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  • Hospital Impact - Healthcare reform calls for new skills, attitude toward patient care
    likely to be in the second group of respondents than younger physicians The ACA overhauls the healthcare delivery system in the following ways It increases access to healthcare for more Americans It creates incentives to foster better care coordination and quality It provides feedback to physicians on cost and quality of their care It changes the payment system from fee for service to value based It emphasizes patient centered care It depends on increased use of electronic medical records It attempts to increase access to primary care and allied health providers Physicians will need to learn how to practice medicine in a new environment with new rules Practices that ensured success in the old world of fee for service medicine may ensure failure in the new evolving value based payment system Physician competencies that will be needed to thrive in the transformed American clinical delivery system include Clinical IT meaningful use skills Systems thinking and analysis Population management skills Reflective practice and continuous quality improvement skills Leadership training Care coordination Cross disciplinary training multidisciplinary teams Additional education around population health management palliative care end of life resource management medical economics health policy and regulation Interpersonal and communication skills These topics have not heretofore been emphasized in medical school and residency training educational programs Physicians who want to be successful under the new set of rules will have to find ways to receive training in competencies that have not traditionally been part of medicine The experience of physicians embracing clinical IT meaningful use skills illustrates the uneven distribution of an increasingly important physician competency Since the federal electronic health record EHR incentive program started in 2011 263 755 American physicians have received 5 4 billion to adopt EHR technology The states with the highest adoption rates are mostly in the Upper Midwest North Dakota 82 9 percent Minnesota 75 5 percent Massachusetts 70 6 percent Wisconsin 67 9 percent Iowa 65 5 percent The states with the lowest adoption rates include New Jersey 21 2 percent Connecticut 30 1 percent Nevada 33 0 percent Oklahoma 36 9 percent West Virginia 36 9 As I interact with physicians all over the United States I find a similar pattern of uneven understanding of how to apply the seven skills necessary to practice medicine in the transformed healthcare delivery system Hospital systems will need to find ways to encourage their physicians whether employed or independent to acquire new skills and new attitudes toward the care of patients in the 21st century Kent Bottles M D is a lecturer at the Thomas Jefferson University School of Population Health and chief medical officer of PYA Analytics Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in

    Original URL path: http://www.hospitalimpact.org/index.php/2014/01/29/healthcare_reform_calls_for_new_skills_a (2016-02-10)
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  • Hospital Impact - React to healthcare change like an NFL quarterback
    better quarterback and teammate I can label much of what I do professionally these days as physician engagement During my classes at Thomas Jefferson School of Population Health in Philadelphia in my keynotes to professional societies and in my facilitation of leadership retreats we talk a lot about how physicians need to change to become leaders in a transformed healthcare delivery system The physicians I work with can be divided into two large groups 1 Doctors who want to remain independent and 2 Doctors who have already become employees of large integrated delivery systems Members of both groups are learning in 2014 that physicians need new competencies to be considered leaders in the new world of American medicine The transformed healthcare delivery system will require doctors who have the following competencies Ability to delivery evidence based medical care that reflects up to date medical science Attitude that welcomes physician report cards as a way to get the feedback necessary to improve performance Attitude that welcomes efforts to increase patient centered care and patient satisfaction as reflected in survey results Ability to function as part of a team that may not always be physician led Focus not on individual practice but on how the entire system coordinates care across the continuum Ability to delivery low cost high quality care that is paid by a value based system Ability to utilize information technology and emerging digital technologies in their care of patients I wish I could report from my interactions with physicians in the field that they all respond like Nick Foles does in a press conference after a tough Philadelphia Eagles loss My experience has been that the current attitudes of American physicians fall into four categories Physicians who ignore all the changes and continue to practice the way they always have Clinicians who intellectually recognize the need for change but are paralyzed and unable to make the necessary adjustments Doctors who have just given up and are counting the days until they can retire Physicians who truly believe they can be part of a team that delivers high quality care in a better way than they have in the past and who accept the challenge of providing the practitioner s perspective to the system approach of integrated care It is vitally important that physicians have increased input into how we construct a better healthcare delivery system A young NFL quarterback just might have some suggestions on how we as physicians approach the daunting challenge of becoming better professionals Kent Bottles M D is a lecturer at the Thomas Jefferson University School of Population Health and chief medical officer of PYA Analytics Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming

    Original URL path: http://www.hospitalimpact.org/index.php/2014/01/07/healthcare_change_nfl_quarterback (2016-02-10)
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  • Hospital Impact - 5 healthcare trends to look out for in 2014
    mobile friendly Your community should view your hospital as a trusted source of advice about the best healthcare smartphone and tablet apps for diabetes monitoring or losing weight or sleep issues 3 Non equity collaborative arrangements The consolidation of hospitals and medical practices as a response to the Affordable Care Act and the transition from fee for service to value based payment systems will continue Some hospital leaders are turning to non equity collaborative arrangements that promise the benefits of being part of a larger network while maintaining governance independence Several critical access hospitals in the Midwest are exploring this option and the AllSpire Health Partners consortium of 25 hospitals in the Northeast came together to partner on using the Institute for Healthcare Improvement s Triple Aim to decrease per capita cost and increase clinical quality 4 Big data Big savings for hospitals Savvy hospital leaders will follow the lead of executives in other industries to start to harness the power of big data predictive analytics According to Frost Sullivan only 10 percent of American hospitals in 2011 were using data analytic tools With McKinsey estimating this approach has 338 billion of annual value to U S healthcare more leaders will investigate how to use analytics The recent development of open source big data analytic platforms and the increased affordability of cloud computing solve the expensive problem hospital executives previously faced of owning and managing their own data warehouses Early adopters like the MultiCare System in Washington State claim they discovered 2 million in missed charges by using algorithms and data analytics California s Heritage Provider Network hosted a 3 million competition for data analytics experts to predict the number of days patients would spend in hospital over the coming year 5 Socialnomics Think Facebook and Twitter Hospital systems that leverage the power of social media will continue to differentiate themselves in an industry that is slow to adopt new technology Social media can increase brand awareness acquisition of new consumers activation of new and existing consumers and patient loyalty Patients are bonding with their network of providers and wellness programs are deploying social apps for activity and calorie tracking with inspiration coming from healthcare based rewards to gamification And patient to patient dialogue has never been greater through social health networks such as PatientsLikeMe MedHelp DailyStrength and CureTogether states a KBM Group whitepaper Hospital leaders tell me there has never been this much uncertainty and change in the last 50 years While nobody can predict the future with certainty executives who understand these five trends will be ahead of the game Follow the advice of Wayne Gretzky who explained how he scored so many goals I skate to where the puck is going to be not where it has been Kent Bottles M D is a lecturer at the Thomas Jefferson University School of Population Health and chief medical officer of PYA Analytics Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search

    Original URL path: http://www.hospitalimpact.org/index.php/2013/12/18/5_healthcare_trends_to_look_out_for_in_2014 (2016-02-10)
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  • Hospital Impact
    of means Paul Starr a Pulitzer Prize winning professor of sociology and public affairs at Princeton University addresses why healthcare is viewed so differently in the United States Read more Leave a comment Why hospital leaders need business intelligence September 25th 2013 by Kent Bottles Recently I gave a keynote at the Healthcare Business Intelligence Summit in Minneapolis I had a basic knowledge of business intelligence programs and data warehousing systems and I had first hand knowledge about how most hospital leaders do not appreciate how business intelligence can help them move to sophisticated data reporting and analytic systems Meeting the other Healthcare Business Intelligence Summit faculty at a pre conference dinner and listening to some of the other presentations improved my appreciation for the importance of hospitals embracing this movement On my flight back from Minneapolis to Philadelphia I read Healthcare Business Intelligence A Guide to Empowering Successful Data Reporting and Analytics by Laura B Madsen M S founder of the Hsummit Her book is a must read for any hospital leader who wants to implement an enterprise business intelligence project from pre concept to execution to decrease per capita cost of care and increase quality Read more Leave a comment The promise of population health August 19th 2013 by Kent Bottles As a lecturer at The Thomas Jefferson University School of Population Health in Philadelphia I sometimes forget not all hospital and medical leaders really understand population health It is one of those phrases like accountable care organization or value based payment or patient centered medical home you hear all the time But what does population health really mean It should not surprise me that front line hospital administrators and practicing physicians are confused by the term because the academics have not really provided us with a workable definition What is population health and why has it become such an important healthcare term Read more Leave a comment Beware unintended consequences of hospital doc integration July 10th 2013 by Kent Bottles The conventional wisdom seems to be playing out all over the United States Because of healthcare reform and the transition away from fee for service payment hospitals are buying up physician practices Many physicians in private practice have decided they do not have the necessary capital for purchasing electronic medical records or the time to understand all the new laws and regulations Many see consolidation of the healthcare industry as a foregone conclusion to the adoption of the Affordable Care Act Although the increasing integration of hospitals and physicians makes perfect sense to me I am reminded that the real world is often messy and does not always do what theory says it will do Read more Leave a comment Previous Page Next Page Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace

