As part of our 2010 Clinical Advisory Board meeting series, we've launched a benchmarking survey to augment our research on the governance and operations of the medical staff organization.
Here are a few interesting insights gleaned from the early survey results and our research conversations on this topic.
Growing number of medical staff organizations adopting service line structures
While the department-based structure is still the predominant medical staff organizational model, approximately 30% of survey respondents report that they have adopted a combination of clinical departments and service lines.
Due to frustrations with silos created by department models based on board certifications and organizational politics, we see growing interest in the service line model. Most significantly, the service line model provides the opportunity to better align complementary services--such as cardiology, cardiac surgery, and vascular services--under a single physician leader and to ensure consistent standards and collaboration across specialties that care for a similar patient population.
Increasing adoption of accountability mechanisms for medical directors
The average hospital has approximately 11 medical director positions, but only 30% of respondents have structured at-risk compensation models for these physician leaders. Organizations that employ at-risk compensation models have greater success in defining clear goals and accountabilities for medical directors focused on the initiatives that will most positively impact the organization.
One member institution shared that a whopping 40% of their medical directors' total compensation is at-risk. Since adopting this incentive structure, the organization has realized significant improvements in core measure performance and patient satisfaction.
Growing prevalence of Board participation in medical staff committees
Finally, despite the broad array of medical staff committees, we consistently hear that it's a struggle to secure physician participation in high-impact initiatives. While organizations employ a number of strategies to increase committee performance and accountability, a growing trend is to involve the Board on high-impact committees. Respondents to our member survey shared that 40%, 38%, and 21% of institutions have a Board member participating on the medical staff quality committee, the Medical Executive Committee, and the credentialing committee, respectively. Interviews reinforced the benefits of this practice; most notably, that Board participation on key committees increases medical staff members' sense of accountability for these important medical staff governance functions.
We look forward to discussing these--and many more--topics in further depth in our 2010 national meeting series.