While individual interventions for residents such as resiliency initiatives are important, HCA Healthcare believes creating a supportive workplace environment is crucial.
At health systems and hospitals, burnout among physicians and residents is a national problem.
A study published by Annals of Medicine and Surgery found that burnout among residents may be linked to long work hours, high educational demands, lack of autonomy, a high level of work-home interference, a shortage of benefits, and insecurity about the future.
To combat burnout among residents, HCA Healthcare is training clinical leaders and medical faculty to create a supportive workplace environment for the health system’s residents.
The health system’s research on resident well-being and assessment of external research has determined that resident well-being is grounded in five factors: efficiency of practice as defined by job demands versus available resources, autonomy, belonging, competence, and whether the workplace environment supports a sense of meaningful work.
"We did a study last year with 2,029 residents and found that we could predict burnout with those five pillars," says Gregory Guldner, MD, vice president of academic affairs at HCA Healthcare.
HCA Healthcare has defined these five factors as follows:
Efficiency of practice: Making the practice of medicine for residents as efficient as possible is a function of hindrance job demands and challenge job demands. An example of a hindrance job demand is a broken piece of equipment in an exam room. An example of a challenge job demand is asking residents to speed up and see more patients.
Autonomy: Residents should feel a sense of endorsement in the work that they do. It is not about freedom or lacking supervision. It is the sense that what a resident does throughout their day is chosen volitionally. They feel they do work is done because they have the choice to do it or because their supervisors endorse what they are asking residents to do.
Belonging: Residents should have a sense of feeling understood and accepted by their coworkers and supervisors.
Competence: For residents, competence has two elements. First, it is a sense of mastery—that a resident can do and affect things in their workplace environment. Second, it is a sense that there is an opportunity for growth—that there is a pathway to grow.
Meaningful work: Faculty members should encourage residents to step back and reflect on the impact of the care that they are providing. For example, if a resident is involved in a procedure that provides life-saving care, a faculty member should tell the resident that they have played a meaningful role in saving a life because of the resident’s training and involvement in care.
Although HCA Healthcare has initiatives that provide residents with resources to help boost their well-being and resiliency as individuals such as therapy and coaching, addressing the workplace environment through the lens of these five factors is essential to reducing resident burnout, according to Guldner.
"We are much more interested in how we work with leaders, faculty members, and the C-suite to create a work and learning environment that supports resiliency," Guldner says. "Our research shows that one of the best ways to support an individual’s resiliency is to create a work and learning environment that addresses psychological needs."
Gregory Guldner, MD, is vice president of academic affairs at HCA Healthcare. Photo courtesy of HCA Healthcare.
Training clinical leaders and medical faculty
HCA Healthcare has a workshop program to train clinical leaders and medical faculty to promote a supportive workplace environment for residents.
"We bring in our faculty, program directors, directors of graduate medical education, and other leaders to work with our organizational psychologists," Guldner says. "This is a change from how you build a resilient person, which is great and important, to how you build an organization with a supportive environment."
Part of the workshop curriculum involves training faculty on how to communicate with residents to support autonomy as opposed to just telling residents what to do when they are providing care.
"With autonomy, our residents may have supervisors say, 'Just do this.' That is a common scenario in graduate medical education," Guldner says. "That approach does not make residents feel they have a lot of ownership or autonomy. We teach our faculty to say things like, 'What do you want to do?' If a resident wants to admit a patient to the hospital and that seems reasonable, faculty member will say, 'If that is what you want to do, let's do that.'"
A focal point for the workshops is self-determination theory, which is an organizational well-being theory.
"We talk about how the ways you behave and the ways you set things up in the environment with policies and procedures support autonomy, belonging, and competence," Guldner says.
In addition, the workshops train clinical leaders and faculty to identify hindrance job demands and address them quickly. Guldner cites the example of a broken otoscope in an exam room.
"From a workplace standpoint, if a resident is in an exam room caring for a child with an earache and the otoscope is broken that is a hindrance job demand," Guldner says. "They have to stop what they are doing to find a working otoscope. Those are exactly the type of things that we want to address quickly because there is a direct connection between hindrance job demands and workplace burnout."
This week's edition of HealthLeaders' The Winning Edge program featured a four-member webinar panel that focused on strategies to improve physician engagement and clinical efficiency.
Physician engagement is essential to drive positive clinical outcomes for patients as well as to achieve physician satisfaction. Clinical efficiency is crucial for healthcare organizations to establish an effective workplace environment and to control costs.
