Improving Trust Between Physicians and Administration
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The webinar focuses on improving trust between physicians and administration by addressing key perceptions and communication strategies. It highlights the necessity of building relationships, understanding each other's concerns, and fostering collaboration to facilitate systemic change. The document also provides case studies and strategies for effective communication and conflict resolution within healthcare settings.
Improving Trust Between Physicians and Administration
- 1. Improving Trust Between Physicians and Administration Thursday, July 28, 2016 Webinar Brian McCarthy, Director Neurosciences/Surgical Services
- 2. “Can’t we all just get along?” At the end of this presentation, participants will be able to: Identify the key issues that need to be addressed from Administration Identify the key issues that need to be addressed from Providers Develop a communication strategy that will open discussion Understand the difference between a “smoke screen” and a true issue Become the conduit to facilitate change within the system
- 3. Key Issues for Administration to Understand Perception of Administration by Physicians • Administration does not want to spend any $$$$$ • There is a hidden agenda • Decisions are made without consulting with those of us who are left dealing with the changes that will occur • Administration plays favorites • Based on volume • Based on profit for system • Many others
- 4. Key Issues for Physicians to Understand Perceptions of Physicians by Administration • Want the latest bell or whistle • If you solve one issue, they will find something else to complain about • When they come to complain, there is an ulterior motive, i.e. what is in it for them • They feel like we play favorites and everyone is treated differently • They make decisions without discussing it first
- 5. Perceptions are NOT the Truth Both sides feel as if they are at odds with each other Neither seems to be willing to work with one another The issue is trust
- 8. Trust Pyramid Trust Constructive Conflict Buy in and Commitment
- 9. Trust Pyramid Trust Constructive Conflict Buy in and Commitment Accountability
- 10. Trust Pyramid Trust Constructive Conflict Buy in and Commitment Accountability Focus on Results
- 11. Give before you take Terrance Moore • “Develop the relationships on the sunny days so that when you need their support on a rainy day they are there to help”
- 12. Building Trust Rounding • Schedule time and meet with the physicians one on one Ask them what their concerns are • Remember this is new and odd so do not expect them to believe in you at first • Commit to helping them and be sure to follow up on a regular basis • If you are waiting on someone else, share that Keep them involved in the process
- 13. Building Trust Rounding Continued • Do NOT commit to a solution • You cannot resolve all problems/issues • Do NOT make promises that you cannot for sure provide • Under promise and Over deliver
- 14. Building Trust Rounding Continued • Send a hand written thank you for the visit and the time • Share a summary of the meeting • Discuss what actions were decided on • Provide a proposed timeline • Make certain that the physician also has tasks to do so you keep them as an active participant in the process
- 15. Building Trust Rounding Continued • Follow-up on a regular basis • Provide updates • Gant chart may be helpful • Discuss road blocks and seek their input on resolving them
- 16. Examples from our Institution
- 17. History • Administration made decisions without physician input • Which instrumentation to use • Cutting staff or not adding staff • Physicians treated poorly or seeing others being favored • OR schedule • Block Time • Jumping rooms • Purchase of equipment • Perception that decisions are made based on the requesting provider
- 18. History Continued • Administration makes a promise but then does not come through • Inpatient rehab • Physicians request is denied without a clear explanation • Vein Clinic • Wound Clinic
- 19. Smoke Screens • Vein Clinic – Complained that asked for it and did not happen – When worked to get things rolling he came up with reasons why we should probably wait. • Key indicator that this is a smoke screen to something bigger. • Its ok to call them out on it. What is the problem?
