Hospitals cut medical staff responsibilities
Glean insights from hospitals’ experience
Other hospitals are joining Air Force Material Command at Wright-Patterson Air Force Base in Dayton, OH, and The Methodist Hospital in Houston, in eliminating committees and streamlining medical staff responsibilities, says Hugh Greeley, chairman of The Greeley Co., a firm specializing in medical staff re-engineering in Marblehead, MA. He provides the following example in his book Seven Success Stories, Medical Staff Re-engineering, Vol. 3 (Marblehead, MA: Opus Communications; 1995).
• West Jersey Health System’s hospitals in Camden, Berlin, Voorhees, and Marlton, NJ, streamlined from two sets of 13 departments reporting to two medical executive committees to a total of 10 departments reporting to a single medical executive committee. The hospitals now have 25 committees, down from 37. A quality council meets monthly to coordinate studies, and a systemwide performance improvement (PI) program allows for each hospital to have its own PI team.
• At Provenant St. Anthony Hospitals in Denver, 25 QI committees looked at more than 20,000 problematic patient charts a year, with the result being one or two actions, according to the medical staff services director. The hospital developed screening criteria that nonphysicians can use to pull files. The files go to a QI committee, which reviews them and decides whether to take further action and call in specialists for input. In addition, three departments replaced 24, and 13 committees replaced 33. Now, about 12 meetings are held per month instead of 65.
• Administrators at St. Joseph Hospital in Denver estimated the cost of the 300 committee and department meetings every year at $770,000 in physician time, paper, and administrative staff. On average, fewer than five physicians attended a meeting, even though the medical staff comprised 1,300 members. Hospital attorneys warned that the poor attendance at meetings raised legal issues. Eleven departments have been reorganized under three services medical, maternal and child health, and surgical. Rather than departments monitoring quality, a hospital quality council meets monthly to review and study overall hospital quality and direct studies. It appoints task forces to work on specific problems.
• Northern Illinois Medical Center in McHenry, IL; Rogue Valley Medical Center and Providence Medford Medical Center in Medford, OR; Dickinson County Memorial Hospital in Iron Mountain, MI; and Swedish Medical Center in Denver have made similar changes.
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