Onboarding New Providers Alignment with Strategic Growth Objectives

Transcription

1 Onboarding New Providers Alignment with Strategic Growth Objectives Christi R. Miller, Director Physician Recruitment & Development, LHP Hospital Group, Inc. Elizabeth K. Cook, Senior Management Associate, Carolinas HealthCare System The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA Society for Healthcare Strategy & Market Development

2 Privately held For-Profit, headquartered in Plano, TX Providing Capital and Expertise to not-for-profit hospitals and health care systems Forming Joint Ventures to own and operate acute care hospitals Current hospitals in TX, FL, ID, and NJ Hospital names are synonymous with JV Partners, not LHP

3 Beyond the Start-up Logistics 1. Strategic Business Plan Goals 2. Physician s (Personal) Practice Goals 3. Mentoring Program 4. Physician Compact 5. Physician Operations Support Team (POST) 6. Administration/C-Suite Engagement

4 1. Strategic Business Plan Goals Growth Initiatives identified by Service Line Includes Physician Recruitment Action Steps are generally summarized Proformas project increased Net Revenue Includes increased Volume projections Increase OP Visits related to XYZ Increase referrals to new Neurosurgeon

5 Strategic Business Plan Goals What s missing : Increased referrals from? Physicians to target..? List of Surgeon/Service Line capabilities? Marketing plan specifics? Community outreach? Are you reviewing the SBP proformas?

6 Source: Crimson Market Advantage Outreach Plan

7 Strategic Business Plan Goals Compare Proforma Projections vs Actual Review progress with Physician Review with Administration/Finance Adjust expectations/strategy as necessary AND use data for future recruitment

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9 NS/Spine Private Practice: Success 2009 Start-up Very clear personal practice goals His Q: Who is the GoTo NS here now? Hired experienced Practice Mgr/Consultant Hospital Joint Ventured OutPt Spine Center Routinely networked Physicians and Vendors Today = 5 NS s, 5 locations, 4 PAs, + Anesthesia

10 2. Physician s Practice Goals Empower Physicians to drive their own success! Focus on what EXCITED the physician about this position What discussions took place during interviews? What promises were made? Are you following through? What happened if/when you handed them off?

11 ORS Group: Success 120 bed hospital, with big ORS egos! Recruited 2 (friends) for Start-up Straight out of fellowship training Young, outgoing, energetic Their personalities made ALL the difference Broke in to local High School Football teams Became GoTo practice for hospital employees

12 3. Mentoring Program Program administered by Medical Executive Comm. New Physician-to-Established Physician Mentors are Trained by an MEC physician Clear Expectations with Written Plan (Strategy) Accountability, including documentation/assessment Assigned at time of Credentialing Often from a complimentary specialty Onboarding Team assigns Spouse-to-Spouse Mentor

13 Neurology Mentoring: Success SBP Growth initiative = Stroke program New Neurologist recruited to Employed group Assigned to ED physician mentor Weekly Friday meetings Attended ED & Hospitalist meetings together Neurologist Attitude = Tell me what I can do to help

14 Female OBGyn: Success Unplanned Strategy = Women taking care of Women Interview dinner with female GS developed into mentor relationship Networked w/female PCPs,Peds,GI,Surgeons Opened SPA like practice in December Was interviewing 1 st partner in March 2 nd partner joined in under 2 years Today = 4 MDs, 1 Midwife, 2 NPs

15 4. Physician Compact Physician s Responsibilities vs Organization s Service, Quality, People, Finance Medical Records, Behavior, Communication Requires a Peer to Peer Discussion Signature coincides w/hospital Credentialing Separate from Hospital s Code of Conduct Speaks to the Accountability Culture of the Medical Staff

16 Physician Compact Examples Physician Responsibilities Service Achieve and maintain optimal patient access Quality Develop, accept and adopt changes that add value to the consumer and improve the performance of the organization People Provide appropriate input into decisions and then delegate authority to elected and appointed leaders Organization Responsibilities Service Maintain quality physicians and staff sufficient to provide excellent patient care Quality Provide physicians with data to show how they perform clinically against established standards People Provide physicians with opportunities to have input & influence into practice decisions through dialogue and access to leadership

