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An Invitation To Join A Journey To Next Level Healthcare Leadership

By DrScott – Posted on March 11, 2015: You already know healthcare is in a time of tremendous transition.

The Question is what role will you play in this change?  How will you skillfully navigate these waters as a leader in your organization or system?  How will you win or lose in the next 3, 5, and 10 years?

Without question your organization will realize greater success if you are prepared to lead.  The greater your capacity, the greater your success will be – from revenue to influence.

How prepared are you to lead?  Do you have a comprehensive, cohesive and integral skill set that allows you to navigate and lead a team through the challenges coming at you today, and will it expand as your role grows?

We are looking for a select group of leaders who want to play a key role for their companies and for the country in this transformation.  The format will be an interactive, collegial exploration of your personal skills in the context of learning proven and transformational leadership skills for groups, corporations, and systems.  This course is for lifelong learners who want to take themselves to the next level.

If you would be interested in learning more please contact us at shelley.egan@stagen.com and/or consider joining us Tuesday, May 26, 2015 for lunch at the Stagen Leadership – the PDF brochure on this course is attached below.

Again, please RSVP to shelley.egan@stagen.com.

ILP Informational Session

When: Tuesday, May 26th

Time:12:30-2:00pm

Where: 3535 Travis St. | Suite 100 Dallas, TX 75204

*Parking is available underneath the building.

Stagen ILP – February ‘Osler’ Class

Here’s to a great future for every person accessing the US Healthcare System – and here’s to the leaders who are going to make it happen.  Hope to see or hear from you soon.

Scott Conard, MD

Course Co-leader

Stagen ILP – Osler Class

www.stagen.com

 

Avoiding the #3 Cause of Death in the USA: US Hospitals & What You Need To Know About It – Part 2

The gauntlet had been laid.  Don Berwick and the Institute for Healthcare Improvement (IHI) had challenged hospitals in America to save 100,000 lives.  Time was ticking away, educational programs, mentoring, training had begun but would they achieve the goal?

Eighteen months later on June 14th 2006 at 9 a.m. – Dr. Berwick took the stage to announce the results: “Hospitals enrolled in the 100,000 Lives Campaign have collectively prevented an estimated 122,300 avoidable deaths and, as importantly, have begun to institutionalize the new standards of care that will continue to save lives and improve health outcomes into the future.”

But that was only the beginning.  Remember, if there are 5,723 registered hospitals in the US, this initiative got 2,300 of them to commit in the first few months.  By the end of the campaign 3,100 hospitals had enlisted.  But thousands of Americans were still dying in US hospitals from preventable causes each month.  So the IHI moved the goal – in December 2006, IHI launched a second, expanded effort, the Five Million Lives campaign.   At its formal close in December 2008, the Campaign celebrated the enrollment of 4,050 hospitals, with more than 2,000 facilities pursuing each of the Campaign’s 12 interventions to reduce infection, surgical complication, medication errors, and other forms of unreliable care in facilities. Eight states enrolled 100% of their hospitals in the Campaign, and 18 states enrolled over 90% of their hospitals in the Campaign.

In 2011 the Secretary of the Department of Health and Human Services Kathleen Sebelius and Dr. Berwick launched the Partnership for Patients, which brings together hospitals, employers, physicians, nurses, and patient advocates along with state and federal governments in an effort to make hospital care safer, more reliable, and less costly.  The Partnership for Patients aimed to decrease preventable hospital-acquired conditions by 40 percent by the end of 2013, resulting in approximately 1.8 million fewer injuries to patients and more than 60,000 lives saved over the next three years. It also sought to reduce hospital readmissions by 20 percent by decreasing the rate of preventable complications during transitions from one care setting to another. The Partnership was to be funded by up to $1 billion in federal money made available under the Patient Protection and Affordable Care Act, including $500 million through the Community-Based Care Transitions Program and up to $500 million through the Centers for Medicare and Medicaid Innovation.    At the core of this initiative are 26 Hospital Engagement Networks, with 3,700 hospitals, working with health care providers and institutions to identify best practices and solutions to reduce hospital acquired conditions and readmissions.  Early results are showing strong progress in 8 of the 10 patient safety priority areas of the Partnership for Patients, more findings are scheduled to be released soon.

But recall that only 3,700 of the 5,723 hospitals in the US are engaged, meaning that over 2,000 hospitals are not on board and thousands of Americans are still suffering unnecessarily.  And recognize that this is looking at the prevention of adverse events, not at which institutions are the best at different procedures.  The best spine hospital may not be (and often isn’t) the best heart surgery facility in your community.

