They get around: How hospital leaders keep fingers on workplace pulse

Hospital leaders must balance a wide range of administrative duties while overseeing day-to-day operations. With so many tasks competing for their time, it can be a challenge to work with medical staff on care quality initiatives.

Becker's Hospital Review asked some of these leaders to share how they stay engaged with medical staff. Read their responses below, presented alphabetically.

Note: The following responses were lightly edited for length and clarity.

Amanda Bates
Vice president of human resources at Indiana University Health (Indianapolis)

Physicians want to be heard, they want input into decisions, and they want to have impact. Our practice group of 1,800 physicians and 650 advanced providers involves physicians by listening and giving them opportunities to influence decisions. Physicians and advanced providers have seats on all six of our management committees where key recommendations and decisions are made. The executive team meets monthly with our chairs as a group, and quarterly with the dyad team of each department. As an academic health center, IU Health also has managers attend faculty meetings with physicians of each division, to jointly discuss issues of interest. Finally, the system CEO holds a series of annual meetings where physicians and other team members can hear updates and ask questions. We have found face-to-face dialogue integral for building relationships and engagement. Our physicians participate in an annual engagement survey, and our leaders address concerns raised in the surveys with their groups.

Nina Beauchesne
Executive vice president of East operations at Memorial Heathcare System (Hollywood, Fla.)

Every couple of years we do a survey of all our medical staff, and we ask them about how they feel about practicing at our hospitals. That, I think, is a good indicatorofwhat things are going well, what things need to improve. We just finished the most recent one. We have a lot of engaged physicians, and what we do is we see what are the things that are engaging them the most. We ask how they feel about nursing staff and how they feel about administration. It helps us to see what are the things that are working well. We love to know what the results are. We love to know what strategies we should put in place to address some of the things they brought up. I think that's a good baseline to help us understand what is important to medical staff.

Also, we have a guideline where we ask physicians to not round alone. They round with nursing. It's helped to promote physician and nursing communication, because most physicians traditionally are coming on a hospital floor, and they're looking for their patient, and they're seeing their patient, and they don't always know the latest thing. What does nursing have to say? So, it really enhances that communication, so basically when they come on the unit, they find the nurse, and the nurse walks with the physician to the patient. It really does promote physician-nurse communication. I think it's one of the things we've done that has engaged physicians the most in the last couple years. It's also helped our patient engagement because the patient sees them working as a team.

We also involve our physicians in helping us develop our strategic plan for the health system. We have an annual medical staff/board/administrative retreat where we talk about strategies and what things we're doing, why we're doing it. We ask for their input. It usually ends up being at least 100 physician leaders who are off-site with us once a year and working through that. I think that's another way they feel bonded, and they know we're trying to be responsive to them and their needs. We want to include them in the planning. We also try to, in those sessions, bring a keynote speaker to talk about the industry and where medicine is going.

Craig Best, MD
President and CEO of the Tufts Medical Center Physicians Organization (Boston)

We do that by listening and communicating. It's really about that more than anything in terms of how leaders engage [with physicians].

A team of administrators does weekly rounding in the hospital and clinic spaces. We have department meetings, and I try to attend at least two a year for every department. This year I've also attended division meetings where I give a short update and take questions. Thirdly, we do town halls. We're doing two town halls this year where again we have my administrative team give updates and leave time for questions. [The physicians organization also] has a newsletter we put out quarterly called TEMPO. We have had "coffee with Craig" meetings where we've invited staff physicians to meet with me for breakfast and coffee, and I basically just get to know them and listen to their questions. Then, finally, we have monthly meetings with the department chairs. We provide them with information verbally and through written or slide deck information. We ask them to cascade that information down to the physicians so we have a cascade of information coming from our senior leadership that gets to the masses. At the same time, we provide mini vehicles where the physicians can bring information back up to the senior leadership.

We've [also] set up a number of committees of the physicians organization. Two recent ones that we started this year were the diversity and inclusion committee and the clinical practice committee. The diversity and inclusion committee has done surveys and gathered information about our diversity. We think about diversity as being invited to the dance and inclusion as being asked to dance. So we not only want a diverse medical staff, but we want to make sure that they're involved in the important committees, that they're involved in leadership positions and that they're also involved at the board level. We're being very prescriptive about thinking about how we can improve that and make that happen. The committees have offered tremendous opportunity for the physicians to have a voice, to really decide on the direction of the physicians organization and improve processes. 

