Earlier this week I had the opportunity to speak at the triennial medical staff meeting about the state of GBMC. I thanked our physicians for their hard work in taking care of patients and also for helping us to be the financially strong organization that we are. We finished the year with a 1.9% operating margin for our system….which is better than what we budgeted. I also shared the results of our annual Physician Satisfaction Survey. The survey showed increased satisfaction among physicians in GBMC’s nursing care, in the overall quality of our care at the hospital, and a small increase in the ease of practice at the hospital. In areas affected by our implementation of CPOE, the speed with which orders are carried out and in the access to information, our scores went up significantly.
Unfortunately, I also had to tell them that in the area of communication and collaboration, our scores went down. The results are not uniform across all members of the staff. In some departments, our scores went up, but in some, they went down. I had to ask myself the question was it really our inability to communicate well with everyone or was it the message?
Our new strategy is about better coordinated care and we cannot do this without building a strong network of primary care providers. So, I have spent a lot of time working with primary care doctors and talking about primary care. I have not spent enough time with our surgeons, and some other specialists and engaging them in dialogue about our future. So, at the meeting, I told the staff that I and the senior leadership team of the system were going to redouble our efforts to hear from them. We will meet with our clinical department chairs individually at regular intervals and we will go to Department meetings. I welcome any physician that has an idea about how we can make it easier to provide exceptional care to our community, to come and speak with his or her department chair or me.
GBMC grew up as a place for private practicing physicians to practice good medicine. It is becoming more and more important that we act together to bring even better value to those we are serving. This is not possible if everyone is doing their own thing. We need a tighter alliance to make things better for our patients and to make the practice of medicine more fulfilling while maintaining its financial viability. Large complex organizations can’t move forward without a hierarchy and a chain of command that includes strong physician leaders – thankfully we have such individuals in John Saunders, Jr., M.D. (Vice President of Medical Affairs), Harold Tucker, M.D. (Chief of Staff), and our department chairs.
We need to have a tighter affiliation with physicians, and the physicians need to understand that they are part of the team. Physicians have to be in the mindset that if they have an idea they should go to their department chair and it’s the department chair’s responsibility to feel empowered to change things or kick things upstairs, if they are beyond their control. Hierarchy is not a bad word, it’s a way of making a complex organization work, and we have to narrow the distance between those doing the work of patient care and the organization’s senior leaders.
We’re looking to our physicians to bring forward ideas. For example, Dr. Bill Crawley, our division chief of plastic surgery, recently suggested that we begin offering microvascular reconstructive surgery and we are making investments in getting that program started. That’s one example of how we have to plan together and be able to hold each other accountable if we are going to get to better health, and better care at a lower cost.
We’ll be investing a lot of time and effort in this in the coming months, working through and with department chairs and division chiefs, to make this happen.
I look forward to hearing from physicians and others about how the organization can further engage doctors and strengthen the relationship with senior management. Please share your thoughts by commenting below.
This weekend, I will be flying to San Diego to the American Hospital Association meeting to be present for the Circle of Life Award presentation to Gilchrist Hospice Care and Gilchrist Greater Living. I will share that experience in the blog next week.