By Shawna O’Neill, RN, MHA

Hospitals may make allowances for employed physicians to attend meetings during the day, private practice physician schedules are not as flexible. It is often difficult to schedule meetings during times that are convenient to physicians in private practice. For ease of operation, some hospitals choose to have employed physicians on committees or task forces. Excluding independent physicians may result in requirements that independent physicians may find unacceptable. Consequently, desired results will not be uniformly achieved resulting in finger-pointing and divisiveness.

While many independent physicians want to be engaged because they support improvement, other independent physicians may want some type of reward for the time they are taking away from their office and patients. It’s difficult for hospitals to ignore the request for some form of compensation for time and effort. Some hospitals pay physicians for their time spent on committee work, which may limit the extent of engagement.An alternative is to create incentives for results that are achieved (e.g. gainsharing, or commitments to purchase new equipment or provide allied health professionals to save physician time when they are at the hospital). This approach is especially helpful when trying to engage more physicians than just a few single leaders.

Dealing with Loss

Like most people, physicians have difficulties accepting the need to embrace changes that result in loss. When physicians are part of the change process, they have an opportunity to be more vocal about their concerns. Hospital leaders will have to address these issues skillfully with physicians. Public stands tend to lock people into inflexible positions, so we often recommend discussing deeply held issues in private. This enables physicians to reconsider their positions outside of the public light.

A No-Lay Off Policy

Personnel matters are often very important to physicians. As processes are streamlined and waste is removed from the system, there may be less staff needed in certain areas. Physicians who work closely with hospital staff tend to be very protective of staff with whom they work well. Hospitals can allay physician concerns by adopting a no lay-off policy. By providing retraining and reassignment of employees and downsizing through attrition, physicians will be better able to accept changes if they feel that staff members will be protected.

Better Care, Quicker

Engaging physicians in process change initiatives will enhance your ability to provide better care more efficiently. Besides being able to address “third rail” issues, physicians will identify issues that might otherwise be overlooked and help to make achievement sustainable by their support and active involvement. Physician engagement can help drive changes through the organization to modify processes so patients receive better care and have a better clinical experience. Cutting waste, making work easier and simplifying processes so they fail less often leads to greater reliability and lower cost.

Since physicians play a key leadership role in determining the clinical needs of patients, they must play a leadership role in redesigning care processes. To assure that integrating physicians in clinical redesign projects is successful, hospitals will need to examine how they organize projects and work with physicians.

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Engage Physicians in Clinical Process Improvements … and Deliver Better Care, Quicker – Part 1

Managing Risks – Engaging Physicians in Process Efficiency Delivers Better Care, Quicker – Part 2