George Figueroa, MD
CMO of Banner Ironwood Medical Center (Queen Creek, Ariz.) and Banner Goldfield Medical Center (Apache Junction, Ariz.)

Quoting Banner Health President and CEO Peter Fine, who I think stated it best: "Be visible. Visibility breeds credibility, and credibility breeds trust. So, if you want to be trusted, you better be visible." The key to engagement is the aforementioned. It establishes the foundation to developing and maintaining relationships with your medical staff, leading to engagement."

Joseph M. Flynn, DO
Chief administrative officer of Norton Medical Group and physician-in-chief at Norton Cancer Institute (Louisville, Ky.) 

On a weekly basis, all senior leaders within Norton Medical Group are expected to visit clinics and to meet with all the staff, to talk with them, to see how things are going. We can directly address concerns and communicate our vision for the group in a more personal way. That’s something that I think brings us a lot of value, for the overall clinical staff to see leaders, know them by name and have a chance to chat with them.

Also, every employee at nine months [after hire] has a sit-down with senior leaders.

When people first join the organization, we strive to get to know them. We ask them questions about themselves, and we reiterate from the beginning of the hiring process our overarching values of care. Our first value at Norton Healthcare is "respect every person." We really try to spend time talking about that and about creating great human interactions, whether it is peer-to-peer or physician-to-patient. We also have a phase two [of onboarding], and that happens three months in, where the senior leaders stand in front of the group, and we emphasize good staff satisfaction and engagement — because staff engagement is key to patient engagement and a positive experience.

We communicate with our medical staff in other ways, including web, social media, email and newsletters. The newsletters provide a sense of what's going on within the organization and across medical service lines, such as cardiology, oncology and neurology.

Through our website, we have a comments/suggestion box option where [medical staff] can make suggestions of things we can do to improve the work environment and care. Those messages are sent directly to Joshua T. Honaker, MD, chief medical administrative officer, and me. We personally respond to each message. We also make ourselves available by text or personal cellphone.

We have events for staff where they can bring their significant others, and we can get to know them on a more personal basis and get to know families as well. I firmly believe that the more we know about each other on a personal level, the better.

Jean S. Kutner, MD
CMO of UCHealth University of Colorado Hospital (Aurora, Colo.)

Regular communication with medical staff is key for long-term satisfaction and retention of providers. Part of our commitment to our medical staff is to ensure they are informed of any developments both locally as well as across the healthcare system that may impact them and their patients. I recently launched a quarterly newsletter directed specifically to medical staff to provide regular updates. This came about as a result of interest from medical staff for robust, thoughtful communication about UCHealth University of Colorado Hospital and the broader UCHealth system.

 We recently conducted surveys to garner feedback from our medical staff. With the quarterly newsletter, we are responding to results from the surveys that indicate feeling valued goes hand in hand with open communication. Soon I also will be sending a weekly email to medical staff that is similar to our Insider Today email, which currently goes out to all employees three times a week with links to articles and important information. The medical staff version will be tailored to contain only stories and news that is relevant to our medical staff. 

In addition to electronic communications, regular rounding and being personally visible and accessible to medical staff is essential as a means for hearing regularly from and sharing information with the medical staff. 

These forms of expanded communication are intended as components of enhancing bidirectional communication, facilitating a sense of common purpose. Our shared ultimate goal, of course, is to provide superior quality, outcomes and experiences for our patients and their families. This newsletter also helps highlight the important work our medical staff are doing each and every day to care for patients, educate learners and generate new evidence. And, of course, medical staff feedback and suggestions are always encouraged.

Jason Mitchell, MD
Chief medical and clinical transformation officer of Presbyterian Healthcare Services (Albuquerque, N.M.)

As an integrated system, clinicians are engaged in everything that we do. Our clinicians drive decisions about how we deliver and design care, and their voices and expertise are essential when we are contemplating changes, such as our recent decisions to embark on new ambulatory surgery centers and 24/7 urgent and emergent care facilities.

