PHYSICIAN ENGAGEMENT FORUM

Arizona Critical Access Hospital Quality Network

Arizona Rural Hospital Flexibility Program

Roy Farrell, MDChief Medical OfficerCarondelet Holy Cross Hospital

Wendy M. Perrell, EdDService Excellence CoachWe Empower Consciousness

• Share evidence-based practices to create a culture of engagement, alignment, and accountability.

• Share evidence-based techniques and tools that will enhance physician engagement and improve the patient’s perception of care.

• Learn how to create a culture of trust, collaboration, innovation, and engagement.

PURPOSE OF TODAY’S FORUM

AGENDA

1. Welcome and Introductions

2. Physician Engagement Transformation and Challenges

3. Engagement Vision and Goals: Alignment

4. Engagement, Collaboration, and Alignment

5. Engagement and Alignment Strategies and Tools

6. HCHAPS Alignment Tool

7. Evidence-based Tools

8. July Topic: Accountability

9. Resources

INTRODUCTIONS

• Name, hospital, and role• What are your current physician engagement

challenges?• What is working well with your physician

team?• What would you like to gain from this forum?• What are your top 2 priorities in your hospital

for 2015?

PHYSICIAN ENGAGEMENT TRANSFORMATION AND CHALLENGES

Explain/Instructions Treatments and Tests

Understanding and caring

Doctor's Quality of Care

Teamwork

55

56

55

55

51

43

48

45

Sample Size 100CY2012 CY2014

Percent of patients who answered “Excellent” to the question.

ENGAGEMENT VISION AND GOALS: ALIGNMENT

• Create a clear vision linking the hospital’s core values and objectives to patient experience improvement goals.- Establish baseline and develop % target improvement goal.

• What should patient-centered care experience look and feel like?- Positive first impression - Don’t harm me- Be nice to me- Heal me

• What is the hospital team capable of delivering? • What culture change is needed to deliver these results?

“Give to us a clear vision that we may know where to stand and what to stand for - because unless we stand for something, we shall fall for anything.” – Peter Marshall

• Create alignment by developing patient experience behavior standards and expectations.

• Engage physicians by collecting their feedback, ideas, and concerns-Physician Engagement Survey-Show you are working on concerns (Stop Light)

• Include all physicians, (independent, contractors and department chairs) in the hospital’s vision .

• Set improvement goals: both organizational and individual • 5-1 feedback to emphasize what is working well (Rounding 101, Rounding )• Use real-time patient experience survey results such as:

– “The doctor was very informative and really gave me details about what was going on. His ability of treating my son amazed me.”

– “The doctor was very in tune, picked up signs and addressed them immediately.”– “If the doctor treated me better, it was an American doctor. He was older, he would yell and I felt

discriminated against.”– “More attention with the doctor. The doctor was the problem like he didn't even care.”

ENGAGEMENT, COLLABORATION,AND ALIGNMENT

ENGAGEMENT AND ALIGNMENT STRATEGIES AND TOOLS

• Create engagement and alignment by implementing patient experience behavior standards and expectations.

-5/10 rule (Decrease Fears)-5/1 feedback (Engagement Communication Techniques)-Stop for the light-Align survey questions with desired AIDET, keywords, and scripting

• Identify and engage physician and nurse champions to support vision• Link all actions and conversations to expectations and goals• Hire for fit at all levels and replace staff who are not a good fit• Review contract expectations• Leaders rounding on all staff

-Daily and weekly check-ins including nights and weekends• Add patient experience data to all meeting agendas• Train the team to understand patient experience expectations, goals and data• Celebrate wins

HCHAPS ALIGNMENT TOOL

• Align HCAHPS survey questions with processes and expectations -Complaints/grievances-AIDET behaviors, key words or scripts (HCAHPS keywords)

• Patient experience is added to orientation

• Patient experience training -Entire hospital team-Understand patient satisfaction data-Teamwork strategies-Cheat sheets

Keyword Examples:

I CARE about your health after you get home

To protect your PRIVACY…

For your COMFORT…I want to keep you

INFORMED…I want to make sure we

are THOROUGHFor your SAFETY

STRATEGIC USE OF EVIDENCE-BASED TOOLS TO CHANGE OUR CULTURE

• 3 types of rounding– Leadership– Support services– Team members

• 5 to 1 feedback• “WOW” cards• Handoffs and

transitions• Behavior standards

– AIDET– Managing-up– 5-10 Rule

• SBAR• Safety huddles• Patient data/comments• Whiteboard protocol• Vocera protocol• Scripting• Audits• Service recovery• Stop for the light• Training and

competencies• Shadow and coaching

EVIDENCE-BASED TOOLS

EXAMPLES AVAILABLE

CHEAT SHEET EXAMPLE

JULY FORUM

• 14 July 2015 at 12 pm • Forum topic: Accountability• Next steps• Registration is required. Please register at

https://mezcoph.webex.com/mezcoph/onstage/g.php?MTID=ec3c480a6a20fdcdad8e31aa036d36416

RESOURCES

• Hunn, Michael, Building a Spirit of Trust/Collaboration with Physicians as Accountable Care Emerges. https://www.studergroup.com/resources/healthcare-improvement-webinars/current/building-a-spirit-of-trust-collaboration-with-phys

• Leebov, Wendy., EdD., and Rotering, C., MD., The Language of Caring Guide for Physicians: Communication Essentials for Patient-Centered Care. Leebov Golde Group, 2012.