PLF hosts session on innovative models of care delivery

This past Tuesday in San Diego, CA, the AHA’s Physician Leadership Forum, along with the American Society of Anesthesiologists hosted an afternoon session in conjunction with the Health Forum/AHA Leadership Summit on Innovative Models of Care Delivery. More than 100 physician leaders and hospital executives gathered to learn about two care models that ease transitions across the continuum of care: the perioperative surgical home and the Hospital at Home^®.

 

Jeff Selberg, executive director of the Peter G. Peterson Foundation, delivered the keynote address. Mr. Selberg stressed the key to innovative models of delivery is in the execution. Innovation requires change; change of self, how teams work together, respect for one another and mutual accountability.

 

Proceedings will be published later this fall. For more information on the speakers and topics, click here.

Shared decision-making leads to better outcomes

A recent article from HealthLeaders Media discusses how a team-based care approach and shared decision-making can improve the patient experience. The article profiles Carolinas Medical Center-Mercy, that wanted to test whether shared-decision making would lead to better outcomes. Carolinas Medical Center-Mercy was awarded a $2 million, three-year grant from the Patient-Centered Outcomes Research Institute to test a shared decision-making toolkit for asthma care in the primary care setting. With shared decision-making, doctors are trying to include discussion that guides patients beyond just stating what their problem is, but what their goals are. The project started last August and includes 30 practices statewide. Preliminary results have been promising with a 5 percent drop in admissions to the emergency department, a 3 percent drop in inpatient hospitalizations and a 7 percent drop in the use of oral steroids. The approach has been working so well that some doctors are using it to treat other chronic illnesses.

What residents should know on day one

New guidelines from the Association of American Medical Colleges (AAMC) will help residents be better prepared to do the tasks related to residency from day one, according to a recent article from H&HN Daily. Improving patient safety was a key driver in formulating the list, the article says. Some of the skills incoming residents should be able to perform include gathering a history and performing a physical examination, prioritizing a differential diagnosis following a clinical encounter and recommending and interpreting common diagnostic and screening tests. Robert Englander, MD, senior director of competency-based learning and assessment for the AAMC, says the next step is for his group to survey residency program directors to see how well prepared residents were on day one. This will help establish a baseline, at which point they can measure and assess how well residents are being prepared. Dr. Englander says the ultimate goal is for residents to come in fully prepared to do the tasks of residency without direct supervision.

ACPE and TJC launch CMO academy

The American College of Physician Executives (ACPE), in partnership with The Joint Commission (TJC), has launched a training academy for chief medical officers (CMO), according to a recent article from HealthLeaders Media. The goal of the academy is to give those who are already in the role or who aspire to the role of CMO the tools and resources necessary to succeed in the position. The article says CMOs will also gain a better understanding of their role as employer and manager of clinicians who are used to acting with great autonomy. Selected course offerings include “Building and Leading Effective Teams,” “Introduction to Finance and Economics in Health Care,” and “Engaging Physicians for Results.” In the article, Peter Angood, MD, ACPE president and CEO, says, "This is not just about getting better with accreditation reviews; this is actually about creating change in health care, and transforming how health care is delivered with the role of the CMO being there."

 

Last year, the AHA’s Physician Leadership Forum together with the ACPE held a half-day session to better understand the changing landscape and the leadership competencies physicians will need to be effective partners with hospitals and health systems and move toward a more accountable and efficient health delivery system. Highlights of this session are discussed in Physician Leadership: The Implications for a Transformed Delivery System. This report discusses the case for developing physician leaders, identifies characteristics to consider for leadership education programs, and concludes with the proceedings from the session.

Spending limited money wisely on GME

A recent article from the New England Journal of Medicine discusses the economics of graduate medical education (GME), specifically that expanding GME funding is not the sole answer to solving the physician shortage. The authors argue that increasing direct medical education funding, the pay that goes toward resident and supervising physician salaries, would do little to offset the cost of training physicians. Because medical training is general and portable, the authors say it makes no sense for employers to subsidize its cost. If the goal is to encourage more physicians to go into primary care or to ease their burden of debt, the authors feel other strategies may be more effective, such as offering selective loan forgiveness or vouchers to offset tuition for trainees who want to go into primary care. The authors say it will take more than expanding GME funding to solve the problems of the current system and that the limited monies available for training must be spent wisely to achieve clearly articulated goals.

Some physicians wary of new MOC requirements

Are new maintenance of certification requirements for physicians too burdensome or are they necessary for physicians who want to practice in this changing health care environment? The answer depends on who you ask. In a recent article for HealthLeaders Media, David Fleming, president of the American College of Physicians, an association representing 120,000 practicing internists, says the new requirements, which took effect Jan. 1, "are not evidence-based, but are expensive, burdensome, and detract from the care of the patient.” Dr. Fleming and his group are specifically against how the American Board of Internal Medicine (ABIM) is interpreting the recertification mandate from the American Board of Medical Specialties (ABMS), the group that oversees all 24 medical specialty boards. In the article, Fleming says, “ABIM’s requirements are as rigorous or more rigorous than many other certification boards.” In response, ABIM President and CEO Richard Baron, MD, says the old way of certification doesn’t work in this changed environment. ABIM decided to move forward with doctors having to satisfy certain performance and education criteria in a series of cycles rather than wait until the last few months to complete it all. Dr. Baron says the public today wants a physician who remains up-to-date on current discipline practices. Articles explaining the issue from the ABIM and from the ACP’s perspective appeared in a recent issue of Annals of Internal Medicine.

 

A related article for Kaiser Health News discusses the same issue. The article says many specialists are wary of the new requirements, warning the demands may force some physicians out of practice at a time when the nation faces a shortage. Supporters contend the new process will ensure doctors incorporate the latest medical advances into their practices.

Utilizing physician differentiation to create value

A recent article from H&HN Daily looks at hospitals acquiring multiple physician practices and the continued struggle for creating strategic coherence among them. According to the article, attaining strategic coherence involves strategy and at the heart of strategy is differentiation, which ultimately generates value. The article says there are five ways hospitals can use physician differentiation in order to create value for the organization. They are:

The article says physician differentiation is the most valuable asset a hospital has and that it will require continued attention and investment in order to generate ongoing value.

Team-based care the focus of next PLF webinar

Register now for the PLF’s next webinar, "Taking Charge of Team-Based Care: Lessons Learned and Results Attained," taking place Wednesday, Sept. 10, 2014 beginning at 3:30 p.m. ET.

 

In this hour-long webinar, presenters Susan D. Douglass, president, Susan Douglass and Associates, LLC, and Paul H. Keckley, PhD, managing director, healthcare, Navigant Consulting, Inc., will present a proven set of building blocks for a successful transition to team-based care as well as two case studies and some key skill sets required for success including some from outside the health care field. Specifically:

To register for this complimentary webinar, click here.

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