Becker's Hospital Review

41 41 CEO/STRATEGY 18. Establish a physician wellness committee in your institution. All medical institutions should have a wellness policy and program that promotes physician health. Some institutions are mandated to have these resources through law or credentialing agencies. Most state PHPs can assist with guideline development and wellness training among committee members within your institution. 19. Watch for signs of concern among your physicians and take action. Look for: • Physical changes • Behavioral changes • Personality changes • Workplace changes • Life changes, including personal loss- es and decreased self-care John Mach, MD, CMO of Evolent Health. 20. I offer these suggestions to primary care physicians. Don't wait for next year's patients to come to you. Go to them, go now and go in new ways. Predictive data modeling can show who will be hospitalized next year with accuracy that frequently surprises health prac- titioners and challenges their assumptions on where to focus population health outreach ini- tiatives. Evolent's data regularly show the "fre- quent fliers" driving the bulk of a population's health costs this year aren't the same people who will be high users next year. Next year's cost-drivers can be kept out of the hospital if primary care providers set aside time to follow predictive data's warning signs and build protocols that reach out to individuals pre- emptively. Find the woman who hasn't picked up her prescriptions and find a way to address the transportation, language or insurance issue holding her back from compliance. Danielle Mitchell, MD, Candidate for Ten- nessee's 3rd Congressional District. 21. Support medical provider wellness programs. e burnout rate of physicians (as well as other medical providers) is more than 50 percent in most specialties. is speaks volumes of the stress our healthcare providers are under. 22. Encourage community leaders, including those from the medical community, to run for government office! Medical providers are oen on the front lines and understand the needs you and your family have, which oentimes goes be- yond clinical care (i.e. the financial burden trig- gered by low wages that drive processed foods consumption, etc.). It makes sense to elect some- one who understands and may even experience the same struggles you face. Ram Raju, MD, Senior Vice President of Community Health Investment, Northwell Health (New Hyde Park, N.Y.). 23. We need to have a patient empowerment moment, so patients feel comfortable asking questions without being afraid. e patient will never be educated to understand the en- tire complexity of medicine, but they can be empowered to ask the right questions and de- mand value for their money and demand the best care possible. Something we did was hand out buttons to all our physicians reading, "Ask me a question." We also had a program asking patients, "Do you know the name of your doctor?" rather than pa- tients just knowing they're going to the cardiolo- gy clinic. at helps foster some connection and accountability. Another example is language barriers may impede people asking questions because they don't feel their language skills are strong enough, or they feel their accent is too heavy to be understood. So we work on giving them language interpreters so they feel comfort- able to ask questions. Rebecca Parker, MD, President of the Ameri- can College of Emergency Physicians. 24. Get out in the community and sponsor ed- ucation and outreach. 25. Offer volunteer and outreach programs that allow medical professionals to grow the pipeline. Start at college, high school and even elementary school. We need more healthcare personnel and together we can recruit the best talent. Being a medical professional is the best job in the world. 26. Do walking rounds on your staff, nurses and physicians. Ask them what they need to do their jobs. Being present; listening and trying to bring solutions to the bedside professionals goes a long way. 27. Look at systems for solutions, not individuals. Things individuals can do at a policy level. Barbara Bergin, MD, Orthopedic Spine Sur- geon, Texas Orthopedics, Sports and Reha- bilitation Associates (Austin). 28. Don't let lobbyists be involved in the pro- cess of healthcare legislation. 29. Everyone should have to pay a copay — even Medicaid patients. Even a $5 to $10 copay would save a lot of money [for healthcare providers]. Stephen Klasko, MD, President and CEO, omas Jefferson University and Jefferson Health (Philadelphia). 30. Government funding for academic medi- cal centers should be at least partially based on reducing disparities in the community, not just what happens once a patient comes into your hospital. In Philadelphia, we have the greatest concentration of academic medical centers in the U.S., and at the same time the greatest dis- crepancy in life expectancies among zip codes. Peter Pronovost, MD, PhD, Senior Vice Pres- ident for Safety and Quality, Johns Hopkins Medicine (Baltimore). 31. We should demand that we have valid mea- sures of how many people die needlessly in the U.S. If you were to ask how big a problem is safety or preventable death, the honest answer is — we don't know. e estimates still range from 40 to 400,000, and it's because we don't have a valid measurement system. We have a valid measurement system for in- fections, created by the CDC. ey should be supported to say, "Let's list the top 10 causes of preventable harm," and, "Let's develop valid ways to measure them and a valid way to count and share that number with the public." 32. e public should ensure the [quality] data hospitals report is just as accurate as their finan- cial data. When any organization reports their financial data there are rules set by the account- ing financial standards board. ey have to fol- low standard accounting principals, the data are audited, the data are posted on EDGAR so anyone can see what you're doing. en there's private sector reanalysis of those numbers. In healthcare there are no rules for what you can report, there's no auditing. ere are lit- tle glimpses when we do auditing that say the data quality is really bad. ere's no public or common book of truths like EDGAR. When all these rating systems go to report cards, they vary widely. Of the top 5 reporting systems — including Leapfrog, Healthgrades, U.S. News & World Report — not one hospital was on all five, and 42 percent of hospitals were at the top of one report and the bottom of another. 33. Invest in quality and safety research. In the U.S. we have a fairly narrow view that biomed- ical research means finding new genes and new drugs. But how we apply those findings to ap- prove care and optimize patient outcomes, called applied research or improvement science, is vast- ly underfunded. About two pennies of every dol- lar we spend on research goes to applied research. If we could apply all the vast knowledge we know, we could see vastly better outcomes, but we don't know how to do that. 34. Demand annual data on the number of different procedures hospitals and physicians perform is listed on their website. Roy Smythe, MD, Global CMO, Healthcare Informatics, Philips. 35. I would start with creating a list of health, wellness and disease outcomes that "matter" to providers and the general public. en I'd re- structure reimbursement such that providers are paid a base rate for provision of services, but a premium for high performance related to these outcomes. ese go well beyond "read- mission" and "patient satisfaction" to include things like survival rates for cancer, mobility, mental well-being, etc. n

• Cover