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Strategic Planning FY2020- 2022Medical Practice/Medical Group/Specialty CareClaudia M. Fegan, MDChief Medical OfficerMarch 25, 2019
Overview of DepartmentCook County Health Medical Staff
Overview of DepartmentMedical Staff Functions“The Medical Staff has the overall responsibility for the quality of medical care provided to patients,and for the professional practices and ethical conduct of its members, as well as accounting thereforeto the Cook County Health and Hospitals System Board of Directors ”Preamble, John H. Stroger, Jr. Hospital Bylaws“The Medical Staff is responsible for the quality of medical care in the Hospital and accepts anddischarges this responsibility subject to the ultimate authority of the Cook County Health andHospitals System Board of Directors ”Preamble, Provident Hospital Bylaws3
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Overview of DepartmentMedical Staff Quality PartnershipClinical DepartmentChairsPeer ReviewCommitteeCredentialingCommitteeExecutive MedicalStaff/Medical ExecutiveCommittees5
CCH Medical Staff by Category16591495826
Advanced Practice ProvidersCategories Physician Assistant-Certified Certified Nurse Practitioner Certified Registered Nurse Anesthetist Clinical Nurse Specialist Certified Nurse Midwife7
Advanced Practice ProvidersAreas of Specialization: MedicineN 49 Correctional HealthN 24 SurgeryN 20 Emergency MedicineN 12 AnesthesiologyN 11 Obstetrics/GynecologyN 7 PediatricsN 8 Family MedicineN 5 PsychiatryN 4 TraumaN 18
Medical Staff by Department*MedicineSurgeryEmergency MedicineFamily MedicinePediatricsAnesthesiologyCorrectional HealthRadiologyPsychiatryObstetrics & GynecologyOral HealthTraumaPathology*Stroger & Provident, Active/Provisional only0501001502002509
Medical Staff Board Certification*5.3%94.7%*Stroger & Provident, Active/Provisional only10
Medical Staff Demographics*Gender45%55%*Stroger & Provident, Active/Provisional only11
Medical Staff Demographics*Age35%30%30%30%25%20%23%17%15%10%5%0% 4040-4950-5960 *Stroger & Provident, Active/Provisional only12
Medical Staff Demographics*Years on Staff199158142758*Stroger & Provident, Active/Provisional only13
Medical Staff %WhiteAsianBlack or Hispanic orTwo orAmericanAfricanLatinoMore Races Indian orAmericanAlaskanNative14
Medical Staff Demographics*Top Non-English Languages Spoken ***Stroger & Provident, Active/Provisional only**Voluntary reporting15
Impact 2020 UpdateHighlights: Status and Results Deliver High Quality Care Grow to Serve and Compete Foster Fiscal Stewardship Invest in Resources Leverage Valuables Assets Impact Social Determinants Advocate for Patients
Impact 2020Progress and UpdatesFocus AreaNameStatusDeliver HighQuality CareGrow to Serve andCompeteInvest in ResourcesLeverage ValuableAssetsLeverage information technology initiatives suchas Vizient (clinical data base) and Clairvia(nursing management system) to improvepatient safetyIn Progress and OngoingDeliver HighQuality CareGrow to Serve andCompeteInvest in ResourcesLeverage ValuableAssetsImprove the availability of and access to healthcare for Cook County residents. Increaseutilization of operating rooms; increase volumeof surgical casesIn Progress and Ongoing17
Impact 2020Progress and UpdatesFocus AreaNameStatusDeliver HighQuality CareGrow to Serveand CompeteMarket Cook County Health as theprovider of a continuum of care withspecial focus on those transitioning toMedicareIn Progress and OngoingDeliver HighQuality CareGrow to Serveand CompeteReduce scheduling wait times fordiagnostic and evaluation andmanagement (E&M) clinic visitsIn Progress and Ongoing18
Impact 2020Progress and UpdatesFocus AreaNameStatusDeliver HighQuality CareGrow to Serveand CompeteFacilitate timely access to Cook CountyHealth SpecialistsIn Progress and OngoingDeliver HighQuality CareGrow to Serveand CompeteInvest inResourcesLeverageValuable AssetsAttain American College of Surgeons (ACS) In ProgressLevel 1 Trauma Certification19
Impact 2020Progress and UpdatesFocus AreaNameStatusFoster FiscalStewardshipLeverageValuable AssetsProviding coding and training support toproviders to ensure they accurately capturethe scope of services and complexity ofpatients treatedIn Progress and OngoingDeliver HighQuality CareGrow to Serveand CompeteInvest inResourcesLeverageValuable AssetsEnhance safety by development of medicaleducation safety culture and reportingIn Progress and Ongoing20
Impact 2020Progress and UpdatesFocus AreaNameStatusDeliver HighQuality CareGrow to Serve andCompeteInvest in ResourcesLeverage ValuableAssetsDevelop and implement a medical staff practiceplan structureIn Progress and OngoingLeverage ValuableAssetsEstablish ambulatory clinical effort agreementsfor each departmentIn ProgressFoster FiscalStewardshipLeverage ValuableAssetsDevelop a mature relative value unit (RVU) atthe department and physician levelIn Progress21
