Becker's Health IT + Clinical Leadership 2018 Speaker Series: 2 questions with McLaren Lapeer Region Community Medical Center Chief Nursing Officer and Vice President, Patient Care Services, Janet Nixon

Janet Nixon, DHA, MS, BSN serves as the Chief Nursing Officer and Vice President, Patient Care Services for McLaren Lapeer Region Community Medical Center.

On May 11th, Janet Nixon will present at Becker's Health IT + Clinical Leadership 2018. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place May 10-11th 2018 in Chicago.

To learn more about the conference and Ms. Nixon's session, click here.

Question: All healthcare is local. How does your market influence your organization's business or operations?

Janet Nixon: I work for a system hospital in a community of 70,000. Our primary service area is rural, and we are the only hospital in the county. There is a lot of local sentiment supportive of the hospital. Our mission and vision focuses on serving the needs and enhancing the health of the people we serve. Every three years, as required by the Patient Protection and Affordable Care Act of 2010, we conduct the Community Health Needs Assessment. The survey indicates major health concerns in our market area are obesity, diabetes and use of tobacco and alcohol. Additionally, we see a lot of cardiac and peripheral vascular disease. As a result, we focus our three-year strategic planning process on ways to mitigate these health concerns and meet the needs of our population. For example, we are recruiting an endocrinologist to support a robust inpatient and outpatient diabetic program. This program will encompass medical management, nutritional counseling and education. Services planned for the future include becoming a bariatric center of excellence and developing a peripheral vascular/limb salvage program. To support the community, we participate in many activities to promote wellness, including school visits, donations to the food bank and health screenings. To improve population health, it is imperative hospital leaders identify the healthcare needs of the people they serve and devote resources accordingly.

HPSA (Health Professional Shortage Area) acumen. 2017. Retrieved from

Q: When was the last time your organization responded to concerns or needs expressed by physicians? What unfolded?

JN: I believe responding to the concerns or needs expressed by physicians is a key role for a healthcare leader. Strategically, healthcare leaders must work with their physician leaders to determine how best to collaborate with the physicians to build relationships that promote trust and communication. However, healthcare leaders must move beyond developing communication channels and determine how they can integrate fully with physicians to drive strategic initiatives (Center for Healthcare Governance, 2012). Together, healthcare leaders and physicians may focus on quality and the value of services, to benefit the health of the population they serve. Additionally, this collaboration will assist healthcare leaders and physicians to prioritize issues and requests for capital expenditures.

Like many organizations, we conduct an annual physician engagement survey. This survey is designed to ascertain immediate concerns that are not detected during senior leadership rounding. Any concerns are addressed as soon as possible, with feedback to the physician or through their section meeting, if the survey was completed anonymously. As important, however, are the comments that we receive for improvements and the identification of strengths and weaknesses. These are addressed as indicated and incorporated into our strategic plan when feasible. Examples of issues that we have addressed include additional assistance with the EMR, new services and equipment and streamlined referrals to other subsidiary hospitals in our system.

The Center for Healthcare Governance, 2012, described the need for healthcare leaders to ensure members of their medical staff are included in quality and patient satisfaction outcomes. At our hospital, every medical staff section meeting includes a review of current quality initiatives and individual physician patient satisfaction scores. The Center for Healthcare Governance indicated it is important to include physicians in these reviews to align them with the organization's goals and develop a physician culture that is aligned with the organization's culture.

I have had good success in physician integration with the development of a joint operations board. Physician representatives from various disciplines meet with healthcare leaders every other week to develop a better understanding of the complex healthcare environment. Initial meetings discussed hospital reimbursement, including diagnosis-related groups and pay for performance initiatives. Later meetings evolved to discuss operational concerns and ideas for new services that were further explored and included in strategic planning, if feasible. The physician representatives served as information conduits to other members of their specialty and discussions at the joint operations board were shared at medical executive committee, general medical staff meetings and with the board of trustees. In a short time, the level of physician engagement increased, as reflected by a physician survey, and the hospital leaders achieved better quality and patient satisfaction results. Kaufman Hall, 2012, described the necessity for hospitals to develop a structure that includes physicians in organizational processes, noting the integration of physicians with healthcare leaders adds to the value of services provided and leads to improved quality and outcomes.

Center for Healthcare Governance. (2012). Organizational culture, clinician engagement and physician integration: Keys to success. Retrieved from Kaufman Hall. (2012).
A guide to physician integration models for sustainable success. Retrieved from

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