1. Physician ‘Alignment’ Achieving Cultural Synergy in the Pursuit of Clinical Excellence Mississippi Healthcare Executives Summer Meeting June 5 & 7, 2013 Mark Williams, MD, MBA, JD Chief Medical Officer

2. Leadership Knowledge Management Customer Focus Strategic Planning Workforce Focus Process Management Results An atmosphere of mutual respect, transparency and learning

3. ‘As health care evolves, mutually productive physician relationships are critical... what are additional opportunities?’ Adapting to New Payment Models Providing More Coordinated Care Eliminating Avoidable Harm Embracing Evidence-Based Care Improving Efficiencies

4. Extensive Professionalization Strong Personal Bonding Focus on Individuals Collegial Relationships Suspect of ‘outsiders’ On the front-lines ‘Now’ Extensive Professionalization Strong Personal Bonding Focus on Individuals Collegial Relationships Suspect of ‘outsiders’ On the front-lines ‘Now’ Less Professional Support Focus on Populations Shared Responsibilities Few Patient Encounters Must Prioritize Issues Need to Manage Politics Less Professional Support Focus on Populations Shared Responsibilities Few Patient Encounters Must Prioritize Issues Need to Manage Politics The Culture ‘Gap’ Healthcare ExecutivesPhysicians

5. A Unified Culture That Leverages Respective Strengths To Achieve Superior Results

6. 1937 The Commonwealth Fund A Legacy of Community

7. The ‘Competent’ Community Collaborates effectively in identifying problems Achieves a working consensus on goals Agrees on means to implement the agreements Collaborates effectively in the agreed actions Vaughn L. Grisham, PhD

8. A Legacy of Leadership Development 1996 2010 1998 20002002 2004 2006 2008 EOS Survey Results

9. The Opportunities Physician Leadership Institute Physician Peer Review Co-Management Comprehensive Unit-Based Safety Program Continuing Medical Education Strategic Planning

10. ‘Designed to serve North Mississippi’s partner physicians by providing innovative leadership training, personal development and practical management/strategic planning skills sets’ NMHS Physician Leadership Institute, 2011

11. Builds Upon the Leadership Development Institute Leadership training is part of the culture Significant investments

12. Specific Selection Criteria Commitment Well-Defined 40 Class Hours 60-80 Out-of-Class Hours Support of Group Expectations Clear Honesty Respect Active Participation Future Leadership Role

13. Physicians Time Homework PI Project Future Leadership Physicians Time Homework PI Project Future Leadership Organization Top Leaders Preparation Transparency Materials, Meals Organization Top Leaders Preparation Transparency Materials, Meals Mutual Obligations

14. Materials provided by organization Wide range of topics Correlated with lecture series

15. Servant Leadership Finance/O perations Medico- Legal Strategic Planning Crucial Conversations EXCEL Performance Management EXCEL Performance Management LEAN PI

16. CEO as ‘lead-off’ Focus on Servant Leadership

17. PI Projects - Examples

18. ‘Tell me where you need me’ ‘Will there be follow-up classes for alumni?’ ‘Hope this organization will view this group as a source for leadership’

19. PLI Participation – Gathering Steam! 2011 2012 2013 2% 5% 8%

20. Physician Peer Review Multi-disciplinary Training for new members Multi-year commitments ‘No Blame’ approach Administration Participation

21. Co-Management Embraces ‘accountable care’ concepts Initial project – partnership with cardiologists Joint management of cardiac ‘cath’ lab Thorough ethical, financial and legal analysis Model for other service lines

22. Fixed Fee Manages lab operations Provides strategic planning Staff development Public relations Vendor and payer issues Performance Fee Employee satisfaction (5) Patient satisfaction (5) Quality component (30) Cost savings (60) https://oig.hhs.gov/fraud/docs/advisoryopinions/2012/AdvOpn12-22.pdf

23. Aligned Incentives Cost Quality Service Aligned Incentives Cost Quality Service

24. Comprehensive Unit-Based Safety Program Physician champions Annual Culture of Safety Survey Goal is broad expansion of the CUSP concept Goal of safest system in U.S. by 2015

25. Quality of Care Initiatives Sepsis mortality rate (%)* *Unadjusted

26. Continuing Medical Education Physician lead program Needs-based content ‘In-house’ expertise Region-wide audience

27. Future Challenges – We’re all at the Table

28. “The problem with health care today is people like me – doctors (mostly men) in our fifties and beyond...now, at many health care institutions and practices, we are in charge... and that’s a problem...” Thomas Lee, MD, Turning Doctors Into Leaders Harvard Business Review, April 2010 (President, Partners HealthCare System) Or, maybe, they’re partners in seeking solutions! Physician Leadership Institute, NMHS

29. Chief of Surgery Medical Staff President Chief of Medicine Chairman of IRB CUSP Advocate Influence beyond numbers!

30. Thank you for allowing us to participate in the summer ACHE event North Mississippi Health Services