Click on the video below to view the webinar session. Click here to read a HealthLeaders story that highlights some of the key takeaways from the webinar.
This webinar was sponsored by QGenda.
The Winning Edge series is an extension of theHealthLeaders Exchange program. The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.
Please join the HealthLeaders Exchange community at our LinkedIn page. To inquire about attending a HealthLeaders Exchange event and becoming a member, email us at exchange@healthleadersmedia.com.
Sharing strategies for boosting clinical efficiency was a central theme for this week's edition of The Winning Edge, which is a healthcare provider-focused HealthLeaders program.
Clinical efficiency is crucial for healthcare organizations to establish an effective workplace environment and to control costs.
This week's webinar for HealthLeaders' The Winning Edge series was centered on the topics of improving physician engagement and clinical efficiency. The webinar featured a four-member panel of experts: Ruric "Andy" Anderson, MD, MBA, chief medical and quality officer at RWJBarnabas Health; Thomas Balcezak, MD, MPH, chief clinical officer at Yale New Haven Health; Patrick Hunt, MD, CMO at QGenda and CMO of acute care at Prisma Health; and Ghazala Sharieff, MD, MBA, corporate executive vice president and chief medical and operations officer for acute care at Scripps Health.
View the infographic below to get four tips on how to improve clinical efficiency. Click here to read the accompanying HealthLeaders story on key takeaways from the webinar.
The webinar was sponsored by QGenda.
The Winning Edge series is an extension of theHealthLeaders Exchange program. The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.
Please join the HealthLeaders Exchange community at ourLinkedIn page. To inquire about attending a HealthLeaders Exchange event and becoming a member, email us atexchange@healthleadersmedia.com.
A four-member panel of experts shares how to successfully engage physicians and boost clinical efficiency.
Physician engagement is essential to drive positive clinical outcomes for patients as well as to achieve physician satisfaction. Clinical efficiency is crucial for healthcare organizations to establish an effective workplace environment and to control costs.
The latest webinar for HealthLeaders' The Winning Edge series was held yesterday on the topic of improving physician engagement and clinical efficiency. The webinar featured a four-member panel of experts: Ruric "Andy" Anderson, MD, MBA, chief medical and quality officer at RWJBarnabas Health; Thomas Balcezak, MD, MPH, chief clinical officer at Yale New Haven Health; Patrick Hunt, MD, CMO at QGenda and CMO of acute care at Prisma Health; and Ghazala Sharieff, MD, MBA, corporate executive vice president and chief medical and operations officer for acute care at Scripps Health.
Enlisting medical staff to drive efficiency and cost savings
The panelists said CMOs and other clinical leaders need to engage medical staff to boost efficiency and achieve cost savings.
Physicians and the choices they make have a pivotal impact on efficiency and costs, according to one of the panelists. CMOs and other clinical leaders need to tap into physician expertise and experience to launch successful efficiency initiatives and control costs, the panelist said.
Health systems, hospitals, and medical groups should establish care pathways and standardized order sets to give physicians insights into cost-effective treatments, such as low-cost medications that are as effective as high-cost medications, as well as gaining insight into clinical efficiency, one of the panelists explained.
To improve physician efficiency, health systems, hospitals, and medical groups should optimize physician scheduling, according to one of the panelists.
To improve clinical efficiency, CMOs and other clinical leaders should encourage a medical staff to focus on access to care. An important part of this strategy is to help physicians use their time efficiently to boost access, the panelists said.
Another strategy to boost clinical efficiency is to improve patient throughput in the hospital setting by making sure physicians are working effectively with other clinical care team members such as nurses and technicians, according to the panelists.
To help control costs, CMOs and other clinical leaders should enlist service line clinicians to work with medical device vendors to secure the best deals for a health system or hospital, one of the panelists explained.
Care team communication strategies
CMOs and other clinical leaders can employ multiple strategies to communicate with physicians, nurses, and other care team members to help drive patient safety and care quality improvements, the panelists said.
One communication strategy is for clinical leaders to emphasize with physicians and nurses the importance of accurate and complete clinical documentation. Ensuring that clinical documentation is accurate and complete avoids reimbursement penalties.
CMOs and other clinical leaders should focus on communicating clinical data with clinicians, one of the panelists explained. This data should be actionable, transparent, and meaningful. Sharing data on clinical outcomes that shows how clinicians are performing can spur the competitive spirit among clinicians to perform at the highest level.