    Original URL path: http://www.hospitalimpact.org/index.php?blog=1&s=kent%20bottles&page=1&disp=posts&paged=5 (2016-02-10)
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  • Hospital Impact - Include caregivers in healthcare process for greater experience
    of care She stated she was unhappy with the attending physician s orders and wanted her husband transferred immediately Any attempt to interject was met with resistance and anger At this point I stayed silent while Mrs Jones voiced her concerns As she spoke her voice quivered and she began to cry while she held her husbands hand It was at that moment I stepped forward and embraced her I assured her we were all here to help both of them get through this difficult time Over the next hour the attending physician and I learned Mrs Jones was recently discharged from the hospital herself and her husband was recently diagnosed with a terminal illness which prompted his readmission Since we were not the hospital that initially diagnosed and treated Mr Jones Mrs Jones was upset with the plan of care established by his new attending physician It was different from the one initially established The more she resisted the treatment plan for her husband the more frustrated the attending physician became until finally Mrs Jones demanded her husband be transferred After several minutes passed Mrs Jones calmed down It was at that moment I asked if we could calmly discuss her husbands care in the presence of her husband Although he was ill he had full capacity to make his own healthcare decisions Over the next 30 minutes Mrs Jones explained her husband s current treatment plan and that she was afraid any change would set him back She said she tried to explain this to the staff and his attending physician but no one would listen to her as her husband was in charge of his own care She said she got off on the wrong foot with the attending physician and didn t think she would be able to repair the relationship and therefore didn t want her husband to remain at this hospital It was at this point the attending physician stepped forward apologized to Mrs Jones and as the two of them shook hands the attending physician said Going forward we are a team What we learned from this encounter was invaluable to the entire healthcare team Yes it s true patients of sound mind drive their plan of care with their physician but we cannot and should not discount the importance of family While patients drive their plan of care families participate in the plan of care Disruption in care caused by poor communication causes a ripple effect across the entire care team Mrs Jones truly wasn t angry with us she was angry at the circumstances that led her and her husband to this point in their lives She was scared of the uncertainty of her husband s future and was holding on to the one thing that she felt was stable the plan of care that had already been in place It was our job to educate and re educate on the changes to that plan while incorporating her concerns and alleviating

    Original URL path: http://www.hospitalimpact.org/index.php/2014/10/09/include_caregivers_in_healthcare_process (2016-02-10)
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  • Hospital Impact - Working hard or hardly working? 8 steps to hold productive meetings
    What do I want to accomplish Standing meetings with an unclear purpose such as status updates are rarely a good use of time Remember don t jump to solutions out of the gate but rather enlist your teams input Plan your meeting by asking questions such as these What will make this meeting a success What decisions will we make How will we get all the input we need Whose input is most critical important Invitee important stakeholders Take time to think about who really needs to be there For example if you announce a change invite the people who are affected by the change If you want to solve a problem invite the people who are good sources of information for a solution When people feel the discussion topic isn t relevant to them or they are not the ones with the skills or expertise to be of assistance they view their attendance at the meeting as a waste of time Stick to the allotted time frame and agenda Create an agenda that lays out everything you plan to cover in the meeting along with a timeline that allots a certain number of minutes to each item and email it to people in advance Then keep your audience focused If one agenda item becomes the focus ask yourself if it is the crux to your meeting and whether you need to stick with it or gather a smaller group at a later time to flush out the key points Maintain control Nothing derails a meeting faster than one person talking more than his or her fair share If someone is monopolizing the conversation call him out For example Say We appreciate your contributions but now we need input from others before making a decision Establishing ground rules early on creates a framework and respect for how your group will function Consider alternatives Challenge assumptions by asking What underlying attitudes beliefs or thoughts are causing us to see this as the best or only solution Solicit alternative viewpoints It sounds like we re all in agreement on the solution here I m wondering if anyone sees it differently Ask everyone s opinion Start on time end on time If you have a reputation as someone who starts and ends promptly it s amazing how many colleagues will make every effort to attend your meetings People appreciate it when you understand that their time is valuable Note Meetings should not last longer than 60 minutes An hour is generally the longest time workers can remain truly engaged Ban technology I know what you re thinking but the reality is technology is great in the right forum If you allow iPads laptops or Smart phones into your meeting your attendees won t focus on the meeting or contribute to it Instead they ll email surf the Web or attend to other business You need them to focus Follow up Summarize the key points and takeaways from the meeting It s quite common

