Article

Turning doctors into leaders

Partners HealthCare System, Boston, USA.
Harvard business review (Impact Factor: 1.27). 04/2010; 88(4):50-8.
Source: PubMed

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Available from: jhmi.edu
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    • "Financial incentives, on their own, have not been found to be sufficient to drive sustained improvements in quality of care[12,212223. Identified barriers to engagement of primary care physicians (PCPs) include limited time and resources, lack of information technology and staff support, and the perception that proposed interventions are either irrelevant or impractical to day-today practice[1,24,25]. However, these studies have largely focused on barriers and facilitators to PCP engagement within hospital or team/group practice quality initiatives. "
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    ABSTRACT: This paper focuses on successful engagement strategies in recruiting and retaining primary care physicians (PCPs) in a quality improvement project, as perceived by family physicians in small practices. Sustained physician engagement is critical for quality improvement (QI) aiming to enhance health system integration. Although there is ample literature on engaging physicians in hospital or team-based practice, few reports describe factors influencing engagement of community-based providers practicing with limited administrative support. The PCPs we describe participated in SCOPE: Seamless Care Optimizing the Patient Experience, a QI project designed to support their care of complex patients and reduce both emergency department (ED) visits and inpatient admissions. SCOPE outcome measures will inform subsequent papers. All the 30 participating PCPs completed surveys assessing perceptions regarding the importance of specific engagement strategies. Project team acknowledgement that primary care is challenging and new access to patient resources were the most important factors in generating initial interest in SCOPE. The opportunity to improve patient care via integration with other providers was most important in their commitment to participate, and a positive experience with project personnel was most important in their continued engagement. Our experience suggests that such providers respond well to personalized, repeated, and targeted engagement strategies.
    Full-text · Article · Jan 2016
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    • "The reason for this was because she pointed out that various physicians were giving conflicting information and she wanted to be sure they actually communicated with each other. According to Lee (2011) this is exactly why a new kind of leader is desperately needed (one that insists on EBML, can organize doctors, improve certain processes and most of all get rid of all the dysfunction that takes place). Gawande (2009) has spent years in his determination to fix healthcare. "

    Full-text · Article · Aug 2014
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    • "The top three employee effects and impacts described in this paper: empowerment, leadership and engagement are key enablers for both Lean Healthcare and Productive Ward: RTC implementation. Successful implementation or transformation in any health care environment using these initiatives or any tools for improvement requires the complete involvement of health care professional groups and employees combined with a new breed of leadership that focuses on patient outcomes and performance measurement as a key motivator (Lee, 2010). "
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    ABSTRACT: Background: Health Services world-wide are continually striving for more cost-effective, improved, quality focused modes and models of care delivery. The Productive Ward: Releasing Time to Care (RTC) is an improvement initiative specifically led by nurses which has been relatively well accepted, adopted and spread internationally. It was designed and developed using improvement principles of ‘Lean Manufacturing’ and formally introduced in Ireland in 2011. Lean and Lean-thinking have their origins in the Toyota Production System. It is a philosophy that loathes waste and strives to eliminate defects and continually attacks both in a never-ending pursuit of perfection. Lean thinking discourages the process of ‘workarounds’ and encourages resolution at the root of the problem. The term ‘Lean Healthcare’ is a relatively new term with a focus on efficiency and patient satisfaction. Aim and objectives: This study reviews the Productive Ward: RTC and Lean Health Care Literature to date, and extracts the reported effects and impacts on employees who engage with it. The study aims to identify key characteristics and investigates the strength of the connection between the two models. Methods: In a systematic review of the literature we searched the published material relating to both Lean healthcare and Productive Ward: RTC, using contemporary nursing and health care journal databases. The literature was then selected using strict systematic inclusion criteria and reviewed. Analysis and Results: The reviewed articles were subjected to a systematic qualitative content analysis to identify key characteristics of reported employee experience, effect and impact. The study identified common and unique employee effects and impacts that exist between Lean-type initiatives in Health Care and the Productive Ward: RTC programme and these are discussed in detail. Recommendations: The themes identified provide insight and impact information to those responsible for implementing improvement initiatives, like Lean or the Productive Ward: RTC, from both a planning and everyday work perspective.
    Full-text · Conference Paper · Feb 2013
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