Additionally, CMOs and other clinical leaders should set goals for their communication with care team members and target particular patient outcomes. By setting goals and targets, communication can be meaningful for clinicians and help drive improvements in patient outcomes, the panelists said.
Engaging physicians in strategy decisions and technology adoption
CMOs and other clinical leaders should be intentional in engaging physicians about strategy decisions and technology adoption, the panelists said. Physicians should be queried about their pain points and should be consulted when potential solutions are identified.
When CMOs and other clinical leaders are considering the adoption of new technology, they should include physicians in the planning stage and have physicians play a role in pilots that test the technology.
Lastly, when there is a change in strategy or adoption of new technology, CMOs and other clinical leaders must provide physicians with a concise and compelling explanation for why change is necessary, according to the panelists. For example, a change in strategy or adoption of new technology may result in better patient outcomes or improved physician experience.
This webinar was sponsored by QGenda.
The Winning Edge series is an extension of theHealthLeaders Exchange program. The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.
Please join the HealthLeaders Exchange community at our LinkedIn page. To inquire about attending a HealthLeaders Exchange event and becoming a member, email us at exchange@healthleadersmedia.com.
In the latest webinar of HealthLeaders' The Winning Edge series, a four-member panel will explore ways to boost physician engagement and clinical efficiency.
For CMOs and other clinical leaders, managing physician engagement and improving clinical efficiency are top priorities.
To learn about strategies to improve physician engagement and clinical efficiency, tune in on Aug. 5 from 1 to 2 p.m. EST for the latest webinar of HealthLeaders' The Winning Edge series. You can register to attend the webinar at this link.
The webinar features a four-member panel of experts:
Ruric "Andy" Anderson, MD, MBA, chief medical and quality officer at RWJBarnabas Health;
Thomas Balcezak, MD, MPH, chief clinical officer for Yale New Haven Health;
Patrick Hunt, MD, MBA, chief medical officer of QGenda and chief medical officer of the acute care division at Prisma Health;
Ghazala Sharieff, MD, MBA, corporate executive vice president and chief medical and operations officer of acute care at Scripps Health
This one-hour webinar will focus on eight discussion topics:
What are the primary strategies for effectively communicating with medical staff in clinical care scenarios such as in time-critical situations?
What part does your medical staff play in driving efficiency and cost savings?
What are the primary care team communication strategies to help drive quality and patient safety improvements?
How do you engage physicians in strategy and technology decisions?
What are some high-impact strategies for investing in medical staff through operational innovation such as effective clinical communications through modernizing scheduling and on-call management?
What are the primary strategies for optimizing physician scheduling?
How can healthcare leaders align technology, culture, and clinical operations to create a more sustainable and efficient care environment?
How can you reduce electronic medical record alerts and make alerts more actionable?
This webinar is an opportunity to learn from the best in the business and take away strategies you can implement at your healthcare organization. Join us as we explore physician engagement and clinical efficiency in depth.
The Winning Edge series is an extension of theHealthLeaders Exchange program. The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.
Please join the community at our LinkedIn page. To inquire about attending a HealthLeaders Exchange event and becoming a member, email us at exchange@healthleadersmedia.com.
The American Diabetes Association (ADA) has established standards of care for diabetes patients in the hospital setting.
Three dozen hospitals across the country have been recognized for providing care to diabetes patients based on the ADA guidelines.
For diabetes patients in the hospital setting, hyperglycemia, hypoglycemia, and glucose variability have been linked to adverse outcomes, including morbidity and mortality, according to a study published by the Journal of Clinical Endocrinology and Metabolism. The ADA says hospitals that follow their guidelines can improve outcomes, shorten hospital stays, and reduce hospital readmissions and emergency department visits.
In this episode of HL Shorts, Harpreet Pall, MD, MBA, CMO of Hackensack Meridian Jersey Shore University Medical Center, which is part of Hackensack Meridian Health, shares why CMOs should be focused on the care of hospitalized patients who have diabetes. Click here to read the accompanying HealthLeaders story.
Telehealth services deliver value for health systems and patients in several ways, according to the new chief physician officer of MulitCare Health System.
Todd Czartoski, MD, was named chief physician officer of MultiCare in June. Prior to being named chief physician officer, he served as president and CMO of the health system's Neuroscience Institute and virtual health service. Before joining MultiCare, he served as chief executive of telehealth and chief medical technology officer at Providence.
View the infographic below to learn about the three primary ways that Czartoski says telehealth generates value for healthcare providers and patients. Click here to read the accompanying HealthLeaders story.