17 5. Physician Operations Support TEAM Service to Physicians is the responsibility of the entire organization - Culture Change? TEAM approach among ALL Departments A working team, with real To Do Lists Leads to increased Physician Satisfaction Positive impact on physician referral development Increases volume and stimulates growth Increases physician retention

18 POST eam Members CEO or Other Administrative C-Suite member Physician Recruiters/Liaisons Physician Onboarding/Retention Depts Medical Staff Department Marketing/Community Relations Department Director/Manager of Employed Practices Various Department Directors (ad hoc as needed)

19 POSTeam Discussion Topics Upcoming New Candidate Interviews New Med Staff Applicants/Resignations New Recruit Start Dates & Needs Physician Retention/Attention Needs Review of Physician Opportunities Upcoming events, speaking engagements, etc Review of Physician Issues with Registration, OR scheduling, ED, Nurse staffing, etc Keep Meetings BRIEF and on topic!

20 6. Administration/C-Suite Engagement Provides clear direction of Business Plan goals Direct Involvement with POSTeam Provides timely follow thru for Opportunities/Issues Ensures participation and accountability of Other Departments Aligns Physician Development and Physician Satisfaction throughout the organization

21 Psych Employment: FAIL Joined Employed group of 2 existing Lead physician failed to voice true opinions during interview stage 1 st Week on the job Site Mgr on Vacation Lead physician refused to communicate 2 nd physician became the Referee No one from the Hospital stepped in to help New Recruit became angry and left

22 CAROLINAS HEALTHCARE SYSTEM Teammates: 60,000 ~1800 employed physicians ~800 employed ACPs Locations: NC, SC, & GA 40 Acute Care & Specialty Hospitals 900 Care Locations Onboarding: ~200 physicians & 200 ACPs each year 2013 Turnover: Physicians: 4.3% (AMGA 6.8%) Physician Assistants: 8.4% (AMGA 7.9%)* Nurse Practitioners: 13.4% (AMGA 10.7%)* >3 years of service: Physician turnover rate was almost 60% before formal onboarding process (2010) Has hovered between 25-30% for last 3 years Retaining ~120 physicians longer than in the past *ACPs do not have a formal onboarding process at CHS

23 ONBOARDING SURVEYS Purpose: The primary purpose of these exit interviews is to obtain insight into the experiences of CHS physicians, both positive and negative. The data obtained during these onboarding surveys will be used to make improvements through the System. Target: All CHS employed physicians Survey Types: New Physician Onboarding (1 mo after start date) New Physician Onboarding for Administrative Lead & Clinical Lead New Physician Onboarding 6 months New Physician Onboarding 1 year Survey Distribution: Retention Team Survey Tool: Survey Monkey Data Type: Quantitative (Likert Scale 1-5) and Qualitative (comments and open-ended questions)

24 New Physician Onboarding Survey (1 month after start date): Purpose: To assess and improve the physician onboarding process. Survey Topics Hiring Process Experience with recruiter Experience with clinical lead Letter of Intent & Contract Credentialing & Privileging Pre-Start Date Experience Integration Specialists Corporate Orientation (including EMR and Coding training) On-site Orientation Office ready Meet with leaders, staff, colleagues Overall Satisfaction Likelihood to recommend Demographic Information

25 New Physician Onboarding Survey Clinical/Adm Leader (1 month after start date): Purpose: To assess and improve the physician onboarding process Survey Topics Provider Fit Procedural and technical skills Rapport with patients & staff Interactions with Physicians & ACPs Work ethic Overall fit Pre-Start Date Experience Integration Specialists Communication

26 New Physician Onboarding Survey (6 months & 1 year): Survey Topics: Your Department/Practice Quality of physician & administrative leadership Morale within the group Response to concerns and requests Career advancement Work/life balance Collaborative relationships Likelihood to stay Would choose this group again Colleague support Feeling Valued & Appreciated Integral part of CHS medical community Support from administration and physician leaders Internal & external interaction with colleagues

