Dan's Profile

As the previous person noted I think in some form you will have to look into renegotiating the contracts or re-evaluating what you consider work hours. If the goal is to ensure overall implementation of extra clinical projects then a blocked portion of each team members time will have to be set. Without structure extra clinical or admin time built in the department is likely to regress as innovation will not take place.

I think one of the biggest barriers of many physicians adopting more technology, myself included, is that it hasn’t been able to improve workflow and in many cases it is slowing things down. In many ways this will end up being one of 2 paths; a forced discontent while waiting for a generational change of normalcy or in some cases we see institutions working to customize the technology more (even though a higher up front cost may take place) allowing the individuals to employ the technology effectively and more likely to adopt additional changes.

2 different institutions Ive worked in faced a similar problem in the ICU. In both cases the key was to utilize social work to make the initial contact with who could benefit from a palliative care consult until the referring physicians evolved the system culture of it being more of a norm. In one institution the social worker presence in the ER was increased and any patient that met certain criteria like age or X number co-morbid conditions was screened automatically by social work and referrals for the palliative team to reach out during the hospital stay. In the second institution, during the daily ICU huddle the social worker would address the need for a consult with the ICU physician if they deemed prudent. Over time the early utilization of palliative care grew into a normalcy.

Someone else eluded to this earlier but the model of micromanaging often hinders the growth of the individuals affected. One clear way for the manager to keep themselves engaged but allow the teams to progress on their reverts back to setting an outlined list of goals and timelines for each project. Then allow each project manager to work through accomplishing them with “update meetings” already scheduled. At that time additional guidance may be given while allowing the teams to still progress on their own.

Like many organizations, we as well continue to struggle with achieving certain required standards with HCAHPS. In our case, our low number of responses continues to be a problem. Especially when many of the patients who have had a positive experience have no desire to fill out a survey, weeks to months later. While at the same time patients that had a negative aspect of their care are ready to point out that areas they were displeased with or felt were inadequate.

One way we are evaluating improving this is looking at digital platforms that will send the survey as a text message or email within hours of leaving the hospital or clinic in hopes of generating increased responses while the visit is still fresh on the individuals mind. A tool like this may help with improving your responses to discharge education. Particularly, when coupled with your already instituted programs that are likely incorporating the term “discharge education” as trigger phrases that they received minutes to hours before. In turn making them more likely to remember that there was a large focus on this at their time of discharge.