So how do you find the right hospital?  It takes research and time. It also takes a willingness to sift through a lot of different data to tease out what information would be important to you. Let’s think through a visit to the hospital – the quality of the health care a patient receives depends on many things besides the skill of the surgeon. Many health care providers at a hospital will be directly involved in care before, during, and after surgery. The metrics a patient will want to know span a broad spectrum of considerations, from scientific data on mortality and complications associated with previous treatment of patients with the same condition to the more subjective data on how patients respond to the physician and staff managing their care.

A result of this complexity in defining a good hospital is the proliferation of information sites that exist. In addition to the payers websites (carriers who are often dependent on contracting agreements with the hospitals), patients can go to anything from yelp.com and Angie’s List (which also provide reviews on low complexity services like dry cleaning), to state report card sites or national sites such as Hospital Compare which may or may not have information on metrics associated with your condition. For heavier science aficionados, there are reporting agencies like CareChecks and The Dartmouth Atlas which may look at patient outcomes on a larger system level. Reports are also often put out by institutions such as the Kaiser Foundation or Commonwealth Fund that speak to hospital quality.  Somewhere in the middle of this very complex gamut are sites like Vitals or Health Grades. More traditional outlets such as Consumer Reports or the US News & World Report create hospital listings as well.

But it is not just the hospital.  The doctor and the care team he or she works with make a significant difference.  In the next blog we will consider how to find and use these “best in class” doctors.

Avoiding the #3 Cause of Death in the USA: US Hospitals & What You Need To Know About It – Part 1

By DrScott – Posted on March 18, 2014 on www.compassphs.com

Preventable Adverse Events (PAE’s) are the #3 cause of death in the US, leading to between 210,000 and 440,000 American deaths annually.  This must stop.  But how?  The answer involves one of the best stories in US healthcare history.

It started when Dr. Donald Berwick, the co-founder, president and CEO of the Cambridge-based Institute for Healthcare Improvement (IHI), was driving with his son, Dan to the airport.  Dan, a political campaign strategist, explained that he was bringing 350 volunteers to Florida for a weekend to knock on 50,000 doors for his candidate.

Awed by the numbers, Berwick, 57 at the time and a clinical Professor of Pediatrics and Health Care Policy at Harvard, shared IHI’s frustration about the slow pace of change in medicine when it came to adopting practices known to improve care and reduce errors.  As the former head of quality-of-care measurement for a large HMO, Berwick knew the numbers: As many as 98,000 American hospital patients die annually from poor care or medical errors. IHI researchers estimate that approximately 15 million incidents of medical harm occur in U.S. hospitals annually, roughly 40,000 every single day.

So, Berwick asked his son the critical question: “What makes your work so effective?” Dan explained what it takes to run a successful political campaign – coming up with concrete numbers (i.e. how many people you want to reach), establishing field offices to reach more people locally, inviting the widest possible participation, giving specific instructions to workers, and setting a deadline.

The IHI  only had 75 people on staff at the time and no way to mount the national campaign needed to create any significant change, or did they?  On December 14th 2004, Dr. Berwick gave a speech to a room full of hospital administrators.  He said, “Here is what I think we should do.  I think we should save 100,000 lives.  And I think we should do that by June 14, 2006 – 18 months from today.  Some is not a number; soon is not a time.  Here’s the number: 100,000.  Here’s the time: June 14, 2006.”

To accomplish this the IHI proposed six specific interventions for hospitals to adopt that had been proven to reduce unnecessary deaths.  If you have been reading the blogs on the book Switch by Dan and Chip Heath, you will appreciate that the “rider” now has a clearly defined goal to achieve.

But this was a challenge for hospitals to embrace and get behind.  If they did embrace it, it implied that unnecessary deaths were occurring in their hospitals.  So, Dr. Berwick made it personal.  At his speech he asked the mother of a girl who had been killed by a medical error to join him.  She said, “I’m a little speechless, and I’m a little sad, because I know that if this campaign had been in place four or five years ago, that Josie would be fine….  But, I’m happy, and thrilled to be a part of this, because I know you can do it, because you have to do it.”  Another guest on the stage, the North Carolina State Hospital Association Chair, then spoke up: “An awful lot of people for a long time have had their heads in the sand on this issue, and it’s time to do the right thing.  It’s as simple as that.”  (Switch: the elephant was motivated).

