Identify restructuring opportunities

Restructuring means eliminating activities that impede efficiency. It offers a solution to busy physicians who must ensure quality patient care while also helping to manage and govern medical staff operations.

Key reasons for restructuring medical staffs include:

• Reducing time spent in meetings
• Simplifying the bylaws
• Improving the quality of patient care
• Meeting regulatory requirements
• Developing more effective medical staff leaders
• Streamlining the appointment and reappointment processes
• Reducing operational costs
• Generating more physician participation in medical staff affairs
• Strengthening the role of the medical staff in hospital affairs
• Positioning the medical staff and hospital to thrive under managed care

Restructuring medical staff functions will allow hospitals to get more done in less time. However, restructuring often prompts resistance from physicians who are opposed to change. That is why it requires the support of the medical staff and hospital leaders. Leaders must show resistant physicians how restructuring will help make their lives easier. They need to look at medical staff operations and ask themselves, “How can we do it better?”  The following four steps will help medical staffs begin the streamlining process:

1. Analyze your current processes.  Although hospitals might have some idea of what they want to change, many don’t know where to start. It can be helpful to begin by analyzing key processes. For example, professionals in the medical staff office (MSO) might complete a “bureaucracy index report” to determine the complexity of the current medical staff structure. The medical staff president or chief of staff will have to answer specific questions and present the bureaucracy index report to the medical executive committee (MEC) to stimulate discussion. While completing this report, consider the size of the medical staff; the number of committees and departments; the frequency, length, and format of meetings; and the general impression of physician satisfaction with the current medical staff structure.
2. Determine medical staff operating costs. The hospital’s finance department or the MSO needs to identify the direct and indirect costs associated with the operation of the medical staff and identify potential savings. This data can add momentum during the early stages of restructuring.
3. Get the opinion of medical staff members. For restructuring success it’s important to have physicians’ feedback regarding the medical staff ’s performance. To begin this assessment, encourage medical staff members to voice their opinions concerning the efficiency, benefit, and value of medical staff meetings and functions. A physician questionnaire may assist you in completing this step and identifying areas that can be restructured. For medical staff leaders, it is important to conduct a medical staff effectiveness survey which will help identify areas in which there are improvement opportunities and help in prioritizing them.
4. Study assessment results and determine a course of action. The MEC should analyze physician views and use them to help medical staff members shape the goals of the reorganization effort.The MEC might even consider putting together a task force to look at this data and recommend specific activities for restructuring.