Getting Physicians to Buy in to Performance Management by Focusing on Trust and Teamwork
- Organization: Gwinnett Medical Center
- Location: Metro Atlanta, Georgia
- Revenue: $809 million
- Beds: 553
- Employees: 5,500
- Customer Since: 2015
- Website: www.gwinnettmedicalcenter.org
- Solution: Diver Platform with Measure Factory, Surgery Advisor
Gwinnett Health System (GHS) is the parent company of Gwinnett Medical Center (GMC), Gwinnett Medical Group and Sequent Health Physician Partners. GHS employs 5,000 associates and has 800 affiliated physicians serving more than 400,000 patients annually. Gwinnett Medical Center (GMC) is a nationally recognized, not-for-profit healthcare network with acute-care hospitals in Lawrenceville and Duluth.
Additional facilities include: the Gwinnett Women’s Pavilion, the Gwinnett Extended Care Center, Glancy Rehabilitation Center, outpatient health centers and surgical centers, imaging centers and outpatient physical, occupational and speech therapy facilities.
GMC had data solutions that were functional but not well-used, so the health system teamed with Dimensional Insight to build a business intelligence solution that would provide dashboards to users and support the hospital’s new intensivist program.
Getting buy-in from decision makers
GMC started a new intensivist program in its four ICUs in early 2016. As the program got under way, GMC wanted a business intelligence solution in place that would provide it with a baseline to show how the hospital and individual physicians performed on a variety of measures. Moving forward, it wanted to use this information to determine best practices in the ICU and measure physician performance against these best practices.
The hospital looked at some ICU-specific analytics solutions as well as some enterprise solutions. Ultimately, the hospital selected Dimensional Insight’s Diver Platform (Diver), an enterprise-wide business intelligence platform.
The Director of Enterprise Data Analytics at Gwinnett Medical Center, Beth Grimes, says Dimensional Insight’s reputation in healthcare analytics helped set the company apart. Dimensional Insight had a defined deliverable and its product allowed GMC to get not only the ICU-specific dashboard that they were looking for, but also solutions for the entire hospital using the same data sources.
It was important to achieve buy-in related to this decision. Grimes says one of the factors that helped sway the decision-makers at GMC was Dimensional Insight’s demonstration of the product and their healthcare knowledge. “The demo was very thorough and our physicians were very impressed,” said Grimes. “Dimensional Insight was able to answer every single question our CMO had and we were able to meet his needs.”
Getting buy-in from physicians
Once the hospital decided on the product, the next step was getting the physicians to embrace it. Many hospitals struggle with getting physicians to buy into performance management initiatives, and initially, GMC was no exception. Fortunately, the attributes of Diver and the way that GMC approached physician performance management made the buy-in process go much more smoothly.
The biggest concern on the physician level, Grimes says, was whether the data was accurate. “Once we were able to prove that physicians can trust the data and that they can access the data down to the patient level, it was very quick and very easy,” says Grimes.
As part of Diver, GMC received a set of defined measures along with definitions for each of those measures. Grimes says the measure set was critical, as any user can easily look up the definition for a measure to know exactly what it comprises, resulting in even greater trust in the data.
A second concern for physicians was that they would be measured on their performance right at the start of the intensivist program. However, GMC decided at the outset that it would not assess performance in this manner. Rather, the hospital decided to focus on obtaining a baseline on certain measures. From that baseline
and insights into the data, GMC would then begin to measure best practice changes for the intensivist program. The organization used Diver to create unique time period comparisons to compare the progress they’ve been able to make (i.e. the first six months of the new intensivist program to the last six months).
Once the intensivist program as a whole has been able to make progress towards achieving the best practices they’ve defined, then GMC will start to use the data to identify physician-led opportunities for performance improvement. Grimes says this approach to physician performance management is critical, as it creates a positive change environment, allows for more open discussions, and decreases team conflict.
For clinical nurse specialists, who have quickly adapted to using Diver for readmission and mortality data, it was important to demonstrate to them that Diver uses the same Centers for Medicare and Medicaid Services metrics that they’ve been used to seeing from other systems.
“We want to use the data to improve performance across the board,” Grimes says. “As we align our best practices with our data, down the road we can start to identify the smaller opportunities where those best practices continue to need to be tweaked, but for now, that’s not the focus.”
Progress requires a step-by-step look at the data
Now that GMC has one platform to access this data, it’s important to avoid information paralysis. This means the teams are systematically looking for areas in which it can make quick improvements.
“While our operational leadership was struggling to review data from various systems that did not always tie together due to differences in definitions, I think now they’re overwhelmed with the aggregation of data in one platform. We were used to making practice modifications based on data specific to a service area, but not necessarily seeing the downstream effects of those changes.”
To make the data more manageable, Grimes says GMC is looking at some of the high-profile resource utilization metrics on the ICU dashboards and helping leadership find the areas where they need to begin to delve into the data.
Another challenge, Grimes says, is changing mindsets. “Healthcare is an industry where we have learned to make a lot of decisions based on pockets of data because access to large amounts of
Grimes is also working with the operational leadership at GMC to get in the routine of using Diver on a daily basis. “We’re trying to get into every single meeting we can,” Grimes says, “and instead of bringing a flat report, to bring up Diver, let the members ask questions, dive down into the details for answers, and make decisions during the meeting.”
This process has already enabled GMC to move some metrics forward, and Grimes says the sooner the organization makes this an everyday occurrence, the sooner business intelligence will make an even bigger impact at Gwinnett Medical Center.