CMOs and other leaders can play a pivotal role for healthcare organizations by identifying and addressing inefficiencies and friction points.
While identifying inefficiencies, healthcare leaders should rely on frontline caregivers, according to Todd Czartoski, MD, chief physician officer of MultiCare Health System.
"I'm a big fan of listening to people who are in the trenches doing the work," Czartoski says. "There is no substitute for talking with as many people as possible about the experience of providing care and any inefficiencies that may be present."
View the video below to get Czartoski's tips on identifying inefficiencies and friction points at healthcare organizations. Click here to read the accompanying HealthLeaders story.
A primary goal of the dual CMO and COO role is integrating clinical care with operational leadership.
Fort Lauderdale, Florida-based Holy Cross Health, which features a 557-bed hospital and is a member of Trinity Health, has created a dual CMO and COO role.
A dual CMO and CCO role is uncommon at health systems and hospitals. Scripps Health is one of the only health systems in the country with established dual CMO and COO roles, with Ghazala Sharieff, MD, MBA, serving as chief medical and operations officer of acute care and Anil Keswani, MD, serving as chief medical and operations officer of ambulatory care.
Jose Lopez, MD, MBA, has been serving as CMO of Holy Cross Health since 2021. He took on the additional role of COO effective July 6. According to Holy Cross Health, one of the goals of creating the dual role is to integrate clinical care with operational leadership.
One of the advantages of forming the dual CMO and COO role will be facilitating connections between clinical leaders and operational leaders, according to Lopez.
"When we had a separate COO, the awareness of clinical and operational opportunities was not always there," Lopez says. "In the dual role, I will have line of sight to both sides, which will make it easier to make connections."
Infection prevention is an example of when the dual CMO and COO role can make a significant difference, Lopez explains.
"Temperature control and humidity control are usually issues that are under the privy of the COO, but they can affect infection rates significantly in a hospital," Lopez says.
Serving in the dual role will allow Lopez to influence care environments from a design standpoint and comfort-of-care standpoint for patients and staff members, including issues such as cleanliness.
"These factors are critical for running a hospital," Lopez says. "In this expanded role, I will be able to have line of sight to these factors and be able to efficiently affect change. "
Jose Lopez, MD, MBA, is CMO and COO of Holy Cross Health. Photo courtesy of Holy Cross Health.
Having the dual role will help identify and address opportunities for improvement, according to Lopez.
"Some improvement opportunities will be from the quality standpoint and how the environment of care affects quality metrics," Lopez says. "Other opportunities for improvement may be in operations such as the functioning of our call center and how that facilitates our patients arriving at our physicians' primary care offices in a timely fashion."
Common operational functions such as the call center have an impact on clinical care, and the dual CMO and COO role will help align operational and clinical staff, Lopez explains.
"In my dual role, I will be able to highlight for both the clinical and operational teams how what they do affects the other side," Lopez says. "Healthcare is a team sport, and we need to support each other."
One of the objectives of the dual CMO and COO role is helping Holy Cross Health achieve financial performance goals.
"My approach to healthcare is if you do a good job from a clinical standpoint and have solid operations, financial performance will follow," Lopez says. "Your reimbursement should improve, and your market share should improve."
In addition to continuing to focus on clinical performance in his CMO role, Lopez plans to be more involved in cost control in his dual role.
"If you control costs by making sure you are providing the appropriate care in the appropriate setting for the appropriate length of time, financial performance should follow," Lopez says.
Physician development should be among the priorities for CMOs and health systems, according the new CMO of two Oklahoma-based SSM Health hospitals.
Mike Angelidis, MD, was recently named CMO of SSM Health St. Anthony Hospital-Midwest and SSM Health St. Anthony Hospital-Shawnee. As a physician leader, he has had extensive experience in physician development.
"When we talk about physician development, the first thing to note is that healthcare organizations and leaders need to be invested in education," Angelidis says. "Organizations and leaders need to invest in medical schools, residencies, and fellowships."
At SSM Health for example, the health system supports physicians who want to enroll in continuing medical education and degree programs. "If you are a physician and you want to get an MBA, SSM will help support pursuing that degree with funding," Angelidis says.
View the video below to get Angelidis' tips on physician development. Click here to read the accompanying HealthLeaders story.
Gregory Guldner, MD, is vice president of academic affairs at HCA Healthcare. Photo courtesy of HCA Healthcare.
Jose Lopez, MD, MBA, is CMO and COO of Holy Cross Health. Photo courtesy of Holy Cross Health.