To ensure that clinicians are engaged, we have leadership development programs specifically for physicians and APCs, regular social events to help them connect with each other and consistent, tailored communication. Senior leaders round with clinicians to ensure their priorities are understood and quickly address concerns. It is also incredibly important to celebrate the amazing work of our clinicians, through special events like our week-long Doctors' Day celebrations and by regularly highlighting their clinical and professional successes.

We also provide regular opportunities for them to enhance their skills, such as through weekly pain and addiction telehealth clinics and classes on motivational interviewing. Lastly, we know that building resiliency is critical to helping our clinicians thrive. We offer an individualized support program coordinated by clinical leaders and our Employee Assistance Program, which supports clinicians after stressful events.

Taken together, these approaches not only help us engage clinicians but also improve how we serve our patients and members throughout the health system. We know that we still have work ahead to continue to truly engage our clinicians but the early results of these efforts have proved positive.

Patrick M. O'Shaughnessy, DO
Executive vice president and chief clinical officer of Catholic Health Services of Long Island (Rockville Centre, N.Y.)

At Catholic Health Services, we believe that engaging our physicians in strategy and operational discussions is an integral part of the solution to the myriad of challenges facing healthcare today.

We engage CHS physicians on a number of levels, including starting with a personal connection to the physician and practice and medical executive committees. Also, we look to engage our physicians through various physician executive forums, where they have an active voice at the table.

One such way we connect with and involve our medical staff is by focusing on key initiatives organized around our clinical service lines. For example, our neuroscience, cardiology, oncology, orthopedic and primary care service lines all have infrastructures comprised of groups of specialists and primary care providers physically at the table, helping to develop and to build our services, as well as mature the clinical enterprise.

Further, we have implemented a physician-led governance structure for our Catholic Health Services Physician Partners IPA [independent practice association] and ACO [accountable care organization] and are developing a physician governance structure for our employed medical group. These groups will advance not only clinical standardization and optimization but also drive future developments in maturing our overarching clinically integrated network.

Ketul Patel
CEO of CHI Franciscan (Tacoma, Wash.)

Throughout the year, I host various meetings with our medical staff leadership, general medical staff and employed medical group physicians and clinical providers. It's very important to me to stay engaged with our physicians and clinicians to understand their perspectives because they are the ones at the forefront of what we do — caring for patients.

I also believe as leaders, we're only as good as what we know. I really value the thoughts and ideas that come from our physicians, clinicians and staff. Transparency and open dialogue support me in being a more effective leader to help improve our organization for the communities we serve.​

Edmund Pribitkin, MD
President of Jefferson Medical Group and CMO of Thomas Jefferson University Hospital (Philadelphia)

At Jefferson, we amplify our personal approach through new technological interfaces. Knowing medical staff by name, acknowledging their contributions, personally, and reaching out during significant life events defines our character as servant-leaders. Today, however, we augment these interactions through innovative channels such as our Tiger Connect application that allows us to text anyone on the medical staff by simply looking up their name. Through MyJeffHub, an SAP-powered digital meeting place, we further promote team-building and collaboration across our entire 30,000-employee enterprise.

Edward H. Sim
Executive vice president and COO of Centura Health (Centennial, Colo.)

As COO of the system, it's important to have relationships with physicians and understand any concerns that medical staff have. However, it's also important for those concerns to be addressed at the facility level first.

Each of our 17 hospitals has a physician leadership council, and the role of the physician leadership council is to act as a partner and adviser to the CEO of each facility. Whenever possible, the goal is to make joint decisions, especially around quality or patient safety. Right now, I'm visiting all 17 PLCs because we are implementing our strategic plan —Centura 2025 — and I'm wanting to talk to them about the plan and answer any questions they may have.

One of our goals of the plan is to become a physician-facing organization, so I go around and talk to them [the councils] about what it means to be physician-facing and tenets such as transparency, timeliness and trust that go into that philosophy. I also talk to them about the role the PLC has with our organization, and finally, answer any questions, address any concerns when possible. So, I'm in the midst of that tour right now. It takes a lot of time, but it's very important. I need to hear from them, and just as important, they need to hear from me as the COO of the health system.

Gary Stuck, DO
CMO of Advocate Aurora Health (Milwaukee and Downers Grove, Ill.)

