1. Physician Engagement

3. Learning Objectives To relate what is meant by physician engagement To discuss strategies at management and staff levels to enhance physician engagement

4. What Do We Mean by Engagement? Engagement: “To involve one self or become occupied; to participate fully and deeply” Active support of the project

5. Where Does Engagement Fit? Work involves technical problems –Evidence –Measurement Adaptive problems –Engagement of nurses, physicians, leaders, IPs –Competing priorities –Overcoming barriers –Ameliorating safety and teamwork climate

6. Stages of Engagement

7. Engage Physician’s Intellect Show them –The evidence –Your hospital’s CLABSI rates –What others have achieved –That you can do the same

8. Engage by Creating Trust Caring –Keep patients as your “North Star,” your focus –Preventable harm is not acceptable –Tell your own Josie story Competent –Learn from mistakes and implement teamwork tools –Demonstrate early successes/project results

9. Physician Engagement Strategies Management level –Identify physician champion for project Unit director, chief medical officer, or senior physician Someone other physicians look up to –Reward physician champions for their efforts Obtain hospital support for their time Feature in newsletters Provide opportunities to present to senior leaders

10. Physician Engagement Strategies Management level (continued) –Create a compact (agreement) Clearly define what is expected of physicians Review performance regularly

11. Example: Physician Champion Compact Hospital will provide support for percent of physicians’ time In return, physician will –Monitor and improve quality –Implement CUSP and CLABSI toolkit –Hold regular meetings with team –Involve other members of medical staff in quality –Report CLABSI rates and learning from defects results to senior leaders and board

12. Example: Physician Champion Compact Further, the physician will –Work with hospital to clarify what will be measured, who will measure it, and who will produce reports –Meet quarterly to discuss progress

13. Physician Engagement Strategies Staff level –Create containing vessel (environment) to have a dialogue with physicians (eliminate decoding errors) M and M, grand rounds, quality meetings, etc. –Identify and overcome barriers to engagement Clinician, intervention, system Try physician engagement self-diagnostic tool (safercare.net)

14. Physician Engagement Strategies Staff level (continued) –Communicate prior to start of project No surprises Who, what, when, where, how –Listen to those who resist/value the dissenter –Create mechanisms to feed results back to physicians

15. Handling Barriers to Change Tune in to WIFM (What’s In It For Me?) People resist loss, not change –Try to surface and mitigate real and perceived loss –Physician’s time is likely a major concern –Perceived losses often much greater than real loss –Perceived loss high when communication is low

16. Manage Communication At each step or meeting –Clarify message –Determine who needs to know –Make time for feedback Assume that all staff have patient as their “North Star” Remind staff they are participating in something greater – “Ohana”

17. Action Plan Cultivate a physician champion for this project Create compact for physician champion role Create containing vessel for communication Develop communication plan for CUSP education Listen to physicians to surface and mitigate loss