The IHI made joining the campaign easy; hospital CEO’s only had to sign a one page form.  Once a hospital enrolled, the IHI team helped them embrace the new interventions.  Research, step by step instructions guide and training were provided, and regular teleconferences with the hospital leaders to share their victories and struggles were arranged.  Hospitals with early successes were encouraged to become mentors of hospitals who joined the campaign later. (Switch: the path had been made easy).

But would they achieve the goal? Eliminating errors and documenting the results had never been done this way in the US Healthcare system. As a patient, the challenge of finding an excellent facility and doctor to use can be daunting.

Exciting Update from GOH Medical-New Clinic Merge!

Important Update from GOH Medical Practice
Dear patients and friends:My dream has been to provide timely, state of the art, proactive, convenient primary care to add years to your life and life to your years by empowering you to take control of your health.  To accomplish this takes significant resources. GOH (Game of Health) Medical has tried to do this as a solo physician practice for the past 4 years with mixed results – and so it is time to evolve.The question was which group do I associate with to bring you outstanding care?  Fortunately, I had access to a huge database to research and find the best medical group.  Working with the team at Compass PHS, we created a Value formula to identify the best primary care doctors in North Texas.  We looked at quality, safety, service and cost – 21 variables in all, to identify The Premier Providers.

A group of practices use team based, outcome-oriented, evidence-based medicine to care for patients.  Some have received the NCQA Patient Centered Medical Home designation.  After this analysis, it was my job to get to know these practices. In doing so, Dr. Chrisette Dharma and Southwest Family Medicine Associates (SFMA) were discovered as the #1 doctors in this analysis. Her new, state of the art office is located halfway between my current office in Dallas and Irving. SFMA has the ability to do online appointments, extended office hours and Saturday appointment availability, all major insurances accepted, and provides extensive imaging, lab, travel medicine and other services.

It is with great excitement to tell you that effective January 1st 2015, I will be moving GOH Medical’s practice to SFMA to join their team and see patients.  Our team includes Nurse Practitioner Angela Kemp, Dr. Asa Hadwell to make sure you get great musculoskeletal care, and our new lifestyle coaching team who will offer you support on weight loss, smoking cessation, and staying with your 2015 health goals.  We will be working with Dr. Dharma and her excellent team of physicians at SFMA to make sure you get the best care possible.

The Park Cities MedSpa, Concierge, Women’s Health & BioTE bio-identical hormone practice will remain at the current GOH Medical location in the Preston Tower. The providing team here includes Celia Dolinta (DNP-Women’s Health), Jill Ethridge, Brandi Padilla (Medical Esthetician) and Cheryl Reinhart (NP). All other medical patients will be seen at SFMA.  To make an appointment at the SWFMA location, please call the direct number below, or you may use our current number and press option #3.

If you have any questions, please contact Lauren Kirschner before Jan 1st atLauren@gohmedical.com.

I look forward to seeing you soon!

Scott Conard, MD

Southwest Family Medicine Associates
8877 Harry Hines Blvd
Dallas, TX 75235
214-393-2940

The Next Generation of Value Based Medicine: Corporate Population Health Management™ – Part 1

Working with corporations and providers to create Value Based Care. Read more at the Open Health Market Blog: The Next Generation of Value Based Medicine: Corporate Population Health Management™ – Part 1.

Special Medical Provider(s) Wanted

GOH Medical is growing.  Over the next several months we will need to add a new medical provider: a doctor, nurse practitioner, or a physician’s assistant.  Do you know the right person for this job?  Here are some thoughts to consider;

