Medical Staff Culture -- Part 2

Dear medical staff leader:

Last month, we asked the question: What is your medical staff culture? We discussed that truly effective cultures must simultaneously embrace and balance interdependent opposites, sometimes called polarities. Those primary polarities that must be optimized to achieve a truly effective medical staff include:

• Collegiality and excellence

• Freedom and commitment

• Appropriate independence and mutual accountability

• Appreciation and continuing performance improvement

• Stability and change

But what happens when the culture is ineffective?

This month, we offer practical suggestions to help physician leaders deal with this challenge:

Conduct a medical staff culture survey: A medical staff culture survey helps answer the question posed at the start of this series, "What is your medical staff culture?" Such a survey instrument is available to members of The Greeley Medical Staff Institute. Results from the survey are validated and entered into a database, the first of its kind nationally. This way, not only can medical staff leaders identify their culture but compare it to others nationally.

Define mission, vision, and values: Virtually every hospital The Greeley Company has worked with has a strategic plan. Conversely, very few medical staffs have created such a formal plan, although increasingly we are seeing the development of specific medical staff strategic plans. If neither one is available, medical staff leaders, through the Medical Executive Committee, should charter the development of a medical staff strategic plan that includes a statement of mission, vision, and values.

• The mission statement should be a precise statement of purpose. The Greeley Company recommends as a starting point that the fundamental purpose of the medical staff is to monitor and improve the quality of care that is primarily dependant on the performance of individuals who have been granted privileges.
• The vision statement articulates the goals the organization wants to attain. The vision statement should answer the question: What would it look like if the medical staff fulfilled its mission? A great starting point is the goal to become a truly effective medical staff in both form and function. Such a medical staff has streamlined bylaws, clear policies, efficient credentialing and privileging processes and an effective peer review system.
• The values statement articulates the principles by which the medical staff chooses to operate. A powerful starting point for medical staff values is the acknowledgement that physicians are mutually accountable to each other for the quality of care they provide.

Change your culture: Does your medical staff have a clearly articulated mission, vision and value statement? If yes, congratulate yourself and continue to improve on your solid foundation. If not, this is an opportunity for improvement. Culture, however, is not easily changed. it requires strong leaders who must:

• Espouse clearly articulated new beliefs
• "Walk the talk" and lead by example
• Be great communicators and reach out to explain the reasons for change
• Build strong social capital and respect to facilitate the necessary changes in behavior

• Hold fellow physicians accountable for not complying with the new culture

The good news is that with strong and effective leadership change will slowly come. This will define your legacy as a medical staff leader.

Next month in Part 3, we will explore issues of medical staff disharmony, distrust or conflict.

Until then, stay well and be the best you can be.

William K. Cors, MD, MMM, FACPE

The Greeley Company