FY2020-2022The FutureEnvironmental Scan of Market, Best Practices and Trends
Multi-Specialty Practice GroupsOn the rise nationally-why?1. Better communication among your physicians. Seeing aligned doctors promotes collaboration and ensures moreefficient care. Medical groups utilize a common EHRs that facilitate sharing of information. Improved communication helpsimprove outcomes.2. Access to new treatments and technology. Not only will do MSPGs provide access to additional physicians andexperts, but increased access to new treatments and technologies as well. Integrated medical groups combine the assets of aparticular health care organization.3. Coordinated care. Integrated medical groups employ physicians who practice in hospital and ambulatory settings,mitigating potential disruption in care when being admitted or discharged. Working as a team improves efficiency andquality.4. Higher standards of quality monitoring. Integrated medical groups have more resources to devote to monitoringand improving the care provided.5. Additional clinical resources. As part of a broader health system, physicians in an integrated group can draw on awider array of clinical services. These may include things like home care, diabetes education, smoking cessation, cardiacrehabilitation, and others. It's no longer just visiting your doctor when you are sick.Nash, MD, Ira. (2018). Five benefits of integrated medical groups. Northwell Health. Available -integrated-medical-groups23
SWOT AnalysisStrengths, Weaknesses, Opportunities and Threats
SWOT AnalysisStrengthsWeaknesses ItemMedical staff committed to CCH mission Medical staff experience/expertiseItem Comprehensiveclinical services Sensitivity to patient needs Lack of job title specificity Incentive structure Relative value unit measurement (industrystandard)OpportunitiesThreats Clinical documentation improvementPractice plan structureIncentive structureQuantified performance measures Medical staff turnover (retirement, competitivemarket) Medical staff burnout Salary structure not market aligned25
FY2020-2022Medical Staff Focus: Quality of Care and Patient Safety
Deliver High Quality CareFY2020-2022 Strategic Planning Recommendations Operationalize high reliability methodologies Interdisciplinary programs Expansion of community-based specialty services Continue to leverage information technology to improve patient safety27
Grow to Serve and CompeteFY2020-2022 Strategic Planning Recommendations Retention of Medicare population Access to care strategies Clinical effort standardization28
Foster Fiscal StewardshipFY2020-2022 Strategic Planning Recommendations Documentation improvement: ongoing provider education and feedback Charge capture29
Invest in ResourcesFY2020-2022 Strategic Planning Recommendations Incentives program Continued precision/specificity to job titles and job descriptions Analyze/maximize utilization and deployment of Advanced Practice Providers30
Leverage Valuable AssetsFY2020-2022 Strategic Planning Recommendations New interdisciplinary programs/services Develop multi-specialty group practice structure31
Impact Social Determinants/Advocate for PatientsFY2020-2022 Strategic Planning Recommendations Innovations to assist in services to patients in areas poorly served by publictransportation, including telemedicine and care coordination32
Thank you.
Impact 2020 UpdateStatus and Results Addendum: Medical Staff
Impact 2020Progress and UpdatesFocus AreaNameStatusDeliver HighQuality CareGrow to Serve andCompeteInvest in ResourcesLeverage ValuableAssetsStrengthen pediatric services by increasingactivity, developing partnerships, retainingpediatric patients and identifying kids at riskIn ProgressDeliver HighQuality CareGrow to Serve andCompeteInvest in ResourcesLeverage ValuableAssetsResume psychiatric consulting services in theEmergency DepartmentIn Progress35
Impact 2020Progress and UpdatesFocus AreaNameStatusDeliver HighQuality CareGrow to Serve andCompeteInvest in ResourcesLeverage ValuableAssetsIdentify new and additional Centers ofExcellenceCompleteDeliver HighQuality CareGrow to Serve andCompeteInvest in ResourcesLeverage ValuableAssetsDemonstrate value of undergraduate andgraduate medical education and academicaffiliations to the organization by analysis ofcosts, returns, pipeline to workforce andfacilitation of Cook county Health mission.In Progress36
Impact 2020Progress and UpdatesFocus AreaNameStatusDeliver HighQuality CareGrow to Serve andCompeteInvest in ResourcesLeverage ValuableAssetsRecruit, hire and retain the best employees whoare committed to the Cook County HealthmissionOngoingDeliver HighQuality CareGrow to Serve andCompeteInvest in ResourcesLeverage ValuableAssetsIdentify areas for formalized interdisciplinaryservicesIn Progress37
Strategic Planning FY2020- 2022 Medical Practice/Medical Group/Specialty Care Claudia M. Fegan, MD Chief Medical Officer March 25, 2019
