Physician Engagement

1. Physician Engagement

3. Learning Objectives • To relate what is meant by physician engagement • To discuss strategies at management and staff levels to enhance physician engagement

4. What Do We Mean by Engagement? • Engagement: “To involve one self or become occupied; to participate fully and deeply” • Active support of the project

5. Where Does Engagement Fit? • Work involves technical problems • Evidence • Measurement • Adaptive problems • Engagement of nurses, physicians, leaders, IPs • Competing priorities • Overcoming barriers • Ameliorating safety and teamwork climate

6. Stages of Engagement

7. Engage Physician’s Intellect • Show them • The evidence • Your hospital’s CLABSI rates • What others have achieved • That you can do the same

8. Engage by Creating Trust • Caring • Keep patients as your “North Star,” your focus • Preventable harm is not acceptable • Tell your own Josie story • Competent • Learn from mistakes and implement teamwork tools • Demonstrate early successes/project results

9. Physician Engagement Strategies • Management level • Identify physician champion for project • Unit director, chief medical officer, or senior physician • Someone other physicians look up to • Reward physician champions for their efforts • Obtain hospital support for their time • Feature in newsletters • Provide opportunities to present to senior leaders

10. Physician Engagement Strategies • Management level (continued) • Create a compact (agreement) • Clearly define what is expected of physicians • Review performance regularly

11. Example: Physician Champion Compact • Hospital will provide support for percent of physicians’ time • In return, physician will • Monitor and improve quality • Implement CUSP and CLABSI toolkit • Hold regular meetings with team • Involve other members of medical staff in quality • Report CLABSI rates and learning from defects results to senior leaders and board

12. Example: Physician Champion Compact • Further, the physician will • Work with hospital to clarify what will be measured, who will measure it, and who will produce reports • Meet quarterly to discuss progress

13. Physician Engagement Strategies • Staff level • Create containing vessel (environment) to have a dialogue with physicians (eliminate decoding errors) • M and M, grand rounds, quality meetings, etc. • Identify and overcome barriers to engagement • Clinician, intervention, system • Try physician engagement self-diagnostic tool (safercare.net)

14. Physician Engagement Strategies • Staff level (continued) • Communicate prior to start of project • No surprises • Who, what, when, where, how • Listen to those who resist/value the dissenter • Create mechanisms to feed results back to physicians

15. Handling Barriers to Change • Tune in to WIFM (What’s In It For Me?) • People resist loss, not change • Try to surface and mitigate real and perceived loss • Physician’s time is likely a major concern • Perceived losses often much greater than real loss • Perceived loss high when communication is low

16. Manage Communication • At each step or meeting • Clarify message • Determine who needs to know • Make time for feedback • Assume that all staff have patient as their “North Star” • Remind staff they are participating in something greater – “Ohana”

17. Action Plan • Cultivate a physician champion for this project • Create compact for physician champion role • Create containing vessel for communication • Develop communication plan for CUSP education • Listen to physicians to surface and mitigate loss