Performance Evaluation Russell S. Phillips, MD October 21, 2009 Division of General Medicine and Primary Care

Who We Are Faculty HCA Clinician-Educators: 52 Hospital Medicine: 33 Clinician-Investigators: 12 PhD Investigators: 4 Other Research: 1 Palliative Medicine: 3 Osher Research: 7 Note: some faculty fit into more than one category

Division Governance: Executive Committee Russell S. Phillips, MD, Division Chief Mark Aronson, MD, Associate Chief for Academic Affairs and Quality Carol Bates, MD, Director of Educational Programs Sara Fazio, MD, Director of Medical Student Education Lachlan Forrow, MD, Director of Ethics, Palliative Care and Community Service Jim Heffernan, MD, MPH, Associate Chief, and Medical Director, HCA Joseph Li, MD, Associate Chief and Director of Hospital Medicine Louise Mackisack, MA, Administrative Director Ed Marcantonio, MD, SM, Director of Research

BIDMC Revenue Generated by General Medicine in Millions FY08 HCA Ambulatory (40,000 pts) HCA Inpts (6,019 admissions, 3,333 to medicine) Hosp. Med. (non-HCA) (4,198 admissions to medicine) Total Net Revenue $79.6 $77.9 $46 $203.5 Contribution Margin (pays for fixed costs) $17.3 $31.2 $21.8 $70.3 Net Margin ($9.9) $6.6 $8.5 $5.2

Context for Performance Evaluation Faculty receive little feedback on performance Faculty survey identified lack of feedback as an important problem Department of Medicine requested that all Divisions initiate a faculty evaluation process

Objectives To celebrate achievements To provide feedback on performance, leading to improvement To identify ways the Division can be helpful to our faculty To facilitate academic promotions, leadership, and changes in job descriptions that promote retention and work satisfaction

Procedures for Annual Faculty Review Annual Reviews: Each faculty member meet with Drs. Russ Phillips or Mark Aronson (Associate Division Chief) to discuss a completed annual self-review form and updated CV. Reviews generally occur during the month of the faculty member’s birthday. Prior to review, each faculty member is expected to submit the annual self-review form and an updated CV to the Division Administrator.

Procedures for Annual Faculty Review Additional information collected by the Division Administrator: Clinical: Administrative Status of credentialing-hospital/BIDPO Online training compliance data TEFRA (physician time studies) Conflict of Interest disclosure form

Procedures for Annual Faculty Review Clinical, continued: Quality Patient commendations Patient complaints Unsigned and/or missing notes Practice or program feedback Productivity RVUs Panel size

Procedures for Annual Faculty Review Teaching Teaching evaluations Medical student Resident Financial Salary allocation worksheets HMFP ECF Academic Harvard appointment history

Procedures for Annual Faculty Review The above materials are sent to both the faculty member and Division reviewer prior to the review. Meetings are scheduled by administrative assistants, and are expected to last 45 – 60 minutes. A brief summary of the meeting and any recommendations are made by Drs. Phillips or Aronson within two weeks of the review. These comments are reviewed and edited by the faculty member. Copies of the materials prepared as part of the review process are included in the faculty member’s Division file and sent to the Department Chair at approximately six-month intervals.

Performance Review Self-Report 1. Please summarize your achievements during the past year - e.g. clinical, teaching, research, or administrative accomplishments. Include any awards, newly received grants, publications, curricular development, presentations, or special clinical or administrative achievements. 2. Did you achieve your goals for the year? Please comment on significant factors that helped or hindered you.

3. Please outline your professional goals for the 3. Please outline your professional goals for the upcoming year and for the next three years, both as an individual contributor and as a Division/Department member. a. Upcoming year b. Three years 4. How could the Division or Department be helpful to you in meeting your goals?

5. Do you have a mentor in the Division. Or a 5. Do you have a mentor in the Division? Or a colleague who provides you with important career guidance? Please identify any faculty or trainees that you are currently mentoring, and in what capacity. (If residency or medical student mentoring roles are a major part of your job description, a brief summary is sufficient.) 6. Are you interested in pursuing a leadership role in the Division? (yes or no) If yes, please describe the types of leadership positions of interest to you.

Results Program initiated in March 2007, now in its 3rd cycle Number of reviews completed: FY07 (last 6 months) 27 FY08 77 FY09 83 Increased adherence to TEFRA, online trainings Reduced missing/unsigned notes Improved productivity Accelerated promotion process Identified new opportunities for faculty leadership Improved faculty morale, work-life Improved Division financial performance

Division-wide Performance Evaluation Each leader works with team members to create annual goals Annual reporting on progress in meeting goals and setting of goals for following year in the following areas: Clinical (HCA/Hospital Medicine) Quality/patient safety Education (medical student, resident and faculty) Research Ethics, Palliative Care and Community Service Faculty work-life and compensation Academic affairs (promotions/awards)

Proposed Additions to Reports Quality Report on % of patients in panel with appropriate cancer screening Mammogram Colonoscopy Pap smear Report on % of patients with diabetes More than 2 hemoglobin AIC in past year Hemoglobin AIC <7, 7 – 9, >9 in past year Ophthalmology visit in past year LDL cholesterol 100 or less in past year Use of aspirin in past year