Medical staff engagement is an important way for us to create loyalty, improve the bottom line and most importantly, build culture. At Advocate Aurora Health, we have an unrelenting focus on safety and delivering the best health outcomes — both of which are deeply embedded in our culture. When it comes to our safety journey, the medical staff rallies around safety as a moral imperative and our target to cause zero harm to patients. We have clinical safety champions, provide high reliability training, encourage reporting and recognize and thank those who report. Our medical staff is committed to delivering top decile health outcomes and the very best patient care — that is why they went into medicine in the first place. And very importantly, we measure everything at Advocate Aurora Health and are transparent in sharing our safety and quality results — both internally and publicly. At the end of the day, medical staff engagement is centered around providing the best, safest care and I’m proud to see this each and every day.

Oren Tepper, MD
Director of craniofacial surgery, director of anesthetic surgery and co-director of the 3D Printing & Innovation Lab at Montefiore Health System (Bronx, N.Y.)

As a plastic surgeon who treats both adults and children, and who performs both reconstructive and aesthetic surgery, I interact with, and rely on, many different healthcare providers to deliver the best care possible for my patients. This may include staff within hospital operating rooms, post-anesthesia care units, other inpatient units and clinics, as well as other locations including ambulatory surgical centers and outpatient offices.

In my experience as a surgeon, I’ve observed a natural gap between healthcare providers in the outpatient setting and those within the operating room. To bridge this gap, I use photographs and 3D and virtual planning technologies to help me communicate with staff from all points in the patient's care and to keep all providers engaged.

While each care team carries unique skills and plays a pivotal role in overall patient care, I have come to realize the gap in sharing information need not be so well-defined. In fact, this gap is often frustrating for staff; most team members welcome updates from colleagues in different specialties. I’ve learned that every provider is invested in the patient's outcome, from start to finish. The full spectrum of providers are eager to know how the patient has been progressing.

Sharing photos and 3D technology with referring providers has helped me work more collaboratively with my colleagues and has foster a team mentality.

Kate Walsh
President and CEO of Boston Medical Center Health System

The input, insights and experiences of our medical staff allow me to better understand the challenges facing our patients, their families and the community, and then determine how we can effectively address and respond to their needs. I round frequently in all units of the hospital and in our clinics to see firsthand the exceptional care being delivered, as well as give front-line staff the opportunity to speak directly with me. While I do hear about some challenges staff may be experiencing, more often than not I hear about positive interactions they had with our patients and with their colleagues. It is always a highlight for me to hear about how team members come together in service of our patients — to comfort them before an appointment or help them get connected to services from one of our community partners.  

Since I began at Boston Medical Center, I have also made it clear that all of our clinicians and staff have a direct line to me. And I am happy to say that they have taken me up on that, and I get a lot of emails from staff across the hospital. They give me direct feedback on things that I should consider, and share inspirational messages about the incredible work being done across our campus — and I make sure to respond to each and every one!

Mark Welton, MD
CMO of Fairview Health Services (Minneapolis)

First, as a new CMO of a large healthcare system, I had to realize that my colleagues valued seeing and hearing from me. Once I came to terms with that, I was challenged by the geographic span of our care delivery system — 12 hospitals and over 150 clinics spread over central, eastern and northern Minnesota. 

For the hospitals, I began listening sessions, where I would spend a lunch in the doctor's lounge or other high-traffic areas, and simply meet providers and discuss their needs and concerns.  At every visit, I learned more than the providers did.  I also established a weekly 30-minute listening session, 12:30-1 every Thursday, where providers can call into a conference line and listen to system announcements and ask questions. I found the callers are more often most comfortable sharing their questions via email, so we created an email account where questions can be submitted anonymously.

I invite guests, such as the chief medical information officer, when we are anticipating an IT upgrade, or a pain management expert to address the changing opioid prescription landscape. I also attend as many physician leadership meetings at the various hospitals as possible. I try to go to make rounds once a week at various locations to see what the providers are seeing in their day-to-day work. When issues arise, we announce that I am coming to the facility to meet with the providers and hear their concerns. Finally, our organization has more than 40 forums in the fall and another 40-plus spring forums for staff and providers, where I present with other leadership an update on organizational activities and answer questions and address concerns.

 

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