  1. “Not on our watch”  The Institute of Medicine has boldly declared that we “know what to do, but are not doing what we know” and this must stop.  What would a clinic look like if the commitment was to proactive, preventive health care first; illness management and reactive care second?  We are looking for a provider that wants to review each patient for possible future issues to address them before they develop symptoms.
  2. “Committed to curing the ‘I Feel Fine’ Syndrome”  There is a big difference between “I feel fine” and “I am healthy.”  Patient engagement before symptoms occur is vital to preventing diabetes and heart disease, and diagnosing cancer in stage 1.  Using The Seven Numbers as a teaching tool and foundation we empower each patient to learn and live the Seven Numbers that Can Save their Life,
  3. “Only the best” When problems do appear what does it take to find the best solution? A large part of GOH Clinic is making sure that each person gets what they need when they need it at the right place for the right price – whatever it takes.  Coordination of care, transitions of care, communicating and getting records sent out, and following up are vital commitments,
  4. “Technology leverage” Text, email, blogs, electronic health and medical records, the latest equipment.  We are looking for a technology geek/nerd with a personality,
  5. “Part of a team”  Each teammate at GOH Medical is a link on a chain that includes everyone from the maintenance crew to the super-specialist at the hospital.  All important for a successful healthcare, over-communication and a commitment to six sigma/lean processes ensure success,
  6. “A teacher committed to delegation and empowerment”  Medical knowledge doubles every 18 months.  The best we can do for patients is to understand their challenge, educate them, suggest a course, and encourage them to learn as much as they can to play an active, vital role in their health; GOH Medical understands that there is more that we know that we do not know, than there is that we know, about any particular topic.  Even if we read 24/7/365 we will fall hopelessly behind.  There is no place for arrogance, coercion or convincing; only sharing what we know, sharing what we expect to occur, and then closely communicating if this does not occur over time.  We are a member of a team, we empower, encourage and give 110% effort.
  7. “Focusing first on lifestyle” Food is the strongest drug we put in our bodies every day, exercise the best medicine; but that is not all, there are The Seven Healers we need to pull into our lives each day.  It is from this foundation that we encourage our patients to win the Game of Health.
  8. “An open minded healer” Allopathic medicine has changed the worldEvidence based, informed, outcomes oriented… and it is incomplete and often fails to provide complete healing.  Weak in mind:body medicine, lifestyle intervention, natural healing, myofascial manipulation, meridian management/acupuncture, supplements and other disciplines that may be less rigorous or researched in their body of knowledge, these other disciplines  must be recruited for whole person, successful healing.  Focusing on the patient, not the dogma of one discipline, is required,
  9. “Courageous” we do not believe in codependency or enabling – this means supporting patients to support themselves through The Empowerment Dynamic – TED, not rushing in to “save” or “cure” our patients.  Our patients are not powerless victims of situations; they are powerful creators of a great life and we are a vital member of their team.  Healthcare workers want to help, but this can digress into a one up: one down dependency – one we are committed to avoid.  Sometimes it takes more time and effort to promote, but ultimately it is the road to health,
  10. “Serving all”  With our innovative GOH4Health, GOH4Wellness, and GOH4Breakthroughs we serve people with and without insurance, insured patients and corporations.  Our population based, proactive approach minimizes the waste and redundancy creating very high Value {= (quality + safety)/cost} care.
  11. “Loving” we are followers of Jesus Christ.  This is not to say we discriminate, convince, coerce or force our beliefs on others – quite the opposite.  We see each patient as a gift, tremendous potential, and our commitment is to make sure they know we are Christians by our actions; the loving, non-judgemental care they receive from us.  At GOH Medical, all are welcome, all are served.

Our systems are in place, our team is becoming more competent and proactive.  By this fall we will be running smoothly and ready to serve a larger group of patients with a population based, whole person orientation.  We are looking for a provider(s) who shares our beliefs and philosophy to add years to the life and life to the years by empowering breakthroughs in the lives of those we serve.

Please contact us if you are interested or if you know someone who is.

I am back in practice in the Las Colinas Area at Prestige Family Medicine

I have missed all of my patients and am excited to be back in the Las Colinas area practicing medicine!

My time to actually see patients is limited to Tuesday afternoons and a couple of Saturday mornings a month.  We do have a full-time Nurse Practioner in the office that is excellent and will be able to take care of you when I am not there. She will communicate with me via text and email on all my patients and I will still oversee all of your care.  Also, for any of you wanting to change your lifestyle and lose weight, Cheryl will be in the office on Tuesday afternoons and Saturday mornings also.

Prestige Family Medicine is located at 701 N. Tuscan Drive, Suite 145, Las Colinas, TX  75039.   We are right of of MacArthur on the South side of the Las Colinas Medical Center.

We are also holding Tuesday evening Wellness classes from 6:00pm – 7:00pm at a company called Wave2.  They have graciously let us use their conference room and are located at:  1421 Greenway Drive, Suite 200, Las Colinas, TX .  The cost of these classes are $50 per month.

If you have any questions, or want to schedule an appointment, please call 972-292-7158 and we will be glad to assist you

Dr. Scott

Did you get the phone call?

Click here to listen to the message (if you have not heard it): Welcome Call.  Practice phone number: (972)292-2247.  Address 2706 Fairmount Street Dallas TX 75201.

Alright so guess how many cups of coffee I had before I recorded the message many of you have received?   I had no idea that I was as wound up as I was but when I got the call (yes I was listed as a patient so I could hear what you heard) I thought “wow, I need to hold off the Starbucks a little!”

All joking aside I am excited to be back in practice.  Randy Brown, a long time patient was the first to be seen at the new practice.  His parents and children will someday be there too as I have had the pleasure of caring for them for two decades.

