Fort Madison (Iowa) Community Hospital was having a physician alignment issue, due in part to outdated medical staff bylaws. These bylaws are paramount when it comes to successful physician alignment, according to a case study from The Greeley Company.
"Medical staffs can't align with hospital administration unless their bylaws allow them to do so," the case study reads. "If it isn't written in the bylaws, it isn't going to happen."
At Fort Madison, one of the main issues was the bylaws didn't allow the medical executive committee to be used to its fullest extent — the entire medical staff had to vote on every change, instead of allowing the medical executive committee to make decisions on behalf of the staff. "One person could tie up a medical staff meeting forever if he had enough people standing behind him," said Fort Madison CEO James Platt.
That issue, combined with a citation from The Joint Commission, meant a medical staff bylaws redesign was in order. Two steps were important to its eventual success:
• Fostering buy-in. According to the case study, some physicians saw changing the bylaws as "an attack against the medical staff for the benefit of administration." The Greeley Company helped overcome this issue and gain physician buy-in by having Fort Madison medical staff leaders attend conferences hosted by the company, where other physicians commented on modern bylaw requirements.
• Reframe change around patient care. A key was to frame the redesign "as an exercise that would create a flexible document that would allow the medical staff and administration to partner together to achieve high quality patient care," according to the case study.
With the new bylaws, several committees once run by the medical staff are now hospital committees that have medical staff participation. Now, the medical staff and hospital administration work together as a team, according to the case study.
"It's a true partnership between the medical staff and administration now. We have been able to move forward to create the trust and positive interactions that have become vital to any successful organization today," Mr. Platt said in the study.