Shared Vision Brian M Tyson, MD Program Medical Director Cogent Healthcare St. Bernadine's Medical Center

Intro/Background Turmoil in our hospital with LOS rising Full ICU’s and Med-Surg units Reimbursement declining due to poor coding Risk for audit high due to lack of “observation cases”

IOI improvement project Physician resource meetings monthly to go over IOI (surrogate for ALOS) data from all physicians as well as overall numbers Transformational care project to correctly classify “observation” and “inpatient”. Looked at ED throughput and accurate registration at time of presentation. Correct coding for maximum CMI and HCC scores.

Lessons Applied From Leadership Academy We needed to align the vision of the Hospital with the Doctors. Understanding IOI, CMI and throughput measures as metrics that reflect hospital business drivers Meetings before the meetings to go over the game-plan prior to the sell. Physician Champion for each level of Transformational care. Continued to reassess and redirect the project to stay on task using the conflict resolution strategies learned.

Summary/Closing Align vision and incentives so that everyone wins in the end. Have the meeting before the meeting Understand that in big groups there will be conflict; choosing the right technique for different people and different situations MATTERS. Re-asses and Redirect when necessary to stay on the path to ultimate goal.