1 / 16

St. Joseph Heritage Medial Group

Physician Leadership and Incentives to Sustain Change Michael Gilbert, MD Associate Medical Director. St. Joseph Heritage Medial Group. Specialty: 40 primary care providers Geographic location: Central Orange County Three clinic sites: Orange, Tustin and Santa Ana

elroy
Download Presentation

St. Joseph Heritage Medial Group

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Physician Leadership and Incentives to Sustain ChangeMichael Gilbert, MDAssociate Medical Director

  2. St. Joseph Heritage Medial Group • Specialty: 40 primary care providers • Geographic location: Central Orange County • Three clinic sites: Orange, Tustin and Santa Ana • Group Ownership: Physician shareholders • Affiliation: St. Joseph Health Care System

  3. Focus on Patient Experience • Chose patient experience to drive our change improvement initiative • Greatest potential for improvement in patient experience • Selected Access as an improvement initiative • Telephone Calls • Appointment Access • Office Wait Times • Measure improvement • Group level: Patient Assessment Survey • Provider level: Avatar International • Monthly survey • Quarterly provider feedback

  4. Creating an Infrastructure for Change • Participated in CQC’s Optimizing Performance Series • Formed a Performance Improvement Team • Team charter • Sanctioned by and reports to Board of Directors • Chose high profile physician and administrative leaders as team members: • 4 physicians: BOD member, Dept. Chair, Medical Director • 5 administrators: Directors of Operations, Performance Improvement, Quality, Practice Development & Health Promotion • Full monetary support by administration and medical group

  5. Improvement Initiative: 1. Appointment Access 2. Office Wait Times 3. Telephone Access Leadership Strategy: Offering Financial Incentives Imposing Fine System Involving Physicians in the Improvement Process Leadership Strategies

  6. Advanced Access Initiative: Financial Incentives • Developed a financial offering through our Provider Service Agreement to motivate providers to partner with administration in opening up schedules • Agreed to and approved by Medical Directors, Board of Directors and senior administrators • Communicated agreement with physicians

  7. Advanced Access Outcome • Met with all 40 providers in 4 months • Changed schedules to create more patient accessibility • Cleaned up schedules for: days and hours of patient care, built in physician preferences and convoluted historical restrictions • Resulted in: any/any schedule for all providers, allowing some preferences rather than hard wired restrictions

  8. Office Wait Time Initiative: Imposing Fines • Generated reports through AEMR • Published data to physicians • Informed physicians of standard of care • In process of implementing a fine system for providers who consistently arrive late

  9. Outcome • Modeled the fine system after a similar system of reporting notification for completion of medical record tasks • Lesson learned: Figure out what works in your medical group for similar problems and replicate it

  10. Telephone Access Initiative:Involve Physicians in the Process • Include staff and physicians in the entire initiative from start to finish – Salsa Worker! • Recognize and clean up messiness in the process • Align success in performance improvement initiative with physicians financial operations and quality bonuses • Cut teeth on reporting and transparency

  11. Outcomes

  12. Data and Reporting • Improvement initiatives should be measurable (CQC tenet) • Data must be: • Accurate to withstand physician scrutiny • Shared at frequent intervals • Presented in provider level detail • Shared with entire team: physician, MA and receptionist

  13. Quarterly Provider Reports

  14. Transparency of Data

  15. Provider Level Data

  16. Provider Incentives • Harper Award bonus • Incorporate performance goals into long standing tradition of measuring quality • Provider Service Agreement incentive • Tied in performance goals to physicians financial operations • Promote team incentives • Align physician goals with staff and leadership incentives • MAs and reception staff receive monetary incentive for improvement in key initiatives

More Related