The Exec: CommonSpirit's New Chief Physician Executive Officer Focused on Care Variation

Setting clinical standards boosts patient safety and care quality, says this physician leader.

One of the primary focal points for the inaugural chief physician executive officer at CommonSpirit Health will be reducing variation in clinical care.

Thomas McGinn, MD, MPH, was appointed as senior executive vice president and chief physician executive officer of CommonSpirit in September. He joined the health system in 2021 as executive vice president for physician enterprise, where he oversaw physician and advanced practice provider employment and alignment models with accountability for advancing clinical integration and population health management.

McGinn says he is passionate about reducing clinical care variation to boost patient safety and quality.

"My background is in evidence-based medicine and looking at clinical standards," he says. "We have a national program that sets clinical standards."

According to McGinn, the key to success in setting clinical standards is to have clinicians drive the process.

"It is not a top-down approach," he says. "We put the standards in front of the clinicians, we give them some options, we have multiple group meetings, then the clinicians come to a consensus about the clinical standards."

The process also involves bringing together clinicians and thought leaders from academic and non-academic facilities drawn from across the health system, McGinn explains.

"We have a support system as we pull the working groups together to give them the latest evidence," he says. "There can be three different groups of 20 people each who are multidisciplinary. We summarize their final conclusions."

Once a clinical standard has been set, CommonSpirit promotes widespread adoption, according to McGinn.

"We educate our clinicians about it. We have internal grand rounds. We have podcasts. We have seminars," McGinn says. "We then look at whether there is an opportunity to embed a clinical standard in the electronic medical record. We follow the data on the impact of a clinical standard, and we keep the clinical standard workgroups in place for about a year."

Thomas McGinn, MD, MPH, is senior executive vice president and chief physician executive officer of CommonSpirit Health. Photo courtesy of CommonSpirit Health.

Capitalizing on size and scale

In his new role, the biggest challenge and opportunity for McGinn will be taking advantage of CommonSpirit's size and scale.

CommonSpirit is one of the largest health systems in the country, with more than 2,200 care sites in 24 states, more than 35,000 providers, and 45,000 nurses.

Where some people see a challenge in managing such a large health system, McGinn sees it as an opportunity to leverage size and scale as well as increase efficiencies.

"We are the largest population health, value-based care provider in the United States. We are also one of the largest Medicaid providers," McGinn says. "We have been combining offices and putting them under one national roof to create centralized expertise on data analytics and technology."

The supply chain impact of Hurricane Helene is an example of how CommonSpirit can benefit from its size and scale.

"The recent Baxter IV fluid shortage hit some of our California, Phoenix, and Las Vegas areas," McGinn says, "but we didn't even feel it because we were able shift fluids from the Midwest. So, size and scale have become a real advantages for us."

As another example, CommonSpirit used to have many ways of answering phone calls with different technology, which the health system has moved to consolidate.

"Over the past three years, we have switched to one centralized connection center with four hubs," McGinn says. "We have reduced our costs and increased our efficiency."

McGinn says he has an opportunity to influence care on a grand scale.

"My new job crosses the continuum of care from primary care to specialty care to acute care to intensive care, so I have a lens on all kinds of care," McGinn says. "The opportunity for me is to connect the dots, so patients have a positive experience in the continuum of care."

Dyad partnership

McGinn will be working in a dyad partnership with CommonSpirit's CNO, Kathleen Sanford, RN, DBA, MBA.

Being a dyad partner has two primary elements, McGinn explains.

"One is you are joined at the hip on your decision-making processes," McGinn says. "Each dyad partner knows what the other person is doing and there is no separate decision-making. You run your own workflows, but people see you standing next to each other all the time."

The other aspect of dyad partnerships is the focus on shared platforms. Currently, McGinn and Sanford are prioritizing wellness and career development.

"Kathy and I are going to share a platform for that work," McGinn says. "We are going to have a shared platform that manages talent development, wellness, and educational activities."

Another area of focus for McGinn and Sanford will be patient satisfaction.

"We have a large, centralized service of expertise and a singular way of measuring patient satisfaction across every type of clinical site," McGinn says. "Whenever we see dips in some areas, we can deploy evidence-based patient satisfaction teams."

McGinn cites the example of when CommonSpirit had a market where there was a decrease in patient satisfaction at ambulatory sites.

"We deployed a patient satisfaction team to that market for a week," McGinn says, "and they helped the physicians, nurses, and staff with everything from simple training on eye contact and greeting patients as they walked into clinics to more advanced approaches to patient satisfaction."

Virtual nursing has also been a major initiative to improve patient satisfaction in the inpatient setting, McGinn explains.

"To address nursing shortages at our hospitals, we have been deploying virtual nursing to relieve some of the administrative work that is not patient-facing," McGinn says. "That has enabled the bedside nurses to be more engaging with their patients."