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Blair Bisher, MHA, PMP, chief operating officer at Sturdy Memorial Hospital and adjunct professor at Suffolk University’s Sawyer Business School, joined a recent episode of MGMA Insights podcast to share his hands-on experience in converting an academic medical center’s primary care unit from a volume-based model to embrace value-based care, as well as the value of strategic planning in the transformation. Bisher also is one of the featured speakers during the 2022 Medical Practice Excellence: Pathways Conference DX.
MGMA: What can someone expect to learn at your session?
Bisher: I think that great ideas are ubiquitous. Everyone’s got one … but great execution of great ideas is rare. I’ll be discussing how to execute effectively on those great ideas.
What I want to talk about at the conference is looking at the [organizational] structure, top to bottom — really outlining how you start with a steering committee at the top, the working groups that get chartered and come out of the actual strategic plan at the bottom, and then what’s in between. Who are the owners of all of this? What’s the cadence of how often does the steering committee need to meet if it’s the CEO of the system? So how do you balance all of that?
MGMA: One area where effective execution can help is running a meeting. What does a well-structured meeting look like?
Bisher: I think a good meeting has some constants. … There always needs to be a value add. What are the defined deliverables that we want to get out of this? If we can’t say what we’re trying to get out of this meeting, there’s no point for anyone to be at this meeting. The duration doesn’t need to be an hour just because that’s how we do things around here.
MGMA: How do you build consensus and approval? Where are the challenges?
Bisher: Consensus building is a lot like great ideas: I think everybody knows most of the principles, but sometimes it’s really tough to execute on it. You’re driving down the highway at 90 miles per hour, and you’re trying to keep everyone in the car. Sometimes people are aggressively trying to get out of the car. You’ve got to manage up. … Looking at alignment is the first place to start. We need to be aligned; we need to have a common goal. Does the organization you manage have a clearly defined goal, mission, vision, values? Or is it something that’s been on the wall for 13 years and nobody really knows what it is?
You have to engage stakeholders super early, and really engage them. I think it’s over-communicating, super-transparent, collaborative-style on the update and back end of it all. Everybody needs to know — at every step along the way — what’s going on. That’s why I love Trello. Anytime that anybody wants to know where are we at on this strategic planning process, they can just go and check and pull that information for themselves. They don’t have to wait for the ivory tower to say, “OK, here’s your update, we’ll be back in 90 days.”
MGMA: Can you share a success story on this approach to planning and execution?
Bisher: I got a chance working at the Beth Israel Deaconess Medical Center, downtown Boston. Our newly appointed chief of general medicine wanted to convert a volume-based fee-for-service primary care group to value. How do we move into the modern era? How do we really start to focus on improving our patients’ overall health?
A management team of about eight came together and mapped out a routework group structure of 20 different workgroups. They all had to be chartered, they all had to move together in progression to be able to achieve the vision, so we did that. For us to make that conversion successfully, it was going to take a 40% increase in staffing. We worked on how we would be able to fund that and submitted a proposal to the medical center, which we got approved, which was amazing. It’s been an incredibly exciting journey.
— Episode recap by Andy Stonehouse, MA, freelance writer/editor
This episode is sponsored by:
- Onsite Women's Health — Onsite Women's Health provides healthcare practices and providers with the ability to bring screening mammography in-house. Partnering with Onsite allows more women to keep up with their annual screening and gives anyone impacted by breast cancer a fighting chance.
- Nuance — Nuance Dragon Ambient Experience, or DAX, captures the patient story securely and accurately to automatically document at the point of care for increased efficiency and patient throughput. Discover how DAX provides a better patient experience and eliminates afterward documentation.
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The MGMA Insights podcast is produced by Daniel Williams, Rob Ketcham and Decklan McGee.