The First Patient at the new office at 2706 Fairmount Street Dallas Texas

To be honest it is very strange to not be at TienaHealth, and I purposely moved to an office that is far enough away that I will not have an adverse effect on the providers there – all of whom I gave my word to when I recruited them that I would support and help them be successful in their practice.  I miss the staff and the providers very much so if any of you see them then give them a big hug for me!

That said I also appreciate that it is a hardship for those of you that wish to remain with me to drive downtown.  Frankly when you think about health care being divided into 1) prevention and early diagnosis of cancer, 2)management of chronic problems, and 3) acute problems really the only one that requires a sudden visit to the doctor ins the acute problem, and often this can be handled on the phone or web just as effectively.

So the vision is to have a very limited number of patients in the practice (say 400 – 500) as compared with a full practice which often has over 3000 people in the practice.  LET ME KNOW IF YOU ARE INTERESTED IN BEING ONE OF THEM (send email – above right) Over the next several days we will share the vision of what we are going to create.  I think you will be very excited!!  Scott Conard, MD

A Tribute to Those Who Focused on Quality at Medical Edge Healthcare Group, PA

Recently I left my position as Chief Medical and Strategy officer for Medical Edge, PA (now part of the Texas Health Physician Group).  It was stupendous.  My job description was to create a medically integrated group, to empower and support 510 doctors achieving every greater levels of clinical excellence.  Little did I realize when I began the amazing group with whom I would get to work.

My first month on the job I attended a conference at which I saw several primary care physicians.  I was asking everyone “are you in Medical Edge?”  It was not long until I found a few who were.  At one point when I asked one doctor who said “yes,” a second doctor standing near by said “your kidding, I am too!”  Their offices were 5 miles away and they both had been in the group for over 4 years…..

It was at that moment that I knew that the “clinically integrated” part of my job was going to be a challenge.  Two years later I can excitedly report that it had occurred.  Honestly, not due to me, but to a lot of work by Lori Clay, Cora Bennett, Tim Wilson and many other directors of operations and staff.  They divided the company into 11 Areas, then into 3 Regions (Lori’s idea).  Soon meetings of the 100 primary care doctors in each region were occurring regularly, specialists and ancillary services shared best practices in ongoing support for the primary care doctors, and the quality of patient care spiraled higher every day.

Within two more years by focusing on the care process doctors, nurse practitioners, and physician assistants received over 160 Certificates of Recognition by the Bridges to Excellent  based on nationally established criteria on diabetes and heart disease risk.  Shawn Parsley, Donald Fowler, Don Holt, and Paul Anthony were the Regional Medical Directors who empowered and worked with Area Directors like Eric Futscher, Randy Perkins, Paul Kim, Roger Tolar, John Wood, Odi Alvarado, Carlos Mijares, Al Hulse, Elizar Alvarez, and Tim McGuire.  Lisa Oleson, the staff of Care Innovations (a part of Medical Edge), Lynn Myers and the electronic medical records staff provided ongoing leadership to re-define the process and consistency of care patients coming to our offices received.

It was both magical and thrilling to stand on the shoulders of such committed, outstanding individuals.  Working with these leaders and with the office staffs of all 183 Medical Edge offices, who had to change the way the did things every day, all the time, was a blessing I will never forget and for which I will always be grateful.

There are people alive today that would not be celebrating Memorial Day in 2011 if these leaders had not created and shared their vision with others.

So in leaving my post with Medical Edge (now THPG) I post this blog to honor and to publicly share the work of many, and the names of a few that came together from 2006 – 2010 to improve the lives of those we served, and save the lives of many.  Most of the patients you influenced will never know your name, but I will never forget you, your spirit and your commitment.

I pray that you will always be blessed, and I know that God knows who you are and blesses you every day for what you do for so many.

Dr Scott

The 15 Minute Train Wreck – AKA the Office Visit

The 15 minute train wreck – running room to room is dead.  It has been shown to be ineffective and expensive.   With just enough time to get a little information the provider (doctor or PA/NP) makes a quick assessment and launches out the door for the next patient.  Frequently proper follow up and ongoing support is completely lost and the patient is left to wander in the wilderness called “modern” healthcare.

The new model is about continuity, transitions from one care environment (say, the hospital) to another (home), and personalized care.  Outreach and follow up calls with problem solving and support, and team meetings to insure that what patients don’t know is not a reason to have unintended disease and death.

Do you know someone who wants to be a part of providing this care?

Let me know.  It is time to build the team.

Dr Scott

 

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