5 Takeaways from the 2014 NAMSS 38th Educational Conference
I had the opportunity to attend the National Association Medical Staff Services’ (NAMSS) 38th Educational Conference in New Orleans last week. While it was my first NAMSS conference, PreCheck has supported the organization as a sponsor for years. Although probably not surprising at this point, it was apparent that the medical services profession is currently experiencing a period of change and transition. In order to head into the next chapter of this profession, it will be necessary to embrace change and adopt new strategies and partnerships.
Here are my top takeaways from this year’s NAMSS conference, which will give you some insight into the change medical services professionals are experiencing.
1. Dr. David Nash’s Lesson on Population Health
This year’s opening keynote speaker, Dr. David Nash, Dean of the Jefferson School of Population Health, shared an important lesson for healthcare professionals. The industry is heading into a new era of value-based payment and population health management. According to a recent report by The Washington Post, the U.S. has the most expensive yet least effective healthcare system. “The number one thing to do is reduce error,” says Dr. Nash. “In the office, the number of errors are four times as high as they are in hospitals. We can improve outcomes and lower cost.”
When it comes to population health, only about one fifth of a person’s well-being is due to the work of healthcare professionals. The remaining 80% is due to social and environmental factors such as access to medical care, how much you weigh, whether you went to college, and so forth.
“We need more leadership for physicians,” Dr. Nash explains. The healthcare industry is entering a new chapter of transparency and accountability and, when there’s no outcome, there’s no income. In order to improve population health, it will be necessary to reduce the slavish adherence to professional autonomy and to engage patients across the continuum of care. “Give them the good data, teach them how to improve, and jump out of their way,” he says.
2. Ongoing Monitoring is Important for Improving Care Quality
In the session titled “2014 Complete Overview of the NCQA Standards”, Frank Stelling, Assistant Director of Policy Accreditation at the National Committee for Quality Assurance, discussed the organization’s accreditation standards. Although I couldn’t address all of them in this article, Stelling reminded attendees of the importance of having an ongoing monitoring process in place. When it comes to ongoing monitoring, “it’s your responsibility to put the documentation in,” he says. “You want ongoing monitoring of sanctions, complaints, and adverse events. We’re looking for sort of a log.”
For exclusions, specifically, the OIG recommends ongoing monthly monitoring of its List of Excluded Individuals and Entities (LEIE) in a Special Advisory Bulletin issued in May 2013. Although conducting criminal background checks on physicians may not be a requirement under the NCQA standards, they can help protect your patients from convicted felons. At PreCheck, we recommend our clients in medical staff services to conduct criminal background checks on physicians at time of appointment and re-appointment. A criminal background check represents a snapshot in time, so there’s always a chance you can find something new in a criminal re-check.
3. How to Create an Accountable Medical Staff
In the session “The Medical Staff Services Department’s Role in Creating a Truly Accountable Medical Staff”, Christina Giles, President at Medical Staff Solutions, and Dr. Richard Sheff, author and consultant, discuss how medical services professionals can help improve healthcare outcomes by how they interact with clinical providers. Once again, Dr. Sheff reminded us that the healthcare industry is transitioning from the business of delivering healthcare services to population health management. “A history of past success is no guarantee of future success,” he says. “The self-governed medical staff organization has wide variation in policy compliance that’s too ‘manage loose’ to the world we are entering.”
The problem we’re facing in the healthcare industry is the imperative to reduce cost and improve care quality at a rapid pace. That’s why it’s important for medical staff services departments to get educated on how to measure physician performance better. Dr. Sheff recommends conducting feedback reports so that they become a driver of physician excellence. But how do you go about creating change in the medical staff services department?
“The big takeaway is that you are going to have to do a better job of communicating and make a plan on how you’re going to do that communicating,” explains Giles. “There’s always people that are going to deny.” You’ll need to create a guiding coalition, group of people that understand the vision for the change. It’s important to build trust with your physicians and become a bridge through communication, conflict resolution, and public speaking.
4. The New Joint Commission Medical Staff Standards for 2014
Dr. Laurel McCourt, Consultant at Joint Commission Resources and former TJC Surveyor, presented the session, “The Joint Commission 2014 Medical Staff Standards Update”. In July 2014, TJC implemented the following standards and elements of performance (EP’s):
Standard MS.03.01.03 - The management and coordination of each patient’s care, treatment, and services is the responsibility of a practitioner with appropriate privileges.
EP 13. For hospitals that use Joint Commission accreditation for deemed status purposes: Patients are admitted to the hospital only on the decision of a licensed practitioner permitted by the state to admit patients to a hospital.
Standard MS.06.01.05 - The decision to grant or deny a privilege(s), and/or to renew an existing privilege(s), is an objective, evidence-based process.
EP 15. For hospitals that use Joint Commission accreditation for deemed status purposes: The surgical service maintains a current roster listing each practitioner’s surgical privileges. (The roster may be in paper or electronic format.)
These standards were featured in The Joint Commission’s Prepublication Requirements issued June 20, 2014.
5. How to Get Physicians On Board With Your Hospital’s Goals
“Physician alignment is the most important initiative you can do in 2014,” declares Dr. Jonathan Burroughs from Burroughs Healthcare Consulting Network. “You cannot use the old model and be successful.” In his session, “Physician-Hospital Engagement and Alignment Strategies: What Works and What Doesn’t”, Dr. Burroughs shared his advice on how to get ready for the future.
The single biggest challenge when working with physicians is that everyone has to give up autonomy and pride in order to get something bigger and more important. Physicians are hard-wired to be their own CEOs, so management will fail if they simply expect physicians to run to the ball. “If it’s not the physician’s creation, it’s never going to happen,” Dr. Burroughs says. “You have to build the strategic plan together.”
Dr. Burroughs also cautions healthcare organizations from utilizing a physician compensation model that could defeat their goals. “Top performing organizations are not afraid of putting 50% of compensation at risk,” he says. “When you take complete ownership of something and you know you can do it, you will get the job done.”
According to Dr. Burroughs, top performing organizations are patient-centered, physician led, and professionally managed. The medical staff services department can act as a facilitator in the process by suggesting the best physicians to management. “You can help orchestrate this because you have a knowledge of your staff better than anyone else,” he says.
As you can see, there’s several reasons why medical services professionals need to embrace change in 2015 and beyond. If you attended this year’s NAMSS conference, what were your favorite takeaways? Please let us know in the comments section below.