An 800-bed Midwestern Community Hospital

The client is an 800-bed community and teaching hospital and the flagship of a Midwestern health system. Its medical staff includes both employed and voluntary physicians.

The Challenge:

The medical staff invited us to conduct an assessment of physician-hospital relationships and recommend models for improvement. 

The Solution:

We assessed the hospital’s history, including the effect that becoming part of a health system had on hospital and medical staff. We reviewed trends in the hospital’s market share, volume, financial performance, quality, recruiting, program development, medical staff satisfaction, and other measures of organizational performance, all of which had suffered.

The medical staff organization did not provide a clear path for physicians to influence hospital policies and programs, or to take collective responsibility for their role in improvement initiatives.

We recommended a more empowered and accountable medical staff model. The new medical staff structure is organized around clinical operating councils. Through these councils, the medical staff can establish its own cohesive policies and collaborate effectively with the hospital. The councils include representatives from both the medical staff and hospital administration in order that they can work together on focused clinical areas.

The councils started by addressing operations and quality improvement then moved on to examine meaningful long-term strategy and capital planning. 

The Impact:

Since the establishment of the councils, the hospital has reported significant improvements in:

• Market share
• Volume
• Margin
• Cost per case
• Quality
• Core measures
• Physician recruiting
• Program development
• Technology adoption
• Nursing and medical staff satisfaction

Based on its success at this hospital, the council model has since been adopted by several other systems.