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Operations Efficiency                through         Physician EngagementGHS Leadership Team    Kevin Gilroy, MDMeeting   ...
The Culture of Engagement •  Department of Medicine DRG Project:   –  Goals:      •  Improve Operational Efficiency      •...
The Culture of Engagement •  Top 12 DRGs identified for cost savings    opportunity   –    Congestive Heart Failure   –   ...
The Culture of Engagement •  Multidisciplinary Physician Team created for each DRG    –  Hospitalist with Subspecialist(s)...
The Culture of Engagement•  DRG Team Review:   –  Physician opportunity / ownership issues identified: Prime Focus!       ...
The Culture of Engagement•  Physician ownership issues (examples):  –  Documentation integrity opportunities     •  Physic...
The Culture of Engagement•  Non-Physician issues (examples):  –  Reactive Case Management / Social Work  –  Coding discrep...
The Culture of Engagement
The Culture of Engagement
The Culture of Engagement•  Benefits outside of cost savings  –  Transparent focus on Physician Improvement / practice opp...
The Culture of Engagement•  Reasons for success  –  Administrative support of Physician-led System     •  An organizationa...
The Culture of Engagement•  Future opportunities / needs assessment  –  Improved data collection and management     •  Tra...
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Leadership Team Gilroy, MD -3-16-11

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Transcript of "Leadership Team Gilroy, MD -3-16-11"

  1. 1. Operations Efficiency through Physician EngagementGHS Leadership Team Kevin Gilroy, MDMeeting Internal Medicine, Lead HospitalistMarch 16, 2011 Associate Program Director, Internal Medicine Residency Program
  2. 2. The Culture of Engagement •  Department of Medicine DRG Project: –  Goals: •  Improve Operational Efficiency •  Cost Reduction –  Via: •  Standardized Care •  Evidence-based focus •  Identification of Process barriers •  Physician Engagement and Ownership
  3. 3. The Culture of Engagement •  Top 12 DRGs identified for cost savings opportunity –  Congestive Heart Failure –  Sepsis –  Pneumonia –  Renal Failure –  Stroke –  Acute Pancreatitis –  Urinary Tract Infection –  GI Bleed –  Diabetes –  Overdose –  Respiratory Failure with Tracheostomy –  Acute Leukemia
  4. 4. The Culture of Engagement •  Multidisciplinary Physician Team created for each DRG –  Hospitalist with Subspecialist(s) •  Physician owned / affiliated (majority) •  Private (GI, Hem/Onc, Nephrology) •  Individual DRG Team education, data overview, goal setting •  Random sample of 25 charts reviewed by each team •  Business Intelligence utilized for further data drill down •  Opportunities identified; Action plans later created
  5. 5. The Culture of Engagement•  DRG Team Review: –  Physician opportunity / ownership issues identified: Prime Focus! •  “Taking care of our own backyard” drilled home –  Non-Physician opportunities identified: Secondary•  DRG specific and common themes identified•  Action Plans created to address major issues identified –  Physician-specific opportunities - Priority –  System specific opportunity recommendations –  Timelines created –  Follow-up data reviewed
  6. 6. The Culture of Engagement•  Physician ownership issues (examples): –  Documentation integrity opportunities •  Physician lack of understanding coding world –  Sepsis management delays –  Plavix procedural delays –  Lack of aggressive management / resuscitation: •  Pancreatitis •  Sepsis –  Lack of antibiotic stewardship –  Lack of evidence-based standardization for •  Pancreatitis •  Sepsis •  PNM •  CVA •  CHF
  7. 7. The Culture of Engagement•  Non-Physician issues (examples): –  Reactive Case Management / Social Work –  Coding discrepancies / Separation from clinical world –  Sepsis management delays •  Nursing education and training in ER •  Transport delays •  ICU bed availability –  Contaminated blood culture results –  Data management •  Lack of Physician-specific utilization •  Lack of Service-focused patient / data assignment –  Limited Behavioral Patient Bed access / State resources –  Lack of coordinated post acute care assessment / transition
  8. 8. The Culture of Engagement
  9. 9. The Culture of Engagement
  10. 10. The Culture of Engagement•  Benefits outside of cost savings –  Transparent focus on Physician Improvement / practice opportunities –  Highlighting “our” unexplained Physician practice variation •  Acceptance of its existence and detriment to our Patients and System •  Taking ownership to create the solutions –  Linking a strong bottom line to enhancing Physician support for patient care –  Physician access and education on Data management and capability –  Shared focus / unified goal of the Department •  Relationship building between Divisions •  Fostering a “Team” atmosphere –  Physician education regarding System operations / processes of care –  Physician education regarding Payment methods and System solvency –  Highlighting Physician responsibility and ownership for financial success •  Equal / equivalent to Quality care •  Everyday practice focus among Divisions –  Fostering Physician creativity in streamlining / maximizing operational efficiency –  Physicians and System = One in the same!
  11. 11. The Culture of Engagement•  Reasons for success –  Administrative support of Physician-led System •  An organizational culture change •  Physician buy-in increasing –  Administrative Leadership •  Transparent, accountable, engaged, accessible, workforce Leadership and development –  Physician owned / aligned Medical Staff (majority) –  Administrative resource support behind project •  Business Intelligence: Janet Thompson and Renee Tollison (phenomenal) –  Department Chair Leadership and Focus •  IM Leadership biweekly Meetings / Education –  Economic downturn –  Local Competition –  Clarity of Healthcare Reform landscape: Keys to survival and success
  12. 12. The Culture of Engagement•  Future opportunities / needs assessment –  Improved data collection and management •  Transparent Physician performance with real-time feedback •  Access to office based EMRs –  Clinical IT decisional support systems •  Gains to date based on Education / awareness alone: short half-life –  Case Management development –  More nimble Pharmacy and Therapeutics committee •  More real-time Formulary efficacy and cost evaluation / adjustment –  Antibiotic stewardship development / growth •  High cost / Highly utilized medications •  LOS opportunity –  Continued Medical Staff involvement / engagement / ownership
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