McLeod Health Speakers Faculty Speakers Faculty Disclosure / Unlabeled Disclosure / Unlabeled Uses Disclosure Uses Disclosure Speakers Faculty Disclosure Speakers Faculty Disclosure Unlabeled Uses Disclosure Unlabeled Uses Disclosure Coy Irvin, MD Coy Irvin, MD No relevant financial relationships No relevant financial relationships Does not anticipate discussing Does not anticipate discussing unlabeled uses of any commercial unlabeled uses of any commercial products. products. Does not anticipate discussing any Does not anticipate discussing any investigational products investigational products
Does not anticipate discussing unlabeled uses Does not anticipate discussing unlabeled uses of any commercial products.of any commercial products.
Does not anticipate discussing any Does not anticipate discussing any investigational products investigational products
Copyright BLI 2003Copyright BLI 2003
Why is it Important to Why is it Important to talk about talk about
SERVICE EXCELLENCE?SERVICE EXCELLENCE?
Source: The Gallup Organization, August 2007
Americans’ Image of Americans’ Image of Business and IndustryBusiness and Industry
Access Problems: Three of Four Adults Have Difficulty Access Problems: Three of Four Adults Have Difficulty Getting Timely Access to Their Doctor Getting Timely Access to Their Doctor
Potential Waste: One-Third of Adults Experience Potential Waste: One-Third of Adults Experience Duplicative or Unnecessary CareDuplicative or Unnecessary Care
17
26
32
0 10 20 30 40
Percent reporting that it is very difficult/difficult
Docotrs ordered a test that had been donealready
Doctors recommended unnecessary treatment orcare
Either/both of the above
Copyright BLI 2003Copyright BLI 2003
Five Keys to Cultural ExcellenceFive Keys to Cultural Excellence
Culture will eat Culture will eat strategy for lunchstrategy for lunch
(every day of the week)!(every day of the week)!
An organization’s culture is the shared An organization’s culture is the shared philosophies, ideologies, values, assumptions, philosophies, ideologies, values, assumptions,
beliefs, attitudes and norms that knit the beliefs, attitudes and norms that knit the organizational members together.organizational members together.
Culture guides the way employees of the Culture guides the way employees of the organization act and think as they go about organization act and think as they go about doing their jobs.doing their jobs.
Culture is about the little Culture is about the little “around-here-isms”.“around-here-isms”.
What Is Organizational Culture?
Act like an owner!Act like an owner!
A Culture of Accountability A Culture of Accountability Requires Two Things:Requires Two Things:
1. A “maniacal” commitmenta. Philosophicalb. Behavioral
2. Tools and practices that support accountability
What drives patient satisfaction?What drives patient satisfaction?
Speed of registration process…………...81 %Speed of registration process…………...81 % Courtesy of the nurses/assistants...........79 %Courtesy of the nurses/assistants...........79 % Courtesy of receptionist..........................78 %Courtesy of receptionist..........................78 % Nurse/assistant’s concern for problem....78 %Nurse/assistant’s concern for problem....78 % Friendliness of person taking call............76 %Friendliness of person taking call............76 % Length of time doctor spent with you.......75 %Length of time doctor spent with you.......75 %
IT”S the LITTLE THINGSIT”S the LITTLE THINGS
Elevator etiquette.Elevator etiquette.
Lost Families and patients.Lost Families and patients.
Speak first, SMILE.Speak first, SMILE.
Service RecoveryService Recovery
Tell the Story's, the ones about staff Tell the Story's, the ones about staff caring about the patients and their caring about the patients and their families.families.
Culture change is a long term Culture change is a long term process.process.
Celebrate the employee that makes it Celebrate the employee that makes it happen. happen.
What’s In It What’s In It For Me?For Me?
