Transform the Physician Experience
with President Dave Fox, Advocate Good Samaritan Hospital, Downers Grove, IL
Back in 2004, physicians at Advocate Good Samaritan perceived nursing care as uneven. They said quality was good but inconsistent, and patient satisfaction was mediocre. Increasingly, technology and facilities were perceived as slipping behind in the county's 'medical arms race.' To address these perceptions, the hospital launched a Moving from Good to Great initiative in mid-2004. The goal: to elevate the hospital's performance and give patients a reason to choose Good Samaritan over other hospitals. Good Samaritan is a 350 bed hospital with 851 physicians and 2,400 employees in Downers Grove, IL.
Today, 99% of medical staff say on physician surveys that they are very satisfied or satisfied with the hospital overall (93rd percentile) and would recommend the hospital to family and friends (96th percentile).
The Journey
Since Good Sam's medical staff is comprised of many "splitting" physicians—who practice at two or more local hospitals—an important strategy has been to differentiate the hospital in the marketplace to move physician referrals, patient volumes and market share to Advocate Good Sam.
Leaders identified a two-fold challenge: to strengthen relationships with "aligned" physicians and to build relationships with "non-aligned" physicians. Aligned physicians were defined as bringing more than 50% of their patients to Good Sam; while non-aligned physicians brought fewer than 50%.
Furthermore, aligned physicians were increasing their number of annual admissions, were more loyal in their admitting patterns, more likely to recommend the hospital to family and friends, were highly satisfied with hospital performance, worked collaboratively with administration, and looked for win-win collaborations between their practice and the hospital.
Specifically, non-aligned physicians wanted to visibly see the administration working on their behalf. They wanted well-trained nursing staff across all shifts to provide better and more consistent bedside care. They also wanted highly skilled hospital-based radiologists who communicated well and were readily available.
Responding to Physician Drivers
To focus more powerfully on physician needs, Good Sam added a Physician Engagement pillar to its performance dashboard and implemented strategies and tactics to respond to the four physician drivers—quality, appreciation, input, and efficiency. Tactics included:
Quality—raised the quality bar for professional nursing staff; partnered with MD leaders to improve clinical outcomes and then celebrated achievements through recognition; developed exceptional hospital-based MD services; improved patient satisfaction above the 90th percentile for most patient categories; and created PHO clinical integration to achieve meaningful pay-for-performance.
Appreciation—wrote thank you notes; publicly recognized clinical champions; developed bookmarks to showcase physician photos and expertise; debuted physician appreciation week; improved food in the physician lounge; created numerous physician recognition opportunities, including a Recognition Wall.
Input—all patient care leaders began rounding on physicians; senior leaders increased their access and responsiveness; solicited input of physicians on issues important to them (e.g.; design of new operating rooms, adoption of block scheduling, and design of new GI facility).
Efficiency—Improved PHO reimbursement; created quick report turnarounds; improved ED throughput and bed flow; made OP scheduling easier; hired pediatric hospitalists; added modified block scheduling for busier surgeons; and personalized support for physicians.
The results? Between 2006 and 2008, Advocate Good Samaritan has increased admissions and observation patients by 11.2% and grown market share by 7.3%. For the fiscal year just completed in December, the hospital achieved a net operating margin of 5.5% in spite of a very challenging economic environment for Chicagoland healthcare.
Top 5 Predictors of Satisfaction by Alignment Status
|
Aligned Physicians
(refer > 50% of patients to Good Sam) |
Non-Aligned Physicians
(refer < 50% of patients) |
1 |
Skill of administration |
Responsiveness of administration |
2 |
Satisfaction with nursing care |
Efforts to improve quality |
3 |
Efforts to improve quality |
Willingness to recommend to family and friends |
4 |
Willingness to recommend |
Satisfaction with nursing care |
5 |
Efficiency of hospital operations |
Ease of scheduling outpatient surgery |
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