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Physicians can no longer simply focus on the effectiveness of their interventions. This changing environment demands
a responsibility for assessing the efficiency and the appropriateness of care, and the quality of the patient experience as well. What is required is a more balanced and integrative accountability. More Info
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The imperative to improve quality and safety while maximizing appropriate productivity translates into the need for dramatic improve¬ment in efficiency. Most hospital processes are notoriously inefficient, having been developed gradually and organically in the face of one stress, and one innovation, after another. For one thing, the number of accommodations that need to be made for emergent and unscheduled care makes efficiency an ephemeral goal for many of our hospitals. In addition, there is the need to accommodate staff—in particular, physi¬cians—who expect their own schedules and time commitments to be honored. The technologies on which we rely increasingly exert their own demands upon us, for access is often limited. Finally, the capital investment necessary for a fully functional information system that might drive efficiency is very difficult to amass, leaving most healthcare organizations stranded somewhere between archaic paper processes and fully implemented electronic solutions. More Info
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Many studies have focused on healthcare quality and healthcare costs in the United States; however, few studies have isolated and evaluated the effect the structure between hospitals and members of their medical staffs has on the outcomes of quality and cost. The goal of this study was to evaluate the effects of the structure of the relationship between hospitals and cardiac surgeons—specifically, employed versus independent cardiac surgeons—on quality and cost in the outcomes of coronary artery bypass graft surgery (CABG). More Info
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Basically, the definition of a competent practitioner has been expanded from technical skill and knowledge to issues such as how well a practitioner works with colleagues (including nursing and ancillary staff), his or her professionalism, behavior, and how well practitioners work within the healthcare system to improve patient safety. Healthcare organizations today realize that the ability to demonstrate that those practitioners granted clinical privileges meet this expanded definition of competency is more important than ever. No healthcare organization wants to grant clinical privileges to those practitioners who are consistently ranked as below average. Today’s healthcare consumer is checking whatever sources are available (most often via the Internet) and has the ability to “comparison shop” for his or her healthcare needs. Documented competency is not only an accreditation requirement, but also a differentiator healthcare organizations can use as a competitive edge for marketing purposes in their service area. More Info
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One of the challenges facing all medical staffs is when to insist that a member undergo physical or mental examination. Your medical staff bylaws should clearly state the circumstances allowing authorized leaders to require such evaluations. But this is tricky legal territory. Several laws may be implicated, including the Americans with Disabilities Act (ADA), the Federal Rehabilitation Act, the Age Discrimination in Employment Act (ADEA), and various state laws. It is always wise to consult hospital legal counsel before insisting that a staff member undergo physical and/or mental testing. More Info
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I just came back from visiting with a client where I had the opportunity to participate in their triennial Joint Commission survey, in particular the Leadership Interview session that happens on the final day of the survey. This is the meeting in which all members of the survey team meet with the hospital’s senior leadership team, medical staff leaders, and several members of the board. More Info
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However, in 2008 Congress revoked The Joint Commission’s statutory authority as a deeming organization. Starting in July 2010 TJC will have to go to CMS and apply for deeming authority just as other accrediting agencies (e.g., Health Facilities Accreditation Program and DNV). More Info
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Hospitals that choose to be accredited by The Joint Commission must be in compliance with the medical staff standards promulgated by that organization. In 2007, The Joint Commission issued a new standard dealing with “focused professional practice evaluation” (FPPE) and made it effective January 2008. More Info
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This interview is meant to assess leaders’ knowledge and involvement in hospital-wide improvement projects, and efforts to communicate across and outside the hospital. More Info
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I agree with those who say we are at a “turning point” in healthcare and those who say that physicians must play key leadership roles in helping us make changes for the better.
The changes necessary for the future of healthcare are transformational, not just incremental; for this reason, three leadership skills are essential for today’s physician leaders:
• Seeing systems
• Collaborating across boundaries
• Creating desired futures More Info
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