The journey to accountable care and value based contracting requires fully integrated care systems along a wider continuum of care and service delivery sites. Health systems across the country now recognize that developing and managing a fully integrated delivery system is unlikely unless physician and advance practice providers are more intimately and effectively engaged in all dimensions of the care model and delivery arrangements.
A recent Becker’s Roundtable discussion in Chicago generated a series of practical ideas and investments that are important for enhanced provider engagement and alignment. They are summarized here in a question and answer format.
Why, and how, can systems invest in a culture that encourages, enables and enthuses enhanced physician engagement as a means for more integrated care delivery and a culture of high performance for superior patient experiences?
To carry out the Triple Aim (Healthy Communities, Patient Experience, Value for patients and for the organization), you need to embrace the Quadruple Aim (Triple Aim plus People) Intrinsic motivators for people (Daniel Pink in the book Drive): Value/Purpose, Autonomy (Voice), Ability to Master Their Craft
Answer: How: Ten Actions Merit Consideration:
- Jointly develop with physicians, executives and board members a formal “Provider Engagement Strategy and Road Map” that defines the importance and apporach fo optimal prvoder participation in, engagement for, and alignment with the budiness plans for accountabel care, population health, and value based contracting.
- Implement or enhance a “Dyad Leadership Model” to support, empower, and amplify the providers’ voice in collaboration with the administrative experience and tools of a partner manager. This partnership guides all aspects of service line planning, marketing, operational quality, superior patient experience mapping, financial plans and budgeting, and performance planninga and management initatives.
- Invite and support providers to control the development of clinical care standards with administrative support, with forums for full provider two-way communications in groups like a “Clinical Practice Council”
- Invest in “Provider Leadership Academies” to enhance Provider Leaders to embrace:
- Program Leadership balanced with Speciality Leadership
- Quality Imporvemnt Processes and Staff
- Inhouse and external expert “faculty”
- Experiential learning with support from real world case studies
- Identify the “Up and Commer Providers” and invest in competency assessments and customized development programming for their professional and personal growth.
- Establish transparent “Authority and Decsion-making Matrices and Policy Sets” across the organization (not just provider voice but other voices as well):
- Determine and declare who will make what types of decisions
- Engage key stakeholders for input/insight/reaction/feedback
- Once decision is made—Explain it transparently
- Clearly state the Expectations
- Remind all players that Health Care is a Team Sport- engage high functioning teams with folks operating at the top of their license
- Develop the right culture- “Our Best Begins With Me”, “Our Service Promise”, etc.See: https://www.centracare.com/about-us/our-best-for-you/
- Improve front line processes and work flows for staff and providers- one of the biggest drivers of burnout is wasteful and un-appreciated work proceses
- Move toward extraoridunary patient expereinces as the central aspect of the value equation, and help provider see how it all maps to issues that align with the organization’s strategy, and the provider compensation model, see: https://www.startupgrind.com/blog/customer-experience-mapping-what-is-it-and-how-to-do-it/
- Invite in employee advisors that help establish a formal Program that has its focus on employee well-being and culture enhancement programming.
What are key take away actions that health systems should consider to maximize physician engagement and alignment, and minimize burnout?
- Egage physician leaders to define a handful of ways to measure what we mean by provider “Engagement” and “Alignment” (see attached white paper)
- Burnout is not just a physician/APP problem. Your approach needs to be broad and not just focused entirely on providers.
- Open and disciplined decision-making processes is a key to allowing people across your organization to have voice—it cannot be viewed as a mechanism to just empower providers—it needs to be a common mechanism to seek insight from everyone across your organization
- Work to identify opportunities for all (not just providers) to master their craft and work at the top end of their licenses
- Invest in Provider Leadership Development Academies, see: https://www.integratedhealthcarestrategies.com/Library/KnowledgeCenter/articles/10-successfully-designed-physician-leadership-academies
How can your leadership team and board best arrange a conversation about these strategies in order to explore which ones fit your unique realities?