27 New Physician Onboarding Survey (6 months & 1 year): Survey Topics: Community Involvement Opportunity to speak in the community Interest in onboarding new physicians Overall satisfaction with CHS Communication with physician leaders & administrators Explanation of administrative decisions Priority of patient care Supportive of various employment models (work/life balance) Likelihood to recommend CHS to an external colleague Fulfilling your expectations Opportunity to be heard Potential candidates for current and future openings Demographic questions

28 Survey Reporting Responsible Party: Retention Team Purpose: To synthesize the quantitative and qualitative data of all providers to share with a large group of leadership across the organization Frequency: Bi-annually (check the data at least monthly) Report Includes: Executive Summary Response Rates (overall & by Care Division/Service Line) Survey Highlights/Themes Key Findings (each survey) Termination/Separation Data Including by years of service Recommendations We create a separate report of all comments, by question & by Care Division/Service Line

29 Examples from 2014 End of Year Survey Report Onboarding & Retention Themes Lengthy and confusing contract process Lengthy and confusing credentialing/privileging process CHS Orientation process is too general for physicians Lacking and/or delayed marketing resources for physicians and practices Onboarding & Retention Recommendations Streamline and shorten the length of the contract process Decrease time between letter of intent and contract Organize and improve credentialing and privileging process Centralize process Create a more formal, physician-specific orientation process Allow for more one-on-one training opportunities (Canopy & Coding) and follow-up sessions (including auditing) Improve internal/external marketing and community outreach efforts Create a marketing plan for all new physicians

30 FOCUS GROUPS Purpose: The primary purpose of this focus group was to obtain feedback from these new physicians and utilize this feedback to make improvements to the new physician experience at CHS. Discussion among the group focused on three different areas: recruitment, onboarding, and retention. Target: All CHS employed physicians who started in the last 12 months Focus Group Topics Recruitment Onboarding Retention Data Type: Qualitative

31 Examples from 2014 End of Year Report In an effort to improve new physician experience, physician participants identified several suggestions that could be implemented. Some of those suggestions included: 1. Increasing efficiencies in the contract process 2. Increasing efficiencies in credentialing/privileging process 3. Individualize Canopy & Billing trainings 4. Enhance communication to the physicians within the System

32 Key Accomplishments Enhanced workflow process strategies for provider recruitment Creation of Onboarding Specialists positions Development of a provider-specific orientation Centralized Contract Office Centralized Verification Office in progress Provider Spouse Employment Assistance Program

33 Key Accomplishments Enhance Recruitment Workflow Streamlined creative services (recruitment marketing & sourcing) Streamlined recruitment process and documentation Sharepoint site Candidate Feedback Form Travel forms Rejection s Surveys Quarterly recruiter calls and yearly internal recruitment conference Monthly calls w/ hiring leaders within each specialty Centralized Contract Office Streamlined technology Sharepoint site Forms Compensation information Streamlined contract process & language Review by the CHS Legal Council Consistent compensation structure across the System in development

34 Key Accomplishments Formal Onboarding Program 2.5 dedicated FTEs Onboarding Specialists Full-cycle onboarding coordination Accepted date to 1 year after hire Pre-employment paperwork Marketing Relocation Travel Realtor Moving companies Reimbursement Coordination w/ support departments Coordinate orientation Liaison for community needs Provider-Specific Orientation Provider-only, Physician-lead Medical Group Structure Patient Satisfaction Provider-specific resources Care Re-design strategies Compassion Fatigue Provider portal (New Provider Portal) Online educational modules Care-specific EMR and billing training Medical Director Guide (attachment)

35 Key Accomplishments Central Verification Office in progress Collaboration with recruitment team Due diligence Pre-application Peer reference review Streamlining credentialing & privileging processes Reduced the multiple submission of the same paperwork Reducing turn-around time Online credentialing & privileging portal Implementation of a new tracking system Spouse Employment Assistance Provide internal and external employment assistance Includes physicians & ACPs Internal: Formal program with HR External: Networking assistance Charlotte Chamber Job Seekers Program Young Professionals Networking Group Almost 40 hires in last 2 years

36 Questions? The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA Society for Healthcare Strategy & Market Development