1. Attracting Talent-Achieving Excellence-Promoting Quality NBRHC’s Integration of Quality in Physician Recruitment

2. Our Quality Journey

3. Past Recruitment Practices No Supportive or Evidence Based Data No Standard Work Lack of Success Metrics Reactive Crisis Driven Limited Short- Term Results =

4. Next Steps Our Quality Journey Need Building Foundation Lessons Learned Implementation August 2012 - May 2013 June 2013 – February 2014 March 2014 – March 2015 April 2015 – March 2016

5. Director, Quality and Clinical Support Manager, Quality 2 x Quality Coordinators - Corporate 2 x Quality Coordinators – Clinical 2 x Quality Coordinators - Mental Health Quality Coordinator – Physician Nursing Practice/Clinical Nurse Educator Quality Assistant Achievement Specialist - Education Librarian – Health Sciences Library Program Assistant, Clinical Support and Quality Quality Team Investment in Quality

6. Report Card Performance Scorecard # of Scorecards by Area Supported, Driven Top Down & Organization Wide

7. Team Building Sessions Development Funding Team Building Sessions Development Funding Creative Problem Solving Sessions Challenge Mapping Creative Problem Solving Sessions Challenge Mapping Support & Formal Education on Quality Processes and Tools Thedacare Visit for Entire Leadership Team

8. Implementation of Formal Medical Leadership

9. Integrating Quality into Medical Affairs

10. Quality must haves for Success Physician & Staff Engagement Support Department and Organization Access & Knowledge of QI tools Regular QI Updates Including standing item at monthly MAC

11. Continuous Improvement Projects & Initiatives PROJECTPHASE DEPT/SERVICE IMPACT RISKNEXT STEPS General Medical Staff Accurate Clinical Documentation & Coding Accuracy Adjust-DCS Template & Active Problem Sheet live in trial. To be dispersed to all units (exemption MH) Education Session completed. Monthly in- service continues IP Surgery, IP Medicine, CCU, Rehab, CCC, Women & Children Ongoing auditing of tools & clinical documentation. Capacity issues in CR. Continue to support trial. Provide support to CR Policy Development (Review phase). Continue to develop an auditing work plan. Virtual Huddle Board Studying- Trial to start in January with Dept. of Surgery. Medical Affairs is huddling weekly and has had physician participation. All Departments* Developing a tool that meets the needs of each dept. Has to work for the group. Trial with Dept of Surgery- Jan 27 th MD of Psychiatry is joining MA in Feb at our weekly huddle. Physicians are more engaged with metrics for next fiscal. Physician Leadership CME Doing- Communication and Applications sent to physicians. Applications have been received All DepartmentsNot defined at this time. Send out an additional communique. Identify potential physicians-may have leadership interest./potential.

12. The Project

13. Family Medicine Physician Recruitment / HR Planning Background/ Problem NBRHC had no formal recruitment process Physician Human Resource Planning historically has been reactive and driven by crisis. The City of North Bay has an estimated orphan patient population (people without a Family Doctor) of 12 000. Aging Family Physician Population Generational change of practice style Shift in scope of Family Medicine

14. Collaboration exercise to address the Family Physician shortage and improve the recruitment process Opportunity to Integrate Quality Improvement Included Members from: NBRHC The City of North Bay Medical Learners from the Northern Ontario School of Medicine (NOSM) Other members of the community

15. Challenge Mapping “How Might We…” Ensure we have adequate data for recruitment decision

16. Example of Challenge Map

17. Future State Candidate Review Candidate Selection Recruitment Process Identify Human Resource Needs Advertise Position Data Gathering Data Gathering Standardized Process Standardized Process & Recruitment Package Standardized Process Advertising Strategy

18. Implementation Plan

19. Reliability & Sustainability Plan

20. Our Success

21. Implementation of Formal HR Plan Department/Service # of Physicians (FTE) # of Physicians Needed for 2016-2017 Recruitment Priority Additional Physicians to meet improvement targets Anesthesia9.80 0 Emergency Medicine13.22.1*Yellow0 General & Family Practice Hospital -39 Military-1.5 Community- 5.0 5.0*Yellow2.0 General Surgery5.00.0 Internal Medicine9.05.0Yellow0.0 Laboratory Medicine4.02.0*Yellow0.0 Obstetrics & Gynecology4.250.0 Ophthalmology3.00.0 Orthopedics4.01.0Green0.0 Otolaryngology2.00.0 Pediatrics5.00.0 Psychiatry Child & Adolescent1.0 Red0.0 General Psychiatry4.61.5*Yellow0.0 Mental Health & the Law 4.02.0Yellow0.0 Specialized Rehabilitation 2.0.5Yellow0.0 Seniors’1.61.0Yellow0.0 Radiology4.50.0 Urology1.751.0*Green0.0 TOTAL120.8222.1 2.0 *physicians currently in Phase 2 or Phase 3 of the recruitment process Not actively recruiting Recruiting Candidate pool is Large Recruiting Candidate pool is Moderate to Small Recruiting Candidate pool is minimal Urgent Need to Recruit Legend Service Area is:

22. NBRHC’s Standardized Formal Recruitment Process Phase 1 Site Visit Phase 2 Locum Phase 3 Panel Interview Phase 4 Finalizing Steps

23. Why medical services should complete a Pre- Recruitment Impact Analysis? Purpose: To align perceived service needs with:Hospital Strategic PrioritiesCommunity NeedsResource Allocation

24. How does it help identify recruitment needs/goals? Asks the right stakeholders key questions including: How the position will impact and/or support other programs? Identifies impacted medical services Identifies resources required ex: clinic time, CCU, O.R. Data Driven Collaboration and/or agreement between Head/Chief of Service and Senior Administration Transparent communication to all future potential applicants Clear direction for recruitment

25. What is the Process? Possible need to recruit is identified Head of Service & Chief of Department complete Part A of Pre-recruitment Impact Analysis (PRIA) PRIA Part B is completed by services where potential impact has been identified Head of Service & Chief of Department discuss potential recruitment at Service Meeting and at Department Meeting Is moving forward with recruitment supported & recommended? Yes – recruitment is supported VP of recruiting service reviews the submitted PRIA Part A and Part B(s) VP completes PRIA Part C VP of recruiting service reviews the submitted PRIA Part A and Part B(s) VP completes PRIA Part C Is moving forward with recruitment supported & recommended Yes – recruitment is supported COS & CEO review the submitted PRIA Parts A, B, C COS & CEO both complete PRIA Part D COS & CEO review the submitted PRIA Parts A, B, C COS & CEO both complete PRIA Part D Recruitment Specialist works with recruiting Head of Service to post position No – recruitment is not supported. Process ends. No – recruitment is not supported. Process ends.

26. Pre-Recruitment Impact Analysis Tool

27. Summary Going forward Lessons learned How do we know we are successful?

28. Questions