Physician Relations Panel: Medical Staff Models of the Future
Edward G. Murphy, MD, President & CEO, Carilion Clinic
Nancy Howell Agee, COO & executive vice president, Carilion Clinic
R. Bruce Wellman, MD, President & CEO, Carle Association
James C. Leonard, MD, President & CEO, Carle Foundation Hospital
Kelby Krabbenhoft, President & CEO, Sanford Health
Dan W. Blue, MD, President, Sanford Clinic
Full hospital-physician integration is often held up as the key solution to many of healthcare's most significant problems. Hospitals are calling on their affiliated doctors to provide an increasing level of support and leadership that is often in direct conflict with the business of the medical practice, "where physicians are on the fee-for-service treadmill every day," says Edward G. Murphy, MD.
Carilion Clinic, where Murphy is president and CEO, is just over two years into a plan to fully integrate by adopting the clinic model. "At the end of the day, it's going to be almost impossible to get stable, real alignment between doctors and hospitals if they don't share real common interest over how to become aligned, which probably requires in its fullest form a common bottom line," says Murphy.
Taking up a similar challenge at Sanford Health 12 years ago, Kelby Krabbenhoft led his organization to the integrated clinic model by adhering to the principle of providing better patient care. Sure, conflicts resulted with physicians and administrators who wanted no part of the cultural and organizational restructuring, but Krabbenhoft says Sanford Health went from a $250 million organization to a $1.5 billion one. "And if it wasn't for this integrated model, a man by the name of Mr. Sanford would not have been interested in giving us $400 million as a philanthropic gift."
Full integration isn't always possible, but today's hospital and medical group leaders need to create more effective medical staff models that require physicians to direct the hospital's patient experience, panelists say. As the leader of a physician organization, R. Bruce Wellman, MD, noted that many hospitals are struggling with both educating physician leaders and compensating them for their time. In nonintegrated systems, individual interest is too frequently protected ahead of the community's needs, he says, and the traditional organized medical staff doesn't allow for the change management needed to deliver the best care, quality, and efficiency.
Quality Panel: Survive and Thrive with Transparency
Wayne Sensor, CEO, Alegent Health, Omaha, NE
Scott Wooten, CFO and Senior Vice President, Alegent Health, Omaha, NE
Thomas Royer, President and CEO, CHRISTUS Health, Irving, TX
Linda McClung, Senior Vice President for Communications, Public Affairs, Philanthropy, and System Service, CHRISTUS Health, Irving, TX
Bruce Crowther, President and CEO, Northwest Community Hospital, Arlington Heights, IL
Angela Stefaniu, Vice President of Marketing and Business Development Northwest Community Hospital, Arlington Heights, IL
Government reporting requirements and increased consumer interest have led many hospitals to post at least some information about costs, quality, or patient satisfaction online. But most organizations still haven't truly embraced transparency.
Alegent Health started its transparency journey in 2004. CEO Wayne Sensor took out full page ads in the local newspaper, even though that meant posting heart failure scores for Alegent's largest tertiary hospital that were below the regional average.
When people realize you are serious about posting both the good and the bad, "what happens is magical," says Sensor. "It becomes part of the culture . . . Nobody wants to be on a losing team." Alegent Health also developed the MyCost tool, which provides consumers with an accurate cost estimate of receiving care at its hospitals.
CHRISTUS Health set clear transparency metrics in four areas: clinical quality, service delivery, business literacy, and community value. It also incorporated a strong accountability component by offering patients a written guarantee of service. "You can't negotiate this," says President and CEO Thomas Royer. "You need to say transparency is who we are, it is part of our brand, and it is where we are going to go."
Northwest Community Hospital was the first Chicago-area hospital to post its patient satisfaction scores, hospital-acquired infection data, and other measures online in the fall of 2007. Northwest made sure to engage community members when developing the prototype for its Web site, says Angela Stefaniu, vice president of marketing and business development.
"We went out into some of the local libraries and met with individuals one-on-one to ask them to comment and share feedback," she says. Northwest also made the transparency model live on its Web site so staff members and clinicians could comment, as well.