Peer review monthly: What are your medical staff’s New Year resolutions?

Like the rest of us, healthcare organizations establish resolutions each year, only instead of vowing to eat their greens and exercise more, their resolutions revolve around strategic goals and budget targets. It is always fascinating to see how much weight organizations place on achieving financial goals. One of the key reasons I believe this happens is fiscal accountability. Leaders present financial targets on a monthly, weekly, and, for some organizations, daily basis. Failure to achieve those targets means that a select few are stuck in lengthy discussions with senior staff and strategic action leaders.

It used to be that,  an organization’s quality goals were a lot like our personal new year’s resolutions for healthy eating and exercise: quickly buried under excuses for why they can't be achieved. But in today’s healthcare environment, organizations are placing equal weight on achieving quality and financial goals. Despite these efforts, many medical staffs fail to clearly define goals. If a medical staff really wishes to improve the care provided by their members (which is the goal of peer review) it needs clear goals.

If a medical staff lacks solid quality goals, its members may simply not know how to define a goal and how to hold themselves accountable to achieving it. It’s not rocket science, but it takes some practice and discipline. Here is a simple, practical approach that makes this more achievable: 

1. Goal identification: To identify useful goals for the medical staff, ask yourself these questions:
   • What quality issues require medical staff involvement?
   • What national or external measures relevant to physician performance are in need of improvement?
   • What physician best practices could be implemented to have the greatest effect on patient care?
   • What medical staff expectations are not consistently met?
2. Goal prioritization: To decide which of the goals established in the first step are the most important for the medical staff, ask yourself these questions:
   • Which of these issues are the highest priority and why are they a priority?
   • Which of these issues are most within the medical staff’s control to achieve?
3. Goal definition: To create a measurable goal, ask yourself these questions:
   • What is the measurable aspect of the goal?
   • What is the target?
   • What is the time frame?

The second component to achieving your quality goals is to create accountability around it. We know from our personal new year’s resolutions that this is where most of us trip up because no one is holding us accountable except ourselves and we can always come up with good reason why we don’t have the time or energy to achieve it. But this can be overcome by making the goal public and asking others to help remind us of our commitment.

So what can a medical staff do to hold itself accountable?

1. Communicate its goals to the board and the medical staff. This raises the stakes in terms of our commitment.
2. Create an action plan for each goal. This plan should include what you plan to do and how you plan measure it.
3. Review the status of the action plan each month at your medical staff quality committee and medical executive committee meetings. Also share this data with the medical staff and the board.

Like eating right and exercising, you have to work at it all year long so when the next New Year rolls around, you're where you need to be. Waiting until December 1 to join a health club won't help you meet your goal of year-long fitness.

If your medical staff has already defined goals for 2010, or plans to use this approach to create them, I would be delighted if you shared them with me and I will share them with our readers next month (anonymously if you wish). Please e-mail me at rmarder@greeley.com.