On the CUSP: STOP BSI Physician Engagement

1. On the CUSP: STOP BSIPhysician Engagement

3. Learning Objectives • To relate what is meant by physician engagement • To discuss strategies at management and staff levels to enhance physician engagement

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5. What do we mean by Engagement? • Engagement: “To involve one-self or become occupied; to participate fully and deeply” • Active support of the project

6. Where does engagement fit? • Work involves technical problems • Evidence • Measurement • Adaptive problems • Engagement of nurses, physicians, leaders, IPs • Competing priorities • How to overcome barriers • How to ameliorate safety and teamwork climate

7. Stages of Engagement Aversion Apathy Engaged

8. Engage Physician’s Intellect • Show them the evidence • Show them your hospital’s CLABSI rates • Show them what others have achieved • Show them you can do the same!

9. Engage by Creating Trust • Caring • Keep patients as your “north star”, your focus • Preventable harm is not acceptable • Tell your own Josie story • Competent • Learn from mistakes and implement teamwork tools (CUSP • Demonstrate early successes/ project results

10. Physician Engagement Strategies • Management level • Identify physician champion for project • Unit director, chief medical officer or senior physician • Someone other physicians look up to • Reward physician champions for their efforts • Obtain support from hospital for this person’s time • Feature in newsletters • Provide opportunities to present to senior leaders

11. Physician Engagement Strategies • For Management, cont’d. • Create a Compact (an Agreement) • Clearly define what is expected of physicians • Review performance regularly

12. Example: Physician Champion Compact • Hospital will provide support for percent of physicians’ time • In return, physician will do the following: • Monitor and improve quality • Implement CUSP and CLABSI toolkit • Hold regular meetings with team • Involve other members of Medical staff in quality • Report CLABSI rates and learning from defects results to senior leaders and board

13. Example: Physician Champion Compact • Further, physician will do the following: • Work with hospital to clarify what will be measured, who will measure it, and who will produce reports • Meet quarterly to discuss progress

14. Physician Engagement Strategies • Staff level • Create containing vessel (environment) to have a dialogue with physicians (eliminate decoding errors) • M and M, grand rounds, quality meetings etc. • Identify and overcome barriers to engagement • Clinician, Intervention, System • Try physician engagement self-diagnostic tool (safercare.net)

15. Physician Engagement Strategies • For Staff, cont’d. • Communicate prior to start of project • No surprises • Who, what, when, where, how • Listen to those who resist/value the dissenter • Create mechanisms to feed back results to physicians

16. Handling Barriers to Change • Tune in to WIFM (What’s In It For Me?) • People resist loss not change • Try to surface and mitigate real AND perceived loss • Physician’s time is likely a major concern • Perceived losses often much greater than real • Perceived loss high when communication is low

17. Manage Communication • At each step or meeting clarify • Message • Who needs to know • Make time for feedback • Assume that all staff have patient as their “North Star” • Remind staff they are participating in something greater – • “Ohana”

18. Action Plan • Cultivate a physician champion for this project • Create compact for this role • Create containing vessel for communication • Develop communication plan for CUSP/BSI education • Listen to physicians to surface and mitigate loss

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