Hospitals, health systems, and physician groups around the country are acutely aware of the increasing need to demonstrate value, not just generate volume. The enthusiastic engagement of physicians is essential to meeting this challenge. But we are no longer in the world of "how do we design quality projects that are interesting to physicians." In today’s world, virtually every health system, hospital, and physician group is trying to get better results through better relationships — whether through tighter bonds, reorganized medical staff activities, financial relationships, revamped payment models, or other relationships. "Clinical integration" and "accountable care organizations" (ACOs) are the primary subjects of these discussions. Typical topics in these conversations include:

• How can we get our doctors to become accountable for basic safety practices such as handwashing, pre-surgical checklists, and careful communication of handoffs?
• We’ve started to have some success with hospital-centered quality and safety initiatives — but now we have to work with physicians across the community to coordinate care for chronic disease, and reduce overuse of services. How in the world do we approach that challenge?
• Specialists are coming to us in droves, asking to be employed. Is this a great opportunity for medical staff engagement, or is it the mother of all "cash for clunkers" programs?
• Trust between the hospital and the medical staff is at an all-time low point. How do we rebuild it?
• We think that engagement would be better if we employed the doctors. Is that true? If so, how does a hospital go about forming a multispecialty group without alienating its independent medical staff?
• We’re trying to "clinically integrate" the medical staff and the hospital, but no one seems to have a clear idea of what this means, exactly. Or rather, each player seems to have a different idea about what we’re trying to accomplish. What is "clinical integration"?
• How do we respond to elements of health reform such as bundled payments and ACOs, with a medical staff consisting largely of independent practitioners?

This program is designed to help participants understand the complex web of relationships among doctors, and between doctors and organizations, whether in freestanding medical groups, hospital-employed or hospital-sponsored practices, or traditional hospital/independent physician structures — and to translate that understanding into practical actions to improve physician engagement in improving quality and value.