Engaging Physicians in Quality and Safety
Changing the culture of an organization to one that is focused on a common mission of quality and safety begins with the board. By setting goals and priorities that focus on quality and establishing accountability where appropriate, the board can influence and drive change throughout the organization, says James Reinertsen, M.D., president of the Reinertsen Group, an independent consulting and teaching practice based in Alta, Wyo.
A critical component to driving this change is collaboration and partnership with the medical staff. Reinertsen, in collaboration with co-authors Alice Gosfield, J.D., William Rupp, M.D., and John Whittington, M.D., provides the following steps for engaging physicians in a quality agenda, as published in a 2007 white paper report, “Engaging Physicians in a Shared Quality Agenda,” from the Institute for Healthcare Improvement.
Discover a Common Purpose:
- Improve patient outcomes.
- Reduce hassles and wasted time.
- Understand the organization’s culture.
- Understand the legal opportunities and impediments.
Reframe Values and Beliefs:
- Make physicians partners, not customers.
- Promote responsibility for quality.
Segment the Engagement Plan:
- Use the 20/80 rule (20 percent of your physicians usually perform the majority, or 80 percent, of the clinical services).
- Identify and activate champions.
- Educate and inform structural leaders.
- Develop project management skills.
- Identify and work with “laggards.”
Use Improvement Methods:
- Standardize what is standardizable.
- Generate light, not heat, with data.
- Make the right thing easy to try.
- Make the right thing easy to do.
Show Courage:
- Provide backup all the way to the board.
Adopt an Engaging Style:
- Involve physicians from the beginning.
- Work with the real leaders and early adopters.
- Choose messages and messengers carefully.
- Make physician involvement visible.
- Build trust within each quality initiative.
- Communicate candidly and often.
- Value physicians’ time with your time.
- Promote both system and individual responsibility for quality.