Becker's Hospital Review

54 CMO / CARE DELIVERY "Failure will result if the organization is not sensitive to their clinical workload," he says. Some organizations have implemented creative solutions to ensure physician champions are compensated for their leadership duties, such as creating RVUs for administrative work. 4. Champions don't have a say in decision-making. An important part of a physician champion's job is serving as a liaison between the clinical and administrative staff. However, a champion should not only act as a mouthpiece to relay information from one team to the other; instead, he or she should have a seat at the table during decision-making processes for changes that affect care delivery. When it comes to including physician champions in the deci- sion-making process, leaders must clarify from the outset what kind of input they expect, according to Mr. Howell. "Physician champions must have full access to [communication with] the top leadership," says Mr. Howell. Depending on the situation, "leaders should be cognizant on when to draw the line during deliber- ations of strategic initiatives, but they should err on the side of inclu- sion." In other words, physician champions have a unique perspective and valuable insight to offer when it comes to care delivery. e rest of the clinical team will be more willing to accept changes if they feel their interests are fairly represented from a clinical leader. 5. You have the wrong physician champion. Of course, one cannot ignore the possibility that a physician champion will fail because he or she is simply not cut out for the job. Mr. Howell said the physician champions he's seen struggle most lacked leadership experience and the common characteristics that so oen distinguish leaders from their peers. "e idea that you can take a raw piece of cloth and develop a leader out of it — there is not much evidence that this will be successful," says Mr. Howell. And while formal leadership training can provide physician champions with valuable insight on how to be an effective leader, Mr. Howell contends the term "leadership development" is ill-founded: "ese courses might be better titled 'leadership refine- ment,'" he says. e characteristics of a physician champion with high success rates include having the respect of their clinical colleagues; the ability to communicate effectively and concisely; and a strong drive to solve problems. *Dr. Tom Smith is a pseudonym to protect the physician's anonymity. n CMS Overall Star Ratings Have 'Several Shortcomings,' Analysis Finds By Heather Punke C MS' Overall Hospital Quality Star Ratings were sup- posed to be released in April, but the agency de- layed the launch until July after many stakeholders expressed concern with the program. Now, a new analy- sis of the program conducted by a Georgetown University economist found the program's methodology has "several shortcomings." Francis Vella, PhD, in Georgetown's Department of Economics in Washington, D.C., came out against the star ratings after conducting an analysis of the program's methodology. Here are three of the methodology's main shortcomings, according to Dr. Vella's analysis: 1. The overall star ratings attempt to take a complex, mul- tidimensional problem and put it into a simple measure, but Dr. Vella wrote he does "not see the net benefit" of doing so. 2. The methodology focuses solely on quality outcomes while ignoring their social determinants. "I feel ignoring other determinants of quality outcomes (such as location of hospital and patient composition) potentially biases the results," he wrote. 3. Finally, a star-based system can give a sense that a three-star hospital is substantially different from a four- star hospital, for instance, even when they are not that different. "Ranking the hospitals by stars is somewhat misleading as it indicates a qualitative jump as one goes from one category to the other and this may be inconsis- tent with reality and only reflects the scoring algorithm," Dr. Vella wrote. Dr. Valla isn't the only person or group to voice opposition to the overall star ratings program. Members from both the House and the Senate sent letters to CMS Acting Ad- ministrator Andy Slavitt earlier this year imploring him to delay the ratings, and many hospital advocacy groups did the same in March. Consumer groups like AARP, on the other hand, have ex- pressed support for the overall star ratings, saying patients need this information to help make smart healthcare deci- sions for themselves. However, Rick Pollack, president and CEO of the Ameri- can Hospital Association, asserts the ratings would be a hindrance to patients if released as-is. "As currently designed, CMS' star hospital ratings program is not up to the task of providing the public with meaning- ful and accurate assessments of hospital performance," he said. "Patients need reliable information to make important choices regarding their healthcare. And hospitals and health systems need reliable information so that they can continue to improve the quality of the care delivered. CMS star ratings misses the mark on both accounts." n

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