Harnessing Physician Competition to Transform the Patient Experience

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HCP-thumb1Most healthcare leaders agree changing the culture is the most difficult aspect of transforming the patient experience at their respective organizations, writes Jacqueline Fellows at HealthLeaders Media, which is why some organizations have begun to take advantage of the competitive nature of physicians in order to implement that change.

Mary Anna Sullivan, M.D., chief quality and safety officer of Lahey Health, based in Burlington, Mass., an organization that was recently formed after Lahey Clinic merged with Northeast Health System, observed, “If anything makes physicians act, it’s not being the best and wanting to be.”

So, at staff meetings, Fellows write, comments from patients are read out-loud for everyone to hear, a practice Sullivan calls “effective” and one that at first glance, may sound suspiciously like “shaming.”

But Greg Bazylewicz, M.D., chief network development officer for Lahey Health and founding member and president of the Northeast Physician Hospital Organization, said there’s a way to “[ease] physicians into the idea of getting graded by patients.”

According to Fellows, at Northeast Health, before the merger, he began surveying “only patients of primary-care physicians before later including specialists’ patients. The process involved giving individual doctors their own score but blinding everyone else’s name for three months.”

“[W]ith the merger,” Fellows continues, “Northeast Health brought over the discipline of surveying its outpatient providers with Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS), which is similar to the HCAHPS, but in an office setting” and now “surveys its physicians’ patients 30 times per year,” with Sullivan saying she wants to do it more so they can increase the number of patients and the types of patients from whom they’re receiving feedback.

“Using CG-CAHPS in a regular outpatient setting, even though it isn’t required, is giving Lahey Health a foundation for its ACO, the Lahey Clinical Performance Network, which was approved by CMS in January as a Medicare Shared Savings Program,” Fellows writes. “CMS is collecting CG-CAHPS data, which will be incorporated in the ACO’s overall quality score, thus influencing shared savings and loss percentages.”

Lahey’s goal is two-fold: create a culture in which both the physicians and the patients are engaged and invested in the quality of care and thus, the patient experience, on the front-end of that care.

Sullivan explained, “An engaged patient has better outcomes, does better, takes better care of his or her diabetes, communicates better with his or her doctor. It may be hard for us to continue on this journey, but I think it’s going to mean better care for patients, and happier physicians and nurses.”

As healthcare executives, how could you engage the competitive sensibilities of your physician staff to enhance the quality of care and the patient experience? What could you do to ensure that this competition was not divisive, but instead, unifying and beneficial to the team? Do you agree with Lahey’s approach?

-by Pete Fernbaugh

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