    Original URL path: http://www.hospitalimpact.org/index.php/2014/08/28/working_hard_or_hardly_working_8_steps_t (2016-02-10)
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  • Hospital Impact - Who should run a hospital: Doctors or nurses?
    More recently Thomas H Lee M D the chief medical officer at Press Ganey and the former network president of Partners HealthCare and Toby Cosgrove M D the CEO of the Cleveland Clinic wrote a white paper entitled Engaging Doctors in the Health Care Revolution The opening paragraph states Despite wondrous advances in medicine and technology healthcare regularly fails at the fundamental job of any business to reliably deliver what its customers need In the face of ever increasing complexity the hard work and best intentions of individual physicians can no longer guarantee efficient high quality care Fixing healthcare will require a radical transformation moving from a system organized around individual physicians to a team based approach focused on patients And yet many physicians are deeply anxious about the changes under way and are mourning real or anticipated losses of autonomy respect and income â Like many other changes endured over the years in healthcare the healthcare reform act has undoubtedly pushed many of us into the stages of grief A number of us are already on this journey However we cannot and should not allow any member of the healthcare team to get stuck along the way In this case it was clear this physician was stuck in the second stage of grief the stage of anger So how do we engage these physicians to accept and embrace change How do we work together with the shared purpose of providing compassionate care as a team As Lee and Cosgrove brilliantly stated engagement requires more than mere cooperation an agreement not to sabotage and strives instead for full collaboration in relentless improvement At the core of any major transformation must be respect Respect for the patients the organization and every member of the healthcare team Interdisciplinary collaboration and good communication are crucial to patient safety In fact agencies such as the Centers for Medicare Medicaid Services Joint Commission on Accreditation of Healthcare Organizations and the Institute for Healthcare Improvement expect healthcare facilities to promote good communication and teamwork to prevent errors and improve patient outcomes The good news is this nurses and physicians who work closely together in a climate of mutual respect are invested in good communication and collaboration Darlene A Cunha R N is senior healthcare executive who focuses on population health management and the patient caregiver experience Leave a comment Please enable JavaScript to view the comments powered by Disqus Enter your search terms Submit search form Web www hospitalimpact org Get Hospital Impact in your inbox Healthcare Industry news Final Obama budget takes aim at opioid addiction superbugs Zika outbreak White House seeks 1 8B to respond to virus More hospitals replace nurseries with rooming in with moms Hospitals must train millennial nurse leaders in empathy frontline engagement St Louis hospital creates unit to improve outcomes through innovation 4 ways hospitals can foster family centered care Pediatric ER seeks to limit stressors for autistic patients Nurses hospital groups clash on Massachusetts bill to improve response to

    Original URL path: http://www.hospitalimpact.org/index.php/2014/07/24/who_should_run_a_hospital_doctors_or_nur (2016-02-10)
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  • Hospital Impact - Leading disengaged workers: Have your managers checked out?
    want inspiration They search for meaning and they want to have someone or something to believe in They want to make a difference and they re looking to their manager for that inspiration Based on interviews and survey data from its consulting practice Gallup says actively disengaged workers cost employers 292 billion to 355 billion a year Furthermore Gallup concludes that disengaged workers miss more days of work and are less loyal to employers With this in mind let s look at a couple of areas where balance is critically needed for employee motivation in organizations today The solution We need to look deeper at the employee employer relationship and figure out what each party needs and wants on a higher more personal level The employee While a paycheck is important it is equally rewarding to have positive work relationships peer recognition and potential for personal and career growth The company It is critical that workers meet the demands of their respective job descriptions for the organization to survive However an organization can only thrive when its people can offer their full potential So what s the answer The answer most often lies in managerial relationships The No 1 factor influencing engagement and disengagement was the employees relationship with their immediate supervisor We all intuitively know our attitude toward our boss has a major impact on our feelings about work but why is the manager employee relationship still so chronically problematic Typically when organizations select managers and executives they often overlook the qualities for building positive productive engaged employee relationships So what are the qualities that foster engaged productive employees as well as build positive manager employee relationships The most effective and inspiring managers and executives I know share these characteristics They are good listeners less focused on imposing their own will than on hearing what others had to say They are perceptive able to understand the sometimes subtle issues their direct reports were dealing with as well as what motivated them and what didn t They are open communicators approachable candid easy to talk to and available when needed They possess a calm demeanor able to remain calm under stress They are genuinely concerned about their direct reports well being men and women of integrity who care about their employees and could be trusted to keep their word They express a passionate commitment to serving their team They communicate a bold specific and consistent vision Just to be clear I m not advocating being a nice guy makes you a good manager Managers who do not address negative behaviors and attitudes of their subordinates may lose the respect of other employees It s easy to look the other way and focus on other priorities but this attitude carries dire consequences People spend a substantial part of their lives working whether in a high profile position or as a laborer The quality of their workplace experience is inevitably reflected in the quality of their lives We must raise the bar

    Original URL path: http://www.hospitalimpact.org/index.php/2014/06/25/leading_disengaged_workers_have_your_man (2016-02-10)
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