This session will introduce the attendees to the power of physician engagement in advancing quality, for hospitals as well as other physician practice venues, including physician groups. To focus early on the issues in developing a practical plan for engagement, excerpts from “In Their Own Voices” will be presented for discussion. Attendees will be asked to address for themselves the extent to which physicians are engaged in their organizations and what their goals are for the two days of the seminar.

To progress from theories of quality improvement to actionable plans for your organization, this session will present the overarching framework and structure the IHI faculty have developed to help you move methodically from concept to real engagement. Tools and resources will be introduced to be referenced and applied throughout the program so that at the end of the second day, attendees will be well on their way to having a written engagement plan that they can expand, apply, and take even further in their home organizations.

In most physician practice settings, and particularly in hospitals, the potential for physician engagement will depend in a significant way on the history of the organization’s interactions with physicians and their current cultural context. This session will present a "cultural assessment" to help attendees identify the specific issues in their setting they will have to address to optimize the chances for success. In addition, for many organizations, legal issues such as Stark, the antikickback statute and antitrust are seen as barriers to innovative relationships with physicians. These mythologies will be debunked and some practical new approaches will be presented that can help physicians with their business case for quality while advancing the organization’s quality results -- all within the boundaries of the law.

From the real-life perspective of a CEO of two organizations which have, in different ways with different cultures, achieved spectacular quality results, this session will address how you go about reframing the values, habits and beliefs that define the physician culture and the relationship between the organization and its physician staff.  

Within any organization that seeks to engage with physicians to improve quality, physicians play multiple roles. Some are structural leaders with titles and offices; some are champions without titles; others do not seek those roles but must be engaged for improvement to be meaningful. In this session, the identities and characteristics of the different types of physicians who must be engaged for a plan to actually work will be presented along with tactics and techniques that speak to each group.

In every engagement initiative it can be expected there will be a moment when physician resistance will arise. Some important physicians will challenge or defy new approaches because their patients are different, their results are different, or they don’t believe the science. This very common problem requires a strong sense of will to proceed. This session will present a few case study/role playing opportunities to confront the realities of these circumstances that are likely to occur as the game changes and the stakes go up.

Because all improvement depends on data, how data is developed and used is a critical challenge when those about whom the data is presented may feel criticized. This session will offer both practical techniques that can defuse problems and some simple principles for sharing and using data that are essential to effective quality improvement.

Virtually every organization concerned about quality is confronting the challenges in standardizing processes of care. Where these changes require physician engagement, special attention is necessary to shift expectations as are non-threatening techniques to get there. This session will present some specific approaches to making this change work more effectively, while managing what can be polarizing conversations about the new reality. 

For any plan to truly engage the hearts and minds of physicians, it is necessary to understand in a deep way the common, distinctive aspects of their perspectives and mindset. This session will discuss what makes physicians different and what that means to practical principles of engagement with them, as well as how physicians themselves should engage responsibly for the new reality to work smoothly.

Throughout the two days, until this point in the seminar, the attendees will have been working on and keeping notes about what their specific needs will be to create a custom-crafted plan for engagement using the framework and techniques presented so far. In this session the whole program comes together with the most significant take home as the result: the first draft of a written engagement plan. With the support of the faculty -- to answer questions, interact, and facilitate discussion -- participants will focus in the first segment of this session on documenting their own plan to engage physicians in quality and safety. The second half will give participants an opportunity to hear from a few others, to further stimulate thinking about what can be improved in their own plan.

After the intensity of two days of real, practical work, each of the faculty will leave the attendees with a specific message to keep in mind to continue the work begun at this meeting with new efforts at home.