
Urology
Allergy
Cardiology
Derm
Endo
G.I.
HemOnc
Neuro
Nephro
Inf Disease
Occ Med
PM & R
Pulmo
Rheum
Rad Therapy
Group Compacts
VPMA
56 Medical Directors
Clinical Programs
Anesthesia
Bariatrics
Behav Inpt
Breast Health
Burn Unit
Card Cath
Card Cath
CCU/Telem
Card Rehab
Perinatal
Plastic Surgery
PM & R
Radiology
Radiology HSC
SICU
ED
Care Management
Card Research
Card EP
Heart Failure Clinic
Card Outreach
Card Clinics
Card Nuclear
Sleep Lab
Surgery 1
Surgery 2
Surgery Gen Call
Surgery Vascular
Surgery Trauma
EEG/EMG
GI Lab
Infection Control
Infec Diseases
Informatics 1
Informatics 2
Intensivist
MICU
Neurology
Neuro Dx Lab
Neuro Surgery
Trauma
Urology
Pediatrics
Pathology
Palliative Care 2
Ortho Gen
Ortho Trauma
Orthopedics
Onc Outreach
Oncology
Occ Med
OB/GYN Peri
OB/GYN GSS
Card Non Invasive Lab
Hospitalists Palliative Care 1
Current Complexity in Accountabilities & Compensation Among Hospital Physician Leaders
Med Education Programs
Emergency
Family Med
Occupational Med
Podiatry
Int Med
Ob Gyn
Gen Surgery
Neuro
Ophthal
PM & R
EMT
Radiology
Plastics
Ortho
Anesthesia
Psych
University
Medical Executive Committee
Market Realities
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Why clear and lean physician leadership structure?
1. To increase the effective empowerment of physician leaders to be more fully engaged in the processes of developing the clinical care and economic vitality polices and procedures;
2. To increase the likelihood that the physician leadership will be more transparent and understandable to physicians and hospital staff;
3. It will be easier to attract and retain the best and brightest physicians into leadership roles;
4. The physician leaders will more likely be successful and find satisfaction in their leadership roles; and
5. The physician leaders will be more effective and accountable to the mission and strategic plans of the hospital
How can hospitals invest to support physician leader development?
Beyond physician comp and fair market valuePrograms of Promise.To proactively design and support the development, compensation and performance enhancement of physician medical directors, medical staff leaders and clinical chairpersons.
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Physician Leadership Academies:
Assessed over 20 Programs: e.g.,American College of Physician ExecutivesBaylor HealthMayoPeaceHealthCedars SinaiCleveland ClinicSt. Thomas Physicians Leadership CollegeAdvisory BoardSeveral MBA and Executive Ed SchoolsInternational Health Leadership Program in Cambridge England
Survey Results on Factors that Facilitate and Frustrate Physician Leader Effectiveness
Input from over 400 hospital leaders
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Factors That Frustrate Success?
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Factors That Frustrate Success?
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Factors That Facilitate Success?
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Physician Leadership Academies
CompetenciesLearning Methods
Competencies
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Competencies
Beyond strong clinical skills, the Healthcare Leadership Alliance recommends 300 competencies five key common domains:
Communication and relationship management; Leadership; Professionalism; Knowledge of the health care environment; And Business knowledge and skills.
1 See e.g., American College of Medical Practice Executives (ACMPE)2 Baylor Health Care System
SelfAwareness
Learning Methods
Coaching or mentoringOn-the-job-experiencesFunding participation in on-campus leadership
trainingSkill building workshopsVolunteerism in other health related
organizationsSelf-study via books, audio tapes, video tapes
and distance learningDegree programs
Learning Philosophy 1.
Rely on small groups of physician cohorts for group learning, but encourage interdisciplinary projects and case studies, according to
Learning Philosophy 2.
Emphasize real-time case studies of serious challenges that relate to enhance patient experience, process improvements and measurable economic gain
Learning Philosophy 3.
Rely on a mix of in-house expert faculty with outsourcing to local business schools, national health leader associations or professional firms
Learning Philosophy 4.
Require short sessions such as a two- to four-hour spread during several weeks to encourage applications in real-world settings and to be respectful of physician time.
Learning Philosophy 5.
Cautious reliance on new digital learning tools, such as Webinars, Pod casting, Teleconferencing and dedicated Web sites for Knowledge Downloads and Expert Bulletin Boards.
