The document details the establishment of a guiding coalition of physicians at the Children's Hospital of Los Angeles, aimed at transforming care delivery with a focus on access and care model redesign. It highlights the importance of physician leadership, collaboration, and commitment to the hospital's long-term success, while addressing cultural challenges faced by division chiefs. The coalition will consist of diverse member characteristics, serve as an advisory body, and eventually expand its role to other transformative initiatives.

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Engaging Providers to Clear Access Hurdles:
Dr. Sajjad Yacoob, Chief Medical Director, Ambulatory
August 2017

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Children’s Hospital of Los Angeles
Private Academic, Not-for-Profit, Freestanding Pediatric Hospital - Founded
in 1901
Emergency Dept. Visits
110,000
Inpatient Discharges
20,825
Ambulatory Encounters
205,050

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Children’s Hospital of Los Angeles

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The Children’s Hospital of Los Angeles Vision
The Aspiration that Inspires and Informs Our Every Decision
To be the pediatric health system of
choice by offering transformative
compassionate care and life-
changing discoveries

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In Support of CHLA’s Vision
A Guiding Coalition of Physicians
To enfranchise a core group of physician leaders to guide
the transformation of Children’s Hospital Los Angeles and
bring its vision to reality
While there are many initiatives critical to this
transformation, the initial focus for the Guiding Coalition
will be Access and Care Model Redesign

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Physician Leadership Cultural Challenges
“I’m overwhelmed with
what is on already on my
plate as a division chief &
all the other change
management requirements
for multiple projects”
“I want an actual policy in
order to not have to be
the bad guy.”
“Aren’t there other things
that we should be
focusing on in access,
instead of asking providers
to simply work harder?”
I cannot be in two
places at once. I have
academic obligations
to meet outside of my
clinical time.”
“You’re asking me to meet
with my providers twice
on the same topic –
session variance &
Posada’s productivity
work.”
Comments from Division Chiefs

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Partnering with Division Leaders
Gastro NeuroENT OPH Endo Pulm
Chair, PediatricsVice Chair,
Surgery & CMO
Chief Ambulatory
Medical Director
Chair, Surgery
Physician Leaders Working Hand-in-Hand with Division Chiefs &
Administrators

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Enfranchising the Guiding Coalition of Physicians
Guiding Coalition of Physicians: Considerations
for Member Characteristics & Functions
Guiding Coalition Member Qualities &
Characteristics
• Demonstrated influencers and change agents
• Can “check” personal and specialty interests “at the
door”
• Currently in non-formal roles (to the extent possible)
• Committed to ensuring the long-term success of
CHLA
• An understanding of the importance of Access & Care
Model Transformation as part of that long-term
success
• Holds values consistent with the articulated values of
the system
• Strategic and system thinkers
• Collaborative (able to function as a member of a
deliberative body)
Roles / Function
• Advisory and guiding body
• General review, oversight and monitoring
• Conduit for innovation and leadership
development
• Input on quality, communication, and
outcomes (clinical, financial &
satisfaction)
• Ambassadors and champions for change
• A resource for feedback from
leadership, faculty & staff
Structure
• Target Membership: 7 - 9 individuals
• 3 Physician Co-Chairs
• Monthly meetings

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Organizational Success Depends on Physician Guidance
• The Guiding Coalition of physicians will focus on guiding and validating
the work being done in transforming care delivery at CHLA.
• Initially, the Guiding Coalition will focus on all access transformation
work.
• The Guiding Coalition will be advisory to the ACT specifically and provide
necessary feedback/input to the changes being advocated by the Access
Transformation team.
• Eventually, the role will evolve into a physician group that extends its role
to other transformative initiatives in the ambulatory clinics and eventually
to CHLA as a whole.
• The Department Chairs, Division Heads/Chiefs, and CHLAMG Leaders will
validate and authorize this advisory group.
Principles for the Guiding Coalition of Physicians

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The Guiding Coalition will be composed of individuals nominated by the
division chiefs/heads and have the following composition & characteristics:
• Diversity and inclusion will be expected (rank, gender, age, race/ethnicity, work
experience, etc.)
• Respected within their own division
• Thought leaders for the ambulatory space or the Medical Group
• Understanding of their division’s clinical practice (operational, clinical, financial,
etc.)
• Willingness to engage, to collaborate and to maintain an enterprise-wide view
• Demonstrated influencers, ambassadors and champions for transformation
• Currently in non-formal roles (to the extent possible)
• Committed to ensuring the long-term success of CHLA
• An understanding of the importance of Access & Care Model Transformation as
part of that long-term success
Organizational Success Depends on Physician Guidance
Composition of the Guiding Coalition of Physicians

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Source: Health Care Advisory Board interviews and analysis.
Executive Leadership Group
Guiding Coalition
Ambulatory Leadership Council
Ambulatory Council for
Transformation
Department Chairs
Creating a Unified Physician Input Structure
Defined Recommendations and Guidance to Optimize Efficacy Across
Organization

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Thank You &
Questions