Medicare refuses to Medicare refuses to pay for hospital pay for hospital
errors…errors…
We must cooperate
We have to cooperate
We are forced to cooperate
Why it is important to share HCAHPS data…
Consumer access to data
Media overage
Volume, revenue, reputation implications
Reimbursement: Inpatient Prospective Payment System
Reinforce your organization’s mission, vision and valuesSource: http://www.hcahpsonline.org/trainingmaterials.aspx
87%87% of doctors report of doctors report overall morale has declined overall morale has declined during the past 5 years.during the past 5 years.
60%60% of doctors report their of doctors report their enthusiasm for practicing enthusiasm for practicing medicine has dropped.medicine has dropped.
Kaiser Family Foundation Kaiser Family Foundation StudyStudy
So what makes it so difficult??So what makes it so difficult??Physicians
Collegial
Tactical
Short/medium timelines
Customer orientation
Clinical accountability
Track team
Personal investment of funds
Hospital Administrators
Hierarchical
Strategic
Medium/long timelines
Operational orientation
Economic accountability
Football team
Organizational investments
So how do we get
aligned??
10.70%
18.20%
26%
30.10%
43.10%
45%
Misinformed patients
Recordsmanagement
Time spent withpatients
Rising rates ofobesity
Cost of healthinsurnace
Cost of malpracticeinsurance
Driving Docs Crazy Doctors were asked to rate the frustration caused by certain issues. Their greatest frustrations: the cost of malpractice insurance and of
health insurance.
Source: Thomson Reuters, Health Leaders Media August 2008
In five years, I see myself working...
42.60%
58.10%
25.30%For my current practiceFor my current practice
In medical practice managementIn medical practice management
For an integrated delivery or hospital systemFor an integrated delivery or hospital system
Overall percentage of respondents who rated these issues as 4 or 5 on a 1-5 scale, with 1 meaning “zero probability” and 5 meaning “extreme probability”
Physician ConcernsPhysician Concerns
• Concerned about competence of nursing service
• Frustrated with administrative decisions
• Trust issues
• Poor staffing
• Administration makes decisions without MD input
Physician ChallengePhysician Challenge
1. Time, how can we save it?
2. Irritants, how can we reduce them?
3. Point of contact, identify for you hospital.
4. Review point of contact for each type of
physician.
– Non admitting primary care– Admitting primary care– Surgeon– Medicine subspecialty
Senior Manager’s office “in” the medical staff loungeSenior Manager’s office “in” the medical staff lounge
31% have Senior Managers who are assigned to physicians to 31% have Senior Managers who are assigned to physicians to maintain on-going relationships (51% very positive impact)maintain on-going relationships (51% very positive impact)
56% Physician Relations Program for members of active staff 56% Physician Relations Program for members of active staff (68% very satisfied)(68% very satisfied)
50% Physician Relations Program for referring physicians 50% Physician Relations Program for referring physicians (54% very satisfied)(54% very satisfied)
Why Working Together is DifficultWhy Working Together is Difficult Physicians control virtually all revenue to hospitals.Physicians control virtually all revenue to hospitals. Reimbursement cuts push physicians into technical Reimbursement cuts push physicians into technical
billing opportunities that have historically been the billing opportunities that have historically been the domain of the hospital.domain of the hospital.
Availability of capital and know-how for ancillary Availability of capital and know-how for ancillary services investment mitigates risks of physician entry.services investment mitigates risks of physician entry.
But…But… Hospitals have the organizational capacity.Hospitals have the organizational capacity. Hospitals are the shepherd of community healthcare Hospitals are the shepherd of community healthcare
interests.interests. Capital availability and know-how are fungible.Capital availability and know-how are fungible.
We need physicians as customers and partners.Without both relationships, we will sub optimize the
opportunity to build a winning medical staff.
We need physicians as customers and partners.Without both relationships, we will sub optimize the
opportunity to build a winning medical staff.
Bottom Line:Bottom Line:We Need Each OtherWe Need Each Other
… The success of healthcare organizations is interdependent on the
success of its physicians.
Failure to cooperate does not remove the interdependence; it just creates a
