The Exec: How to Boost Medical Group Operational Performance

Operational excellence is a quality strategy from a clinical standpoint as well as a financial initiative to maintain a medical group's sustainability, this new CMO says.

The new CMO of Holy Cross Medical Group says there are five core components of improving operational performance at a medical group.

Lawrence Ward, MD, MPH, was named as CMO of Holy Cross Health's medical group in January. Ward's prior leadership experience includes serving as vice president of physician services and clinical integration at Dover, Delaware-based Bayhealth Medical Center.

For a medical group CMO, there are five tenets of achieving operational excellence, according to Ward.

"First, you must take care of patients," Ward says. "Second, you need to take care of each other in the organization. Third, you need to strive for perfection. Fourth, you need to avoid surprises from your staff. Fifth, you want to have people come to you with solutions rather than complaints."

Ward says monitoring basic clinical data metrics are part of making sure that a medical group is taking care of its patients such as performance in cancer screening, diabetes care, and immunizations. But a medical group CMO also needs to focus on how patients feel, including how they are greeted at the front desk and how physicians and nurses relate to their patients, Ward explains.

"Patients want to be treated as people rather than part of an assembly line," Ward says. "They want to be taken care of, and they want to be heard. Sometimes, a medical group can get lost in its data elements, checking boxes, and the financial aspects of healthcare. We can talk about putting patients at the center of what we do, but we must live that every day."

With workforce shortages challenging medical groups across the country, an essential part of promoting staff member well-being is addressing burnout, according to Ward.

"For physicians in particular, you need to make sure the electronic medical record is easy to use and their electronic in-basket messages from patients are manageable," Ward says. "For example, we recently went live with an Epic tool that uses AI technology to help physicians manage their electronic in-basket."

To strive for perfection, medical group CMOs need to be accountable and transparent with the data they share with staff members, Ward explains.

"You can do that by developing dashboards and key performance indicators such as access to care, productivity, clinical quality, and financial performance," Ward says.

Efforts to avoid surprises from a medical group's staff include standardizing workflows, to a point, according to Ward.

"It is important to have standardized workflows, but it is also important to determine what practices are doing well, so there can be room for local flexibility," Ward says. "You want to reduce unwarranted variation, but leaving room for some customization gives staff members a sense of control over their daily work."

A medical group CMO must encourage staff members to come forward with solutions to problems rather than complaints, Ward explains.

"It's easy to complain and nobody loves change," Ward says. "This is a challenge because the healthcare industry is going through constant change, which is not necessarily for the better. If all people do is complain, it sets up a confrontational environment such as administration versus clinicians."

As a medical group CMO, Ward wants to know the viewpoints of physicians and their suggested solutions for problems so that they can be brought to the C-suite.

"If physicians come to me with complaints, my response is going to be soliciting proposals to fix the problems," Ward says. "As long as I listen to suggestions from physicians and do my best to implement their solutions, physicians will understand that is how they can get things done better and have a greater chance of success."

Achieving operational excellence at a medical group is imperative from both clinical and financial perspectives, according to Ward.

"As CMO at Holy Cross Medical Group, I view operational excellence as a quality strategy from a clinical standpoint," Ward says. "It's also a financial initiative because if we don't make money we don't have a roof over our heads."

Lawrence Ward, MD, MPH, is CMO of Holy Cross Medical Group. Photo courtesy of Holy Cross Health.

Promoting Physician Engagement

To achieve clinical excellence and a high level of operational performance at a medical group, Ward says physician engagement is foundational.

"A medical group CMO must engage physicians in all of the things that the medical group needs to do," Ward says. "A CMO must convince physicians that duties outside of direct clinical care achieve the betterment of the care for patients."

To succeed in physician engagement, a medical group CMO must serve as a bridge between administrative leaders and physicians, according to Ward. The goal is to help physicians take care of their patients while also meeting organizational benchmarks.

"My approach to physician engagement is to be transparent, honest, and accessible," Ward says. "I want to avoid a situation where the administration and physicians are butting heads. I want to work in partnership with physicians. I am an advocate for physicians, and I am their voice in the C-suite."

A medical group CMO can boost physician engagement by addressing administrative burdens, Ward says. In addition, a CMO should show an interest in physicians as people and help develop them as professionals by mentoring them and creating leadership development pathways, Ward explains.

At Bayhealth Medical Center, an example of physician engagement was when the organization needed to create new endoscopy suites for gastroenterologists.

"We explained the slowdown in getting the new suites to the gastroenterologists, including the financial barriers and the budget timeline," Ward says. "It was frustrating for them, but at least they understood that administrators were not dragging their feet in getting the new suites."

If physicians can understand what is going on behind the scenes to get them what they want, they can get a better understanding of the process, according to Ward.

"In addition, it helps physicians understand what administrators need from them to get what they want," Ward says.