Today’s value-oriented health care environment emphasizes organizational and interpersonal skills, data-driven decision-making and communication – much like today’s business world. To help young doctors prepare, many medical schools and teaching hospitals are beginning to incorporate the management of people and systems into physician education and training. At the same time, physician leaders are adopting leadership, management and team-building techniques used by business executives and bringing these skills and expertise to today’s medical practices.
Embracing data-driven management techniques
Curious about how Temple University Hospital and other hospital systems could apply the team-building assessments, data and skills commonly used in business settings, we approached our colleagues at the Center for Executive Education at the Fox School of Business at Temple University for guidance. They informed us that we could enhance individual, team and organizational performance by capturing real-time behavioral interactions as they happen on the hospital floor, thereby driving competencies and encouraging communication among key personnel.
As a result, we adopted a technology solution that provides feedback for clinical staff so that they may make immediate adjustments to their personal performance. This technology complements our face-to-face feedback with the use of hard data and analytics, enhancing our ability to create a culture of continuous improvement. Through a mobile app or web-based software platform, our clinicians rate their peers, direct reports and supervisors in real-time on competencies we have identified as essential to succeeding in value-based care:
- Interpersonal and communication skills, such as the minute-to-minute teamwork required to manage OR throughput.
- Leadership, including organizing and implementing new care pathways.
- Medical knowledge.
- Patient care, including the close attention to detail required during the perioperative period.
- Practice-based learning and improvement.
- Professionalism, including acting as the patient’s fiduciary under all circumstances.
- Systems-based practice, or exercising the coordination and cooperation mandated by the complexity of 21st century medical care.
With the assistance of analytics, feedback on provider performance is quantified and visualized against a benchmark, providing actionable intelligence on areas of potential improvement. With multiple users participating each day to provide feedback, such a platform provides insight at an individual level, as well as a cross-sectional view of our entire workforce.
Constructive feedback from analytics
At first blush, there would seem to be little doubt that capturing and analyzing real-time data regarding professional interactions between hospital staff should enhance patient safety and outcomes of care. However, our experience suggests that new tools and skill sets need to be carefully cultivated in order to achieve the full potential of continuous personal improvement.
To best effect change, we believe feedback must optimally be given in near real time, when the memory of events is greatest for all parties. While two-way communication in an annual performance review may offer some limited insight, capturing and measuring feedback in real time across a variety of interactions seems to drive immediate performance improvement across all levels of the organization.
Of course, this is not always a possibility during a crisis or when time constraints press for the start of the next procedure. Nor should it be.
Putting data into practice
The data we are capturing, measuring and analyzing at Temple University Hospital addresses competency and communications challenges. It also helps us demonstrate how we are evaluating self-improvement behaviors among doctors.
While much importance is placed on collecting feedback from patients through satisfaction surveys, we have yet another reason to believe in the value of capturing and analyzing interprofessional interactions. In the past two years, we have followed a structured program targeted at enhancing the communication patterns among our clinical staff: faculty, residents and nurse anesthetists. This programmatic change is not simply aimed at meeting abstract educational objectives; a wealth of data indicates that good physician communication skills may help to prevent adverse patient events.
Thus, enhanced communication, one of the “soft skills” key to the success of many business leaders, is also vital for hospitals and health care systems. Technology and analytics are the tools that allow us to quantify and codify such essential behaviors in our workforce.
Bolstering desired outcomes
Hospitals and health systems continue to strive for achieving the Triple Aim of improving quality, lowering costs and enhancing the patient experience. Success transitioning from fee-for-service to value-based care depends on the coordinated efforts of teams of highly organized and skilled individuals employing advanced communication and technologies.
Driving this team performance will require pioneering physicians and institutional leaders to transform medicine into something new and previously unseen. The rigorous use of meaningful data to foster enhanced personal performance will be necessary if hospitals are to eliminate adverse events, produce well-oiled efficiency and drive out unnecessary resource use. The early adopters among our physicians are now breaking new ground and bringing these tools to bear.
Gordon Morewood, M.D., MBA, FASE, is anesthesiologist-in-chief at Temple University Health System Inc. in Philadelphia. Abiona Berkeley, M.D., JD, is anesthesiology residency program director at Temple University.
The opinions expressed by the authors do not necessarily reflect the policy of the American Hospital Association.