Jack Silversin, DMD, DrPH, a consultant whom Weiner calls the "grandfather" of physician-organization compacts, was brought in to speak to the medical group. The organization's leadership met with the clinics' physician practice leaders and began having meetings to describe the organization's current state and to describe the future state they wanted to achieve. From those conversations, a one-sentence vision was crafted: "We collaborate to provide the highest-quality patient-centered care."
The vision may have been succinct, but it was a far cry from the organization's starting point.
"We weren't collaborating. We were siloed," Weiner says. "We all thought we provided excellent care, but we weren't really measuring it. We weren't doing process improvement, and we were physician-centered."
A physician-organization compact was created to guide both the physicians and the leadership toward their new vision.
"The next step was to look around and see: 'Is our system set up to help people achieve what it is we said we want to achieve?' Namely physician engagement and the change process," Weiner says.
This led back to the whole issue of those meetings and committees that no one was attending.
"We took all of the leaders of the committees and brought them into one think tank called the TIC—the tactics and implementation committee," she explains. "It takes a strategic plan, takes the feedback from what's going on on the frontlines, and synthesizes and prioritizes projects based on what we are trying to achieve strategically and what the pain points are out on the frontline."
When an issue "rises to the top," the committee calls a work group, which is headed by a physician who is knowledgeable about the issue. A charter is created so there is a beginning, middle, and end to the project, and there are deliverables and measurables to be met.
"There's an executive sponsor that's overseeing it and supporting it, and who's making sure it has all the resources it needs," she says.
Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.