Physician engagement and leadership are essential to the pursuit of safe high-quality patient care. But often the challenge for healthcare organizations is understanding what strategies will work best to strengthen physicians’ commitment to quality and safety priorities.
Interior Health (IH) has made physician engagement a top priority since 2014. With their physician engagement framework in place for the past year, physicians have become increasingly more involved in IH’s quality and safety goals and evidence of positive change can be seen throughout the organization.
In a recent interview, Dr. Ron Collins, newly appointed Executive Medical Director (as of April 2015) and Patty Garrett, Director, Risk Management, Quality, Risk and Accreditation, shared their experiences with physician engagement and offered insight into what’s been working well at IH.
“One of the most obvious interfaces between Health Authority administrative leaders and physicians is around quality improvement,” Dr. Collins began. “Quality and safety is necessary work and I don’t think any physician sees this as optional.”
True physician engagement begins with “trust”
A key variable for engaging physicians in quality and safety is earning their trust.
Dr. Collins credits his long history with IH for allowing him to build trust with his peers, something that he says has been vital to taking on his new role as Executive Medical Director. “I’ve been with IH for nearly 25 years so you could say I’ve been around the block for a while,” he says.
At the same time, Dr. Collins believes that it’s been important for him to maintain a frontline connection with physicians and patients at IH to ensure he has a clinical perspective on quality and safety.
“I’m an Anesthesiologist and I work part-time in the OR. This new role gives me the opportunity to speak directly with physicians about quality and safety and what we’re trying to achieve at IH – that helps to build trust. I think that’s why my colleagues find it easier to see me in the Executive Medical Director role.”
In his view, physicians will always get behind quality and safety if it means better outcomes for patients.
Patty agrees. “I think we’re fortunate at IH because we’ve always had a strong physician voice at the table, first with Michael (Dr. Michael Murray) and now with Ron (Dr. Ron Collins). Each has a credible background in quality and safety so that builds the trust we need to influence quality improvement at IH.”
Just culture: A catalyst for patient safety
Patient safety can only be improved when the whole organization comes together to bring about positive change.
“We’re working towards a culture that is just – a culture that values openness, transparency and learning,” says Dr. Collins.
As Co-Chair of the provincial Enhanced Recovery After Surgery (ERAS) collaborative and advisor to the BC Patient Safety & Quality Council (BCPSQC) on issues related to physician engagement, Dr. Collins is passionate about how healthcare culture influences patient safety. Specifically, what resonates with physicians and will lead them to a higher level of commitment to the organization’s overarching goals.
“Physicians are intimately involved in ERAS and making improvements to patient care, so they’re behind it and driving it forward. That alignment between the values of physicians and improved outcomes for patients is something they can get behind.”
Building a just culture – one in which all healthcare staff feel that they will be treated fairly and with respect – is essential to improving patient safety. “It’s our role to be open and transparent with all staff, including physicians, and to promote a culture of no blame,” says Patty.
What about BC PSLS?
For Dr. Collins, BC PSLS takes physician engagement one step further.
“There’s tremendous integrity in the work we’re doing with BC PSLS and physicians see that. BC PSLS supports physicians and diffuses situations where the outcome for a patient was less than ideal – it does not set them up for blame.”
According to Dr. Collins, BC PSLS opens the door to a different way of viewing patient safety, making it an easier sell for IH physicians. In addition, he says IH’s critical incident review process is an important interface where the values of the organization become more apparent and transparent to physicians (and other healthcare workers) on the frontline.
“I think everyone should take a step back and look at what we’re trying to achieve. In my view, BC PSLS is about transitioning organizations from being reactive to being proactive. Recognizing the signals of harm that are emerging from the healthcare system and responding appropriately.”
Physician engagement takes times and it does not happen on its own. For IH, strong physician leadership has been key to their physician engagement strategies over the past year. But, change is coming.
Looking into the future
Both Dr. Collins and Patty expressed concerns about the upcoming retirement of Dr. Halpenny, IH President and CEO, who was instrumental in recruiting Dr. Collins as the new Executive Medical Director.
“Any time you have a major leadership change there’s uncertainty about the future,” says Patty. “Dr. Halpenny cares so much about the quality of care we deliver at IH, so in the back of my mind I wonder where will we go when that leadership change happens in the fall.”
But, fundamentally speaking, physicians want to improve the system. A new leader may offer opportunities for IH to improve an already successful physician engagement model.
“I’m excited with how far we’ve come and I think the next six months will be really important,” Patty says.
“The good part is we’re not alone – all the IH Medical Directors are very engaged in quality and safety. They’re always there for us and they see Ron as their ‘go to’ guy. That team effort has been pivotal to moving this work forward and, I think, will get us through this next hurdle.”
We’ll check back with Dr. Collins and Patty in a few months.
Contact Ron at firstname.lastname@example.org
Contact Patty at email@example.com