Earlier this month, medical services professionals (MSPs) gathered in Philadelphia, the City of Brotherly Love, for the 43rd National Association Medical Staff Services (NAMSS) Educational Conference and Exhibition. The 2019 conference theme, “Going the Distance: The Future of our Profession,” reflects the association’s forward-thinking approach to the evolving role of the medical services profession in the healthcare industry. With the healthcare industry’s rapidly changing landscape, MSPs must embrace change and be willing to embark on the journey that the next decade will take them. 

The following represent my top three takeaways from this year’s NAMSS conference.

The Unification and ‘Systematization’ of Medical Staffs

With the prevalence of mergers and multi-hospital systems in the healthcare industry, healthcare systems can now unify their medical staffs. In a learning session, Todd Sagin, President and National Medical Director at Sagin Healthcare Consulting, explained the potential benefits of combining medical staffs across hospitals:

• Greater user friendliness for physicians. If hospitals are geographically close, physicians no longer have to apply to multiple medical staffs, which can be a burden.
• Greater efficiency. The consolidation of medical staff offices and staff and effective use of physician leadership from a deeper pool both yield greater efficiencies.
• Reduced waste. Fewer meetings, fewer silos, less fragmentation of medical staff work, and less work for a health system board means more is accomplished by doing less.
• Reduced potential for liability. By acting as a system, the unified medical staff has the ability to reduce unwanted variance in policies, procedures, rules, regulations, and decisions.

While the unification of medical staffs has been around for years, it does not have to be an all-or-none approach. “You don’t have to unify all of the medical staffs into one,” Sagin explains. “You can unify the ones in one state, but not the others. One size fits all is never the answer, but in most organizations it can be standardized and in 10% it can be customized to meet local needs.”

LEAN Process Improvement for Medical Staff Services

Although the LEAN methodology was developed by the manufacturing industry, there are many applications to the healthcare industry. Presenters Dustin Jackson, Director of Medical Staff Services at Virginia Mason Medical Center and Heather Woodring, Credentialing Specialist at St. John’s Hospital, discussed its benefits during their session on “Transforming the Medical Staff Office.”

Implementing LEAN can create more value with fewer resources, reduce waste, and pave the path towards perfection. “We know we can never be perfect,” Woodring explains, “but we have to understand where we are currently to become better. We have to follow through with a path of continual improvement.” 

“Improvement never stops,” Jackson added. “That’s why we set that goal of perfection because that drives us to continually improve every single day. We need to be constructively [dissatisfied] with where we are at all times. When you apply that constructively, then we need to be willing to take action to get better.”

But how can MSPs get started with applying the LEAN methodology at their organization? Jackson and Woodring suggest the following: 

• Identify the process stream that will be mapped. What is it that you want to improve? (i.e., initial applications, reappointment applications, etc.)
• Create a mission and vision for the project. What do you want to accomplish?
• Identify your customers involved in the process. Think about every single customer and how the process is going to touch them. Customers extend beyond the patient may also include physician leaders, administration, board of directors, and so on. 
• Identify information systems involved. What are the software and applications used to carry out the process? (i.e., email, Microsoft Word, etc.)
• Identify the critical successes needed for the project. In order to be considered a success, what is necessary to accomplish?

The Just Culture Approach to Medical Staff

In a learning session on Just Culture, Michael Callahan, a nationally recognized healthcare attorney at Katten Muchin Rosenman LLP, explained the problems of the “blame game” that carries out when physicians fear discipline in the traditional way of things. A Just Culture, by contrast, balances the need for an open and honest environment with the goal of establishing a quality learning environment and culture. “Just Culture requires a change from errors and outcomes to system design and management of behavioral choices of all employees and practitioners,” according to Callahan. “One of the goals is to move away from the ‘blame game’ and instead develop a supportive environment where practitioners can acknowledge a human error.” 

But how can medical staff services cultivate a Just Culture? Consistent with the philosophy, it is important that the medical staff bylaws, rules and regulations adopt provisions and language which moves away from the purely punitive and disciplinary approach when addressing quality or behavioral problems.

“A Just Culture approach will help limit the degree of defensiveness expressed by healthcare practitioners who have a tendency to blame others when errors are identified,” Callahan explains. “In addition, it may lead to a culture of being more comfortable with self-reporting as well as the reporting of such incidents when witnessed by others.” 

When implemented properly, the likely result of a Just Culture approach can be fewer formal investigations, fewer hearings, and less litigation. 

In order to prepare for the healthcare landscape of the next decade, MSPs must embrace change. By considering the advantages of unifying medical staffs in multi-hospital systems, using LEAN process management to drive efficiencies, and adopting a just culture approach for medical staff affairs, MSPs can pave the way for success in the new decade to come.

Did you attend this year’s NAMSS conference? Please share your favorite takeaways in the comments section below.