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Managing through the chaos

Posted August 8, 2019 by in Blog

ED physician alignment strategies for the value-based care era

In busy emergency departments, there’s no such thing as routine.

In the United States, there are roughly 146 million ED visits each year, including 42 million injury-related visits, 13 million visits that require a hospital stay and 2 million that result in a critical care unit stay, according to Centers for Disease Control and Prevention (CDC) data.[1] Of these millions of visits, nearly 40 percent of ED patients are seen within 15 minutes, and less than 10 percent result in a hospital admission, CDC data shows.

Clinical decisions there are often made quickly and independently, and with a patient’s best interests in mind at that particular moment. Amid the clamor of an especially hectic shift, however, that means even the best-laid plans may, at times, be cast aside. One such area that frequently suffers in this hectic environment: Physician alignment, or the integration of a patient’s care within a hospital or health system’s clinical referral network.

And while there appears to be a consensus among physicians that clinical integration is important, there’s a wide gap between acknowledging its importance and actually putting it into practice. According to a Deloitte survey, 90 percent of U.S. physicians say alignment and clinical integration are top priorities. Meanwhile, only 65 percent of them have access to the details necessary to make an informed referral decision and, even when they do, just 16 percent say they use it.[2]

“Despite the proliferation of data, many physicians do not have access to insights that can support clinical and care management decisions,” the Deloitte study concluded.

As healthcare continues its transition from volume to value, clinical integration and physician alignment will remain prerequisites for success. A recent American College of Healthcare Executives survey underscores this need: physician-hospital relations — a general barometer of clinical integration — ranks among the top 10 biggest concerns of hospital CEOs; and about half of the hospital leaders surveyed list the switch away from fee-for-service as one of their biggest financial challenges.[3]

Poor physician-hospital relations also may lead to high ED physician turnover, which may affect the entire hospital and harm long-term patient outcomes, according to a Western Journal of Emergency Medicine study:

“Turnover significantly impacts hospitals through lost productivity and recruiting and relocation costs; remaining faculty may have decreased morale. As well as having an immediate economic impact on the hospital system, departures can also affect efforts to study and improve clinical practice through quality improvement efforts and knowledge translation initiatives.”

Interested in learning more about physician alignment? Let’s talk. We’d like to discuss how your practice can gain access to a strong partnership of like-minded groups and a robust technology platform that increases efficiency, supports clinical integration and facilitates participation in value- and quality-based payment models. Specifically, our physician alignment strategies include:

  • Clinical consistency: We believe consistency drives quality and efficiency. We also achieve it by assembling a core group of physicians who understand their colleagues’ practice patterns — in the emergency department and throughout the hospital or health system.
  • Local control: Our physicians are part of the communities they serve. They understand — and often know personally — their patients, families and colleagues.
  • Leading turnaround times: Patients in the emergency department want to be seen quickly and told what will come next. We use the latest technology to identify bottlenecks and, more importantly, facilitate conversations among a core group of physicians on how to fix them.
  • Smart financial incentives: Reimbursements are increasingly dependent on value, not volume. Using the latest technology, we are continually improving our workflow and processes to improve patient outcomes and operational performance — and we share these successes with our partners.

Professional Emergency Medicine Management’s partnership model provides alignment between our team, the hospital and physicians, allowing us to work as a unit and break down barriers that hinder process improvement. Our goal is to remain small and focused, allowing us to provide tailored services to emergency departments and work hand-in-hand with staff to drive metrics.

  • What we do: We offer data-driven management and real expertise in emergency department services — exploring the complete extent of the efficiency process. Our process improvement strategies are based on proven lean methodologies and transparent, collaborative relationships with hospitals and physicians. Our services aim to enhance patient satisfaction by making visits better, faster and more efficient.
  • How we do it: In many cases, we offer a physician partnership model which enables us to accomplish several goals. First, the establishment of an engaged core physician group and consistent staffing. Second, the implementation of interdepartmental, collaborative meetings centered around process improvement. Third, the delivery of quality care and a premier patient experience. Our end game is to attract physicians who will support the management and continuous improvement of the department.

 


[1] https://www.cdc.gov/nchs/fastats/emergency-department.htm

[2] https://www2.deloitte.com/us/en/pages/life-sciences-and-health-care/articles/physician-alignment-strategy-health-system-executive-survey-findings.html?id=us:2el:3dp:mdrnhlth:eng:lshc:012518

[3] https://www.ache.org/learning-center/research/about-the-field/top-issues-confronting-hospitals/top-issues-confronting-hospitals-in-2018

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