When the Baylor Heart and Vascular Hospital began, physician and administrative team started with common goals and a similar vision for improved patient care, but Vish acknowledged there were challenges “getting the entire team on board.”
But that has changed. The hospital’s twice-monthly medical leadership meeting involving physician and administration leadership is a key element toward “problem solving, goal creating and strategizing,” says Wheelan. The meetings “get longer with the complexities of certain issues and the government always continues to throw us curve balls of new processes and paperwork to deal with,” he says.
“The meeting is the environment in which we do a lot of problem solving. It’s a very open environment to address issues of quality, service, finance,” Wheelan says. “Data is a very critical element to our process and we believe the data needs to be transparent. Without metrics, comparisons and benchmarks, it is very difficult to achieve a higher level of excellence.”
“A lot of physicians will bring ideas problems from a clinical perspective and then hand off to an administrative team,” says Convery. While there have been tendencies to “compartmentalize,” meetings between administration and physicians on a “regularly structured basis helps keep all of that moving.”
The Accelerating Best Care at Baylor is an innovative educational program that focuses on healthcare quality and improvement, teaches healthcare leaders theory and techniques of rapid cycle quality improvement, outcomes management and staff. It facilitates the enhancement of skills by physicians, nurses, administration and others to lead quality improvement efforts.
Referring to physician and hospital alignment in co-management plans, panelist Tim Attebery, CEO of Wellmont Cardiology Services in Kingsport, TN, expressed some caution for those embarking on the process. He says many physicians are taking the wrong, initial steps. “A of cardiology groups are in discussion with hospitals about an integration arrangement and they have not put together a service line management arrangement,” he says. For physicians to be “truly at the table to be accountable for the overall performance of the enterprise, they have to have management responsibility and those responsibilities need to have quality metrics, cost metrics, patient satisfaction metrics and growth metrics. The physicians need to maintain a level of intensity and engagement.”
Suzette Jaskie, MBA, executive director of Frederik Meijer Heart & Vascular Institute for Spectrum Health in Grand Rapids, MI, says physicians are weighing autonomy or working within a system after determining “their ability to impact the system of care.” They may find that “autonomy is a small price to pay for impact,” she says.