Physician Leadership in Healthcare

Transcription

1 Physician Leadership in Healthcare Robert J. Trenschel, DO, MPH, FACHE President and CEO Yuma Regional Medical Center I have no actual or potential conflict of interest in relation to this program/presentation 1

2 About Us 406 licensed beds Not for profit sole community provider Opened in 1958 as Parkview Baptist Hospital 24/7 hospitalists & intensivists (Adult, OB, Peds) 2,300 Employees 450+ Medical Staff, 49 physicians employed Robust Ambulatory Platform Family & Community Medicine Residency HFAP Accredited What We Are Doing in Healthcare is Not Sustainable 2

3 4/12/2016 US Healthcare Expenditures as a % of GDP Trillion 2.5 Trillion % GDP

4 Evolving Roles and Competencies in Healthcare Leadership Changing Roles Chief Administrative Officer Chief Experience Officer/Patients Rights Officer Chief Quality Officer Chief Integration Officer Chief Clinical Transformation Officer Chief Data or Analytics Officer Rebecca Apple, Evolution of the C Suite Physician Executive Journal May/June 2014 Evolving Roles and Competencies in Healthcare Leadership Increasing executive turnover 2013: CEO Turnover 20% 2014: CEO Turnover 18% Most Likely to leave after CEO CFO 42% COO 35% CNO 28% Hospital CEO Turnover Rates Remain Elevated ACHE March 5, CEO turnover rate 15.cfm 4

5 Evolving Roles and Competencies in Healthcare Leadership NEW ROLE PARAMETERS ADVANCED COMPETENCIES CORE PERSONAL TRAITS Dobbs et al., Management Intuition for the Next 50 Years, McKinsey Quarterly September 2014 Evolving Roles and Competencies in Healthcare Leadership Emerging competencies and skill sets Continuous planning Driving and managing innovation Rapid decision-making Ability to deal with ambiguity Soft skills Courage and honesty Building physician leadership Dobbs et al., Management Intuition for the Next 50 Years, McKinsey Quarterly September

6 The Difference Between Leadership and Practicing Medicine Medicine Prescribe and expect compliance Immediate/short term focus and results Relatively well defined problems Individual/small team focus Being the expert/carry responsibility Receive lots of thanks Respect/trust of colleagues Leadership Lead/Influence/Collaborate Short/Medium/Long term focus and results Complex processes over time Ill defined, messy problems Larger groups crossing many boundaries, integrated approach Being one of many experts/sharing responsibility Encountering lots of resistance Suspicion of being a suit Trustee Magazine, Vol. 65, No. 10; 2012 Health Forum Key Qualities to Successful Leadership of a Health System Objective identification of problems in areas in need of improvement Ability to standardize internal processes in partnership with physicians an clinicians Establish, communicate and gain buy in and support for an overall vision for the organization Sensitivity to the impact of change on all stakeholders and maintain clear and consistent communication with them Engage fully with communities Robust financial and CQI acuity Original and creative strategic thinking High level of comfort and confidence in new payment systems Recognition that developing care centric delivery systems requires leaders with the unique combination of analytical and relational skills Recognize value of marketing directly to consumer as retail competitors enter market Singleton, Robin; The New Health System CEO, 2015 DHR International 6

7 What is Driving the need for Physician leaders? The complexity of health care and current health care climate Physicians disinclination to followership and collaboration Traditional practice of promoting physicians to leadership positions based on clinical or academic skills and accomplishments rather than leadership competencies General inattention to training physicians in leadership competencies Stoller Ph.D., James, The Case for Physician Leaders, Physician Leadership Education, American Hospital Association, White Paper Changing Skill Requirements for Physicians Text here Changing Demographics, Competencies and Physician Leadership.P. Angood, MD 7

8 Top 10 Physician Leadership Characteristics Clarity of purpose Sustaining the focus of others on a vision Building trust and credibility Persistence when challenged by obstacles Political Savvy Working with and through others with an attitude of service Freely giving praise and recognition Keen self awareness Having a mentor More formal education with emphasis on the human side of leadership Physician Leadership Education, American Hospital Association White Paper, 2014; Hansen, Richard, MGMA How Do Leaders Develop On the job Learning Structured Learning Feedback and Coaching PLF Leadership Session; Donald Casey, MD July 27,

9 Three Distinct Clinical Leaders Frontline Leader Service Leader Institutional Leader Changing Demographics, Competencies and Physician Leadership, P. Angood, MD Presentation, July 27, 2013 Frontline Leader Many Identity: Great frontline clinician who focuses on delivering and improving excellent patient care. High level of direct contact with patients. Sources of Power: Passionate about clinical work, credible to colleagues. Close to patients and frontline realities can see opportunities for improvement Leadership and Knowledge Skills Required: Understanding of systems and quality improvement techniques, process mapping, operational improvements. Self starter, able to work well in teams 9

10 Service Leader Moderate Identity: Passionate advocate for own service, feels responsible for clinical and financial performance. Moderate level of contact with patients Sources of Power: Highly credible to colleagues, primarily as a clinician; well connected, can tap into centers of excellence. Innovative, willing to take risks. Leadership Skills and Knowledge Required: Fluent service managemet skills, strategy/people development, budgeting. Detailed knowledge of evidence based medicine in own clinical area Institutional Leader Few Identity: Clinician Executive as steward of the whole organization. Little direct contact with patients Sources of Power: Highly credible to colleagues as leader, able to communicate vision Leadership skills and Knowledge Required: Corporate level strategic thinking, talent management, succession planning. Political savvy, strong skills in negotiation and influence. 10

11 Physicians as Hospital Leaders US News Best Hospitals , Honor Roll Types of Intelligence 11

12 What Does the Next 5 Years Look Like for Healthcare Leaders The Patient Experience Capital Strategies Leading the Change from Volume to Value The Rise of Accelerators Reengineering Promoting Health New Payment Models Behavioral Health Health Administration Press, American College of Healthcare Executives Futurescan Healthcare Trends and Implications, 2016 to 2021 How I Got From There to Here 12