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Physician Performance: Designing Success
Transcript of Physician Performance: Designing Success
Jonathan Griffin, MD, MHA
Quality gets you in the game.
Service helps you win.
If the other guy's getting better, then you'd better
be getting better faster....or you're getting worse.
Health care...we're in CLASS 5 waters right now
And we need everyone on the boat.
Why are measures so important?
Physician behaviors are contagious
Measurement intensifies effort to achieve desired goals
Illumination of performance feedback
is great way to activate change
Our self-assessments are often inconsistent with objective measurements
Measurement, reporting performance, awareness of performance and clarity of expectations are requisites for physician effort to achieve an outcome.
Measures are the only way we KNOW when care is efficient, effective, safe, and patient-centered.
"It's all data baby" to use in designing your leadership tactics to build a culture of accountability, reliability with decreased variation.
If we were to rely on physician opinion and self assessment to create a "call to action" for change, how loud to you think that call would be be?
"There can be no greater justification for performance measurement that it's power to impact that which it is measuring."
Vahe Khzanjian, PhD
Purpose of Physician Measurement
Clarity of current performance
Create need to change
Align physician efforts to execute shared system goals
Create "balanced" physician effort and performance
Recognition of high performance
Help physicians that are struggling
Balanced Physician Performance
Quality : clinical metrics, evidence-based care
Growth: patient retention and loyalty
Finance: productivity, utilization, value
Service: patient satisfaction, perception of care
People: team work, colleague and nurse interactions
1. What is measured?
2. Who do we measure?
3. How do we report performance?
4. Do we tie physician pay to performance measures?
1. What do we measure?
Measure what you want to achieve
"Show me how you'll measure me
I'll show how you how I'll perform."
Physician Value Measures
Complex imaging utilization
Cost per episode of care
Percent generic utilization
What physicians say...
"This sample size is not significant
"This data is flawed"
"My patients are..."
"I think of myself as a physician who
aggressively controls risk factors.
Then I got my list..."
2. Who can we measure?
Employed (integrated) physicians
3. How do we report performance?
The physician dashboard
"A visual display of the most important information needed to achieve one or more objectives; information can be monitored at a glance."
-Stephen Few, Information dashboard design, 2006
Dashboard Rollout Guidelines
Must be clear, simple and easy to read
Less is more, avoid goal dilution
Reporting must be coupled to organizational goals
Reporting must be "coupled" to training
Position as verification tool
Clarify that this is how payers will assess us
"This is what the BEST do"
4. Do we pay for quality?
Most common non-financial measures include:
Clinical quality measures
Cost efficiency measures
Ranges between 10-20% of annual pay
Data MUST be accurate, reliable and trusted
if physician payment is on the line!
Performance Support Action Items
Set organizational performance goals with physicians at the table
Performance goals are drawn from organizational strategic goals
Goals reflect balanced physician performance
Assemble simple scorecards with current performance and goals
Assess for possible payment incentives for hitting goals
Establish recognition and assistance/coaching processes
We are being judged by these measures