1. The Seven Pillars Model
The Robotics Program
A presentation based on The Robotics Program: A How-to-Guide for Physician Leaders on Starting Up a Successful Program, by Terrence J. Loftus, MD, MBA.
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The Seven Pillars Model
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2. The Seven Pillars:
Are higher level elements that differentiate successful programs from unsuccessful programs.
Serve as a foundational structure for successful program building.
Focuses leadership on the organizational elements required to build a successful program.
Are transferable from program to program.
Help healthcare leaders become successful by building a useful skill-set that produces better quality, improved utilization and cost savings.
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3. The Seven Pillars Purpose: Understanding why our program exists.
Engagement: Motivating stakeholders to achieve success.
Communication: Educating and learning through mutual feedback loops.
Infrastructure: Building a strong foundation for effectiveness and sustainability.
Accountability: Ensuring responsibility through informed governance.
Leadership: Building trust in competent and inspirational leaders.
Performance Improvement: Getting better through intentional effort.
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4. Purpose
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5. Purpose Program structure drives performance.
Less structured Robotics Programs had a complication rate that was 46% greater than Robotics Programs that were highly structured.
Less structured Robotics Programs were found to have costs that were 37% higher compared to highly structured programs.
If you want to improve patient care, resource utilization and cost, then develop a highly structured Robotics Program.
Independent study at a large integrated delivery network.
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6. Comparison of Programs
Comparison of the observed to expected complications between highly structured Robotics Programs (>75%) and less structured Robotics Programs (<75%).
Comparison of the observed to expected cost between highly structured Robotics Programs (>75%) and less structured Robotics Programs (<75%).
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7. Engagement
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8. Ten Rules for Physician Engagement
Rule #1: If you want physician engagement, then avoid behaviors and language that are known to disengage them.
Rule #2: If you want physician engagement, then proactively mitigate the effects of unavoidable actions that are considered disengaging to physicians.
Rule # 3: If you want physician engagement, then start with what they are already engaged in doing.
Rule #4: If you want physician engagement, then help them solve a problem they are already attempting to solve.
Rule #5: If you want physician engagement, then appeal to their sense of fairness and what is right for the sustainability of their practice, their service line or even the hospital in which they practice.
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9. Ten Rules for Physician Engagement
Rule #6: If you want physician engagement, then appeal to their interest and passion for science.
Rule #7: If you want physician engagement, then appeal to their competitive spirit.
Rule #8: If you want physician engagement, then empower them to create their own solutions.
Rule #9: If you want physician engagement, then listen to them when they are upset, because they are already maximally engaged and may be harboring ideas worth considering.
Rule #10: If you want physician engagement, then communicate with words that positively reflects the things they value.
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10. Communication
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11. Communication Stakeholder Groups Robotics Committee Medical Staff
Agenda/Minutes
Medical Staff
Utilize Medical Staff Services & Newsletter
C-Suite
Consistent message as with Medical & Nursing Staff
Nursing & Ancillary Staff
Utilize system process already in place
Community
Coordinate with Marketing & Public Relations
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12. Infrastructure
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13. Infrastructure
Infrastructure is the foundation on which any program will be built.
Infrastructure refers to all the people, process, technology and cultural elements that are required for the successful implementation, management and sustainability of a program.
The specific elements are categorized according to people, process, technology and culture.
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14. Infrastructure: People
Physician Lead
Nursing Lead
Administrative Representative
Anesthesia Representative
Multidisciplinary Representatives
CVT, ENT, Gen-Surg, OB/Gyn, Urology
Data Analyst
Administrative Assistant
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15. Infrastructure: Process
Regular Meetings
Maintain Agenda and Meeting Minutes
Established Reporting Structure
Communication Plan
Data Review
Goal Setting
Credentials & Privileges
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16. Infrastructure: Technology
Robot/Case Mix Alignment
Electronic Medical Record
Risk-adjustment & Benchmarking Capability
Centralized Storage for Documents
Tele-conferencing Capability
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17. Infrastructure: Culture
Quality Improvement Program
Epicenter/Center of Excellence
Quality Awards
Robotics Supportive Environment
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18. Accountability
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19. Accountability Which Model? Medical Staff Model Administrative Model
Pros: Established infrastructure, Established governance, Strong ties to Medical Staff Leadership
Cons: Potential for interdepartmental squabbles, Nursing & Administration typically do not have voting rights, may not be effective at changing operational practices
Administrative Model
Pros: Multidisciplinary approach promotes inclusivity among stakeholders, Strong ties to C-Suite, Greater access to resources and data, greater support for operational changes
Cons: May lack adequate skills around organizing physician meetings, Inexperience with dyad leadership model can create conflict among the dyad leadership
Best model reports to both the Medical Leadership (MEC) and Administrative Leadership (C-Suite)
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20. Leadership
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21. Leadership: Expectations
Physicians
Value patient care, scientific method, autonomy.
They want a say in how they will be expected to practice and clear expectations on performance.
Administration
Will be held accountable for the success of the business operations.
Define and shape their expectations of success in specific terms that appeals to all stakeholder groups.
Nursing
Value patient care & will be accountable to administration.
Understand their incentives and align goals whenever possible.
Conflict Resolution
Community
Work with Marketing & be ready with elevator speech.
Robotics Committee
Data is a great starting point, since everyone is usually interested in seeing it.
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22. Performance Improvement
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23. Performance Improvement
Level
System
Operating Room
Medical/Surgical Unit
Surgeon/Team
Metrics
Utilization
Volume
Throughput
Cost
Quality
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24. Performance Improvement
SMART Goals
Specific
Measurable
Achievable
Realistic
Time Bound
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25. Dashboard Example
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26. QUESTIONS
Please contact Dr. Terry Loftus at or visit his website at
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