As I finish my term as Chief of Staff, I'd like to share a few thoughts on the state of the Stanford Hospital & Clinics medical staff. Over the past three years the medical staff has continued to grow and mature as a self-governing organization of physicians who care about our patients, our colleagues and our organization. We have faced the challenge of increasing clinical needs in a hospital that is bulging at the seams. We have improved quality in nearly every arena. And we have improved the experience of our patients as evidenced by measures like Press Ganey, but also by the unsolicited comments from patients about the outstanding and compassionate care they receive from the physicians and staff at SHC.
One of my main goals in the last three years has been to make physicians feel supported in the difficult work of providing that outstanding and compassionate care. Without personal and professional satisfaction, providing compassionate care and a comforting and nurturing environment for anyone else is virtually impossible.
To that end, something as simple as sharing with physicians the compliments they have received from patients has been very well-received. Each month, Amir Dan Rubin and I send out 30 to 40 letters to individual physicians quoting their patients' praise of their care.
I also recognize that it is easy to feel beleaguered by the pressures of an increasing workload and increasing demands to improve quality while at the same time teaching and doing scholarly work. The Stanford Committee for Professional Support and Satisfaction (formerly the Wellness Committee), launched and co-chaired by Bryan Bohman, was developed to help physicians deal with this pressure. The committee has grown and flourished and now has a well developed website (http://wellmd.stanford.edu/) that offers information about health, burnout, work-life balance and other topics, as well as resources available to physicians and students on campus.
It is also important to be accountable for our actions, and the Committee for Professionalism was formed to serve as a resource to monitor and improve the professional behavior of the medical staff. We have found repeatedly when talking with colleagues that many instances of "unprofessional behavior" result from stressors in the environment that we as medical staff leaders can have some influence over. In individual instances we have been able to work with hospital and school leadership to lighten clinic loads, change staff assignments, offer coaching, and on occasion offer the services of the Stanford Help Center (https://helpcenter.stanford.edu/) to help deal with both personal and professional challenges. In most cases, addressing the real triggers for unprofessional behavior has been a successful approach.
Taking things to the next level, we have successfully advocated to increase physician involvement in hospital initiatives to improve processes of care in our own environments. In the Emergency Department, physicians played a vital role in a series of projects designed to shorten "door to doctor time," improve medication reconciliation and increase throughput. The result has been an increase in both patient and physician satisfaction. In an ophthalmology clinic, the willingness of one provider (with the support of SHC) to apply "lean cell methodology" to his clinic has resulted in a 20 percent increase in the number of patients seen while at the same time shortening the average time he spends in clinic by about 90 minutes per day.
Recognizing the importance of including physicians in the ongoing process improvement efforts at SHC, we launched a series of four half-day seminars offered on multiple dates to teach physicians and others about the Stanford Operating System. These have been well received by those who have participated. As a result of discussions at one of the first seminars, one clinic chief was able to work with his clinic staff to introduce a standard for medical assistants that he had previously been unable to accomplish.
On a more mundane level, we have attempted to decrease the number of nuisance email messages to medical staff by consolidating all but the most urgent announcements into a MedStaff Weekly email message. The old paper Medical Staff Update has gone electronic and a guest column written by other leaders you want to hear from has replaced the monthly Chief of Staff message. We have regularly honored retired colleagues by annually adding to the list of Honorary Lifetime Medical Staff members and highlighting their accomplishments at the annual Medical Staff Gala. And coming soon will be an updated and hopefully more interesting and informative Medical Staff website.
We are at the threshold of great things at SHC. Bryan Bohman began the legacy of a self-governing medical staff six years ago, and over the past three years I have attempted to carry on his work to improve the experience of our patients by supporting and improving the experience of our physicians. Mark Welton will become Chief of Staff on May 1, and together with newly elected Vice Chief of Staff Edward Damrose and newly appointed Associate Chief of Staff Christopher Mow, he will have the opportunity to accomplish even greater things as we face the next challenges of affordable care, building a new hospital and negotiating an ever-changing environment.
Thank you for the opportunity to serve you over the past few years. It has truly been a privilege and an honor.
– Ann Weinacker, MD, Chief of Staff