- 20. Building trust by Example
- 21. Develop a communication strategy that will foster discussion Case Study I • Female Urinary Incontinence Slings • Four Hospital Health system (FY 2010) • High number of slings throughout system Inventory varied among each hospital • The idea • Put a team together • To Reduce the number of slings and vendors
- 22. Case Study I Cont. Meeting • Participants • Physicians • Staff • Reps • Format • Reps came in one by one • Presentations • Discussions
- 23. Goal Reduce variability Successful patient outcomes Availability of product Increases staff competency Reduce costs • Higher volume drives down costs for a vendor
- 24. 50% 12%1% 36% 11% AMS J&J Coloplast Bard Boston Scientific Slings Quantity Purchased FY11 (7/1/10-6/30/11) by MidMichigan Health
- 25. 7% 43% 9% 3% 1% 36% 1% MiniArc Monarc Obturator Abbrevo Aris Align Obtryx Purchased Quantity by Sling Model FY11 by MidMichigan Health
- 26. Vendor/Mfr Type Cost Vendor 1 1A $$$$$$$ Vendor 1 1B $$$$ Vendor 2 2A $$$$$ Vendor 2 2B $$$$$$ Vendor 3 3 $$ Vendor 4 4 $$$ Vendor 5 5 $
- 27. Scenarios Volume = 144 in each Scenario Estimated Spend Estimated Impact Scenario A Vendor 1A $71,280 -$77,615 Scenario B Vendor 3 $129,413 -$19,482 Scenario C Using 2 Vendors $141,450 -$7,445 Scenario D Vendor 2 B $176105 -$27,001
- 28. Post Meeting Follow-up Reminders needed Continue to Round Letter to all that attended highlighting the savings Give those in attendance the credit for the results
- 29. Case Study II Surgical Mesh Change in Format of meeting Results of this meeting Rep issues at this meeting
- 30. Surgical Mesh Four pages of Mesh Products • When you included various sizes over 100 different products Able to reduce to one page and about 20 products Biologics were not considered in this due to the legal issues with mesh still on going
- 31. Prior to April 2012
- 32. Results Prior to 2012 Mesh meeting: 67 different types & sizes Applications – Selections: • Lap Ventral/Incisional – 20 Types • Open Ventral/Incisional – 13 Types • Lap Inguinal – 6 Types • Open Inguinal – 17 Types • Umbilical – 9 Types Stock on Hand = $155,259 Current: 15 different types & sizes • Applications – Selections: • Lap Ventral/Incisional - 2 Types • Open Ventral/Incisional - 2 Types • Lap Inguinal - 3 Types • Open Inguinal - 2 Types • Umbilical - 2 mesh Types • Stock on Hand = $71,386 • Par Value = $63,805
- 33. Spine Instrumentation Two Surgeons Two Sales Reps • “Follow the Fool” Each Surgeon Requested a switch to two different companies. End Result was a compromise where most of the instrumentation will come from one company and unique products from another.
- 34. Quick Win Surgeon scheduling in block time but wanting to add a case and go longer than scheduled. • Request was denied by OR staff • Met with OR Director • Discussed issue • Reviewed the schedule • Found that could offer to jump rooms in afternoon • Resolved issue, built trust, Win Win
- 35. Quick Win Continued Surgeon refused to host clinics in Northern geography • I had already spent time one on one assisting with growth • Colorful discussion ensued and asked surgeon to trust me • Held initial clinic and I stayed with them all day • Spent down time marketing to other offices
- 36. You are the conduit to change • Get them to come to you with their issues • Have frank discussions with them • Get them involved in the discussion
- 37. Questions on the first Case Study
- 38. 38 Managing Orthopedic Episodes of Care www.wellbe.me
- 39. 39 Upcoming Live Event Musculoskeletal Leadership Summit October 6-7, 2016 – Chicago, IL http://www.orthoserviceline.com/summit Speakers include: • Renee Glanzman of Midwest Orthopedics at Rush and Christopher Nolan of Rush University Medical Center, on “Keys to a Successful Spine Bundle” • Kristi Crowe, Associate Vice President and Orthopedic Service Line Leader at Sg2, on “The Move to Outpatient Total Joints” • Bill Munley, VP of Professional Services and Orthopedics at Bon Secours St. Francis Health System, on “A Program for Hip Fractures” • Eula Ramroop, Associate Vice President at CHI Franciscan Health, on “Orthopedic Service Line Strategies” • Leslie Jebson, FACHE, FACMPE, Administrator and Adjunct Lecturer at the SIU School of Medicine, on “Recruitment, Employment and Integration of Orthopedic Surgeons” • and more!