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Academy: One Part of Comprehensive Program
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Physicians Leadership Academy
Building Blocks for Enhanced Physician Leadership
Quality & Patient SafetyPay for PerformanceIntegrated Care SystemsCost EffectivenessAttract & Retain Excellent Clinicians and Staff
Leader Positions Defined1
Position Descriptions2
Recruit for Competencies3
Performance Metrics4
Orientation5
Development6
Support7
Performance Reviews8
Recognition & Rewards9
Periodic System Refinements10
Strategic Imperatives:
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Mod 1: Clarify strategic directions for your physician leadership initiatives:
1. Review your most recent strategic and financial plans.2. Forecast your competitor moves for growth.3. Review your current incentive compensation philosophy
and systems for executives and physicians.4. Identify your key frustrations with physician/hospital
alignment and collaboration.5. Define preliminary strategic vision and goals for your
enhanced “Physician Leadership Performance Plan.”
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Mod 2: Establish workplan to audit and establish your enhanced PLS™:
1. Review board, CEO and CMO strategic motivations and priorities for enhanced physician leadership programming.
2. Define scope of work via number of physician leader positions to be reviewed, and expected degree of consultant involvement in program development and implementation.
3. Convent meeting with CEO and executive team to a defined timetable to complete analyses and plans for enhanced physician leadership.
4. Review preliminary workplan, timetable, and budget with CEO/Board.
5. Publish final workplan, calendar, and budget.
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Mod 3: Audit Physician Leader Arrangements:
1. Review Medical Staff Structure2. Review Physician Co-Ventures3. Review Medical Director Jobs4. Review Physician Leader Compensation Arrangements5. Review systems for recruiting and developing physician
leaders
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Mod 4. Assess Physician Leadership Culture:
1. Interview selected leaders of board, management, and medical staff
2. Conduct Web Survey of Physicians3. Conduct Web Survey of Physicians4. Conduct Web Survey of Nurses5. Conduct Web Survey of Board and Management
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Mod 5: Design performance development program:
1. Establish organization chart of key physician leader jobs in medical staff; in physician co-ventures; and as needed to execute the organization’s strategic business and financial plan.
2. Define ideal physician leader competencies and code of conduct.3. Update all physician leader job descriptions and performance
metrics.4. Design physician leader recruitment plan.5. Design physician leadership development program, staffing, and
materials.
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Mod 6: Establish performance appraisal system:
1. Identify SWOT of existing physician leader appraisal system.2. Establish strategic vision and philosophy for physician leader
appraisal linked to formal development and to recognition and reward.
3. Design infrastructure for physician appraisal system.4. Conduct orientation to appraisal system.5. Develop and install final physician appraisal system (staff,
software, hardware, web-based manuals, user guides).
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Mod 7: Develop performance-based pay:
1. Define “Physician Leader Compensation Philosophy” with CEO and Board.
2. Document current base and incentive compensation for each physician leader and position.
3. Conduct analyses on appropriateness and reasonableness of base and incentive compensation for each physician leader and position.
4. Develop data base that links each leader’s performance expectations with pay arrangements.
5. Develop policies and procedures to link performance appraisal systems with incentive pay arrangements.
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Mod 8: Publish PLPP™ manual:
1. Conduct client evaluation of all results and systems associated with Mods 1 through 7.
2. Develop updated text on vision, philosophy, goals, and strategies for Physician Leadership Performance Program (PLPP).
3. Seek final CEO, board, and medical staff approvals of draft PLPPpolicy and procedure manual.
4. Produce print and digital versions of the PLPP manual.5. Distribute PLPP manual to leadership of organization.
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Mod 9: Orient leadership to PLPP:
1. Develop orientation program, calendar and materials.2. Schedule invitations for leadership of board, medical staff,
co-ventures, and managers to be introduced to final PLPP.3. Conduct board retreat on PLPP.4. Conduct medial staff leadership retreat on PLPP.5. Conduct manager retreat on PLPP.
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Mod 10: Install infrastructure for PLPP in “Physician LeadersNet™” website:
1. Develop staff to implement and administer PLPP within updated medical staff office.
2. Design enhanced medical staff intranet for access by members of active medical staff.
3. Design enhanced “Physician LeadersNet™” as hosted website is integrated into hospital intranet.
4. Publish educational and motivational materials to facilitate understanding and use of PLPP and “Physician LeadersNet™”.
5. Conduct six-month surveys on use and effectiveness of PLPP and “Physician LeadersNet™”.
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Questions
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Webinar Series Continues...
Webinar #3 – GLS: Executive Coaching for Healthcare LeadershipThursday June 19, 2008 10:00 AM CDT
Webinar #4 – GLS: Leadership Continuity: Ensuring the C-Suite Chairs are never Empty Thursday July 17, 2008 10:00 AM CDT
Webinar #5 – GLS: Helping Develop the CEO through the Performance Appraisal Thursday August 14, 2008 10:00 AM CDT
Webinar #6 – GLS: Governing Executive Compensation: It's more than just creating the Rebuttable Presumption Thursday September 11, 2008 10:00 AM CDT