1. PHYSICIAN ENGAGEMENT FORUM Arizona Critical Access Hospital Quality Network Arizona Rural Hospital Flexibility Program Roy Farrell, MD Chief Medical Officer Carondelet Holy Cross Hospital Wendy M. Perrell, EdD Service Excellence Coach We Empower Consciousness

2. Share evidence-based practices to create a culture of engagement, alignment, and accountability. Share evidence-based techniques and tools that will enhance physician engagement and improve the patient’s perception of care. Learn how to create a culture of trust, collaboration, innovation, and engagement. PURPOSE OF TODAY’S FORUM

3. AGENDA 1.Welcome and Introductions 2.Physician Engagement Transformation and Challenges 3.Engagement Vision and Goals: Alignment 4.Engagement, Collaboration, and Alignment 5.Engagement and Alignment Strategies and Tools 6.HCHAPS Alignment Tool 7.Evidence-based Tools 8.July Topic: Accountability 9.Resources

4. INTRODUCTIONS Name, hospital, and role What are your current physician engagement challenges? What is working well with your physician team? What would you like to gain from this forum? What are your top 2 priorities in your hospital for 2015?

5. PHYSICIAN ENGAGEMENT TRANSFORMATION AND CHALLENGES

6. ENGAGEMENT VISION AND GOALS: ALIGNMENT Create a clear vision linking the hospital’s core values and objectives to patient experience improvement goals. - Establish baseline and develop % target improvement goal. What should patient-centered care experience look and feel like? - Positive first impression - Don’t harm me - Be nice to me - Heal me What is the hospital team capable of delivering? What culture change is needed to deliver these results? “Give to us a clear vision that we may know where to stand and what to stand for - because unless we stand for something, we shall fall for anything.” – Peter Marshall

7. Create alignment by developing patient experience behavior standards and expectations. Engage physicians by collecting their feedback, ideas, and concerns -Physician Engagement Survey -Show you are working on concerns (Stop Light) Include all physicians, (independent, contractors and department chairs) in the hospital’s vision. Set improvement goals: both organizational and individual 5-1 feedback to emphasize what is working well (Rounding 101, Rounding ) Use real-time patient experience survey results such as: – “The doctor was very informative and really gave me details about what was going on. His ability of treating my son amazed me.” – “The doctor was very in tune, picked up signs and addressed them immediately.” – “If the doctor treated me better, it was an American doctor. He was older, he would yell and I felt discriminated against.” – “More attention with the doctor. The doctor was the problem like he didn't even care.” ENGAGEMENT, COLLABORATION, AND ALIGNMENT

8. ENGAGEMENT AND ALIGNMENT STRATEGIES AND TOOLS Create engagement and alignment by implementing patient experience behavior standards and expectations. -5/10 rule (Decrease Fears) -5/1 feedback (Engagement Communication Techniques) -Stop for the light -Align survey questions with desired AIDET, keywords, and scripting Identify and engage physician and nurse champions to support vision Link all actions and conversations to expectations and goals Hire for fit at all levels and replace staff who are not a good fit Review contract expectations Leaders rounding on all staff -Daily and weekly check-ins including nights and weekends Add patient experience data to all meeting agendas Train the team to understand patient experience expectations, goals and data Celebrate wins

9. HCHAPS ALIGNMENT TOOL Align HCAHPS survey questions with processes and expectations -Complaints/grievances -AIDET behaviors, key words or scripts (HCAHPS keywords) Patient experience is added to orientation Patient experience training -Entire hospital team -Understand patient satisfaction data -Teamwork strategies -Cheat sheets Keyword Examples: I CARE about your health after you get home To protect your PRIVACY… For your COMFORT… I want to keep you INFORMED… I want to make sure we are THOROUGH For your SAFETY

10. STRATEGIC USE OF EVIDENCE-BASED TOOLS TO CHANGE OUR CULTURE 3 types of rounding – Leadership – Support services – Team members 5 to 1 feedback “WOW” cards Handoffs and transitions Behavior standards – AIDET – Managing-up – 5-10 Rule SBAR Safety huddles Patient data/comments Whiteboard protocol Vocera protocol Scripting Audits Service recovery Stop for the light Training and competencies Shadow and coaching EVIDENCE-BASED TOOLS EXAMPLES AVAILABLE

11. CHEAT SHEET EXAMPLE

12. JULY FORUM 14 July 2015 at 12 pm Forum topic: Accountability Next steps Registration is required. Please register at https://mezcoph.webex.com/mezcoph/onstage/g.php?MTID=ec3c480a6a20fdc dad8e31aa036d36416 https://mezcoph.webex.com/mezcoph/onstage/g.php?MTID=ec3c480a6a20fdc dad8e31aa036d36416

13. RESOURCES Hunn, Michael, Building a Spirit of Trust/Collaboration with Physicians as Accountable Care Emerges. https://www.studergroup.com/resources/healthcare-improvement- webinars/current/building-a-spirit-of-trust-collaboration-with-phys https://www.studergroup.com/resources/healthcare-improvement- webinars/current/building-a-spirit-of-trust-collaboration-with-phys Leebov, Wendy., EdD., and Rotering, C., MD., The Language of Caring Guide for Physicians: Communication Essentials for Patient-Centered Care. Leebov Golde Group, 2012.