I believe that unnamed concerns also could encompass
– lack of seniority of these personnel
– real need to invest time to train and help them operate efficiently with limited ROI as these interns usually stay for short periods
You need to discuss these and try to provide the positive perspective
– identifying very early on the best talents
– training those that will take cre of us latter
– using them as an excellent tool to check if the department is in line with digital and social trends
This is a very difficult but also a very relevant question
To me it comes down to anticipating disruption of our healthcare model in academia. The best way to achieve that is to be the ones in charge of that disruption!
However the endeavor here is so large that it will only work if you implement a strategic retreat that will allow the key stakeholders of the institution to understand what is at stake and the need for them to free resources for this program
You need to establish a win-win relationship with those departments that are reluctant to embrace EHR. What is in there for them that you could highlight and will tip the balance? Are there publications you can get from data mining in EHR?
I assume email and text message reminders could help to a limited extent considering the poor population target
Probably trying to provide an extra benefit to that physiotherapy consultation would make sense (ie dietetary advice, etc)
What should be monitored? Clinical and non-clinical goals?
I believe that you want to have both type of goals. Complication rates are a clinical goal you can measure, length of stay is more of a mixed goal because it is not only clinical-dependent. Publications is also an interesting mixed goal
Short-term and long term goals (general hospital)?
I believe that as a minimun you need yearly goals. But some companies have found that this does not allow enough dymanic feedback and shorter term reaction to trends. So they do it on a semester basis
Types of incentives? Score cards – metrics proposal?
Waiting time above a certain threshold is a good metric that most people will accept and that really impacts patients life
How is the data collected, performance review intervals?
Build-in IT system
Can you propose 2-3 goals in every dimension?
Clinical: number of consultations, number of new patients, number of patients enrolled in clinical trials
Publications: number of peer-reviewed publications as 1st or last author, same if just co-author, and then same for publications in high impact journals (high IF can be defined as > 15 or 20 in oncology, but has to be adapted to each speciality, in stomatology 3 is high IF)
Processes vs. outcomes measurement?
Is the incentive rather individual or group-focused?
A mix is needed, individual and department performance as well as global hospital performance
What is in stake? I.e. monetary and non-monetary incentives to perform well.
Monetary is important, but you can also make expensive training (ie MHCD) an incentive
How is the final score calculated (measuring performance) and linked to the remuneration … i.e. bonus payments or any other benefits (please list some of them)?
How significant is monetary incentives comparing to annual salary (%)?
At least 10%
Do you have any advice on how to involve emotions when starting this project?
Ask people to suggest the best goals to measure and what they believe is the best methodology
This is a great subject where patient’s expectations and hospital routines are not aligned. Some hospitals have tried to address this issue by building one-day clinics. Breast is one such example where in a single day they can perform the mammogram, the biopsy and even the cytology study and provide a same day orientation to the patient. It needs restructuring but has been very well received. I know also of one-stop clinics for thyroid nodules