HARDWIRED RESULTS ezine - ISSUE 10 - Round on Referring Physicians

Spring 2008-Issue 10


	Message From Quint: Build Physician Loyalty, Trust and Collaboration

	Create Physician Loyalty that Joint Venture Firms Can’t Beat

	Re-Recruit New Physicians

	Build A Shared Agenda

	Transparency Gets Results

	Round on Referring Physicians

	You Speak. We Listen.

	Hire the Right Physicians

	Wow Physician Splitters

	Deal with Difficult Doctors

Take this SELF-TEST:


	Is your organization vulnerable to physician joint ventures?

Round on Referring Physicians
with CEO John Fitzgerald, Inova Fair Oaks Hospital, Fairfax VA

I	n the past five years, 182-bed Inova Fair Oaks Hospital in Fair Oaks, VA has moved physician satisfaction from the 71st to 99th percentile (Professional

Research Consultants) in their quest to be the leading hospital in the nation by 2012.

In addition to working targeted action plans that responded to key issues that hospital-based MDs identified, each administrative leader “adopted” a group of physicians to improve communication through regular rounding and attendance at department meetings. Targeted physician visits focus on operational issues to encourage active physician input into operational decision making while strategic planning sessions include key physicians for real partnering in the delivery of world-class care.

ED Physicians Reach Out
However, when a survey of 150 referring physicians three years ago revealed that their satisfaction with Inova Fair Oaks’ emergency department was in the 37th percentile—despite aggressive changes two years earlier—ED physicians stepped up their responsiveness even more.

First, they sent the surveyed physicians a letter to let them know they were committed to process improvements that were physician satisfiers and to anticipate a call. Then each of the 14 ED physicians made 10 calls to referring physicians (broken down by specialty) so they could identify specialty-specific needs.

The response? Physicians said they were frustrated when they couldn’t get a nurse on the phone to give admitting orders; that wait time for patients was too long; and it was too difficult to make contact with ED physicians. As a result, Inova Fair Oaks ED developed a set of limited holding orders and asked nurses and ED physicians to carry a cell phone so physicians could get easy access. New patient flow processes cut wait times with triage for better throughput. And discharge instructions were automatically faxed to referring physicians so they could better track their patient outcomes.

Four Questions to Ask Referring Physicians

What is working well? Capture the wins first.
Explain actions taken in response to concerns. During their 2007 calls, Inova Fair Oaks ED physicians focused on concerns expressed the previous year on efficiency and communication. They offered ample evidence of changes made in response to physician requests, including faxed summaries of patient care, cell phones to reduce physician waiting time, a streamlined triage process, the adoption of new collaborative practice guidelines, and more phlebotomists to expedite blood draws and IV starts.
Ask what’s most important when referring patients. You’ll need to address the unique needs of specialties and individual referring physicians to get their business. When physician satisfaction in outpatient pediatrics remained stubbornly low, an inpatient pediatric hospitalist and ED physician with pediatric expertise at Inova Fair Oaks teamed up to visit area pediatricians.
Ask what else you can do to ensure excellent satisfaction. Inova Fair Oaks physicians now commit to a continuous “we hear you” cycle where they send a letter communicating the latest changes just prior to the next physician satisfaction survey. Then they follow up by phone to learn more about key satisfaction drivers after each survey and how they can raise the bar. In March 2008, the ED was excited to share good news with physicians: They could look forward to the imminent adoption of electronic medical records for easy access to patient records from home or office.

“There’s so much we can do to create a more productive, efficient environment for physicians,” adds Inova Fair Oaks CEO John Fitzgerald. “Our success in the ED is just one part of a multitiered approach that has earned high physician loyalty.”

John Fitzgerald is senior vice president of Inova Health System and CEO of Inova Fair Oaks Hospital in Fairfax, VA since 2003. Inova Health System includes six hospitals as well as emergency and urgent care services, home care, nursing homes and more.