Amerinet Executive Education Series: Collective Learning on Contemporary Healthcare Issues

Transcription

1 Amerinet Executive Education Series: Collective Learning on Contemporary Healthcare Issues The VirtualCMO Improving Quality of Care and Patient Satisfaction while Reducing Risk in Rural and Small Community Hospitals

2 The VirtualCMO Improving Quality of Care and Patient Satisfaction while Reducing Risk in Rural and Small Community Hospitals Presented by Susan F. Reynolds, M.D., Ph.D. Leonard M. Randolph, Jr. MD President and CEO Maj. Gen. USAF (Ret.), Faculty Member The Institute for Medical Leadership Amerinet iqast January 28, 2014

3 The VirtualCMO Uniqueness of Rural Healthcare Challenges faced by Rural Physicians The Rural Physician Executive: If there is one

4 The VirtualCMO Uniqueness of Small Community Hospitals Challenges faced by Physicians in Small Community Hospitals The Physician Executive in the Small Community Hospital: If there is one

5 The VirtualCMO The Benefit of a VirtualCMO: a Resource for Rural and Small Community Hospitals Improve Quality of Care Improve Patient Satisfaction Reduce Risk Lower Cost

6 Uniqueness of Rural Healthcare* * National Rural Health Association

7 Uniqueness of Rural Healthcare Nearly 25% of US Population, but only 10% of physicians Only 40 specialists per 100,000 population vs. 134 per 100,000 urban 1/3 of all MVAs, and 2/3 of MVA deaths are on rural roads Non-MVA accidents are more serious and more deadly

8 Uniqueness of Rural Healthcare Older and poorer population: $19K average per capita income ($26K urban) Poorer health, higher death rates Higher hypertension rates Higher suicide rates Lower Medicare reimbursement (470 rural hospitals have closed within the past 25 years)

9 Uniqueness of Rural Healthcare Transportations issues: Long distances to reach providers Availability of specialists (part-time) Patient transports: Air or Ground? How far? How long? Best qualified facility? Communications: Patient acceptance

10 Uniqueness of Rural Healthcare Providers: The Old Guard New grads paying off debt FMGs (J-1 Visas) Other Doctors (DDS, OD, PhD, etc.) AHPs (Mid-level practitioners) CNPs, CNMs, CRNAs, PAs, Mental Health Providers First responders: 57-90% are volunteers Great variability in care!

11 Challenges faced by Rural Physicians

12 Challenges Conflict Resolution Old Guard versus Young Turks Disruptive Behavior

13 Challenges Medical Staff Bylaws Outdated Active Medical Staff members Quality of Care Improvement

14 Challenges Quality of Care Improvement Credentialing Privileging Peer Review: Outside Reviewer?

15 Challenges Allied Health Professionals DDSs, DDMs, Ods, PhDs CNPs/CNMs/ CRNAs PAs Mental Health Providers

16 The Rural Physician Executive: (Is there one?)

17 The Rural Physician Executive If there is one: Senior member for the medical staff Long-time practitioner in the community Decreasing clinical practice hours Hard to stay up-to-date: no local resources

18 Small Community Hospitals

19 Small Community Hospital Financially viable? Small Medical Staff with Financial and Social Connections Peer Review Conflicts of Interest: May require independent outside peer review +/- Physician Executive External Physician Leadership Development

20 Community Hospital Challenges Conflict Resolution Small Factions can Control Disruptive Behavior

21 Challenges Medical Staff Bylaws May Be Outdated Medical Staff Structure: Recycled Leadership Quality of Care Improvement: Peer Review Challenges

22 Challenges Quality of Care Improvement Recruiting Concerns: Whom to Credential/Privilege? Peer Review Conflicts of Interest: Outside Review can be expensive

23 The Physician Executive If there is one: Senior member for the medical staff Long-time practitioner in the community Decreasing clinical practice hours (? Full or Part-time) External training, no in-house resources

24 The VirtualCMO For Rural and Small Community Hospitals

25 Purpose: VirtualCMO Resolve Key Rural and Small Community Hospital Issues Improve Quality of Care/Reduce Risk Cost Savings Provide Back-up Resources, Education, and Coaching Services

26 The Position VirtualCMO Strengthen existing physician leadership through coaching, education, online resources/support Resolve conflict and improve disruptive behavior Improve quality outcomes, patient safety, patient satisfaction, and reimbursement Review/update medical staff bylaws and rules & regulations (frequently out of date) Provide executive coaching and board education Resolve staffing issues and continuity of care issues Provide input/oversight for implementing IT strategies

27 The Service VirtualCMO Initial on-site assessment of physician leadership needs and key issues Weekly coaching/consulting calls with hospital CEO, Chief of Staff, and/or Medical Director Troubleshooting of identified issues that need to be addressed Review and update medical staff bylaws and rules & regulations, working with hospital counsel when indicated On site visits for education and/or conflict resolution as indicated

28 The Service VirtualCMO Blogs and other online teaching formats to provide current updates Consulting at least 10 hours per month provided by highly qualified physician executives who have served as members of hospital senior management teams and have had rural healthcare experience

29 Questions?

30 Thank you! Susan Reynolds, MD, PhD Leonard M. Randolph, Jr. MD President and CEO Maj. Gen USAF (Ret.) Faculty Member The Institute for Medical Leadership Los Angeles, CA

31 Thank You