Strategic “Before and After” Editing
I edited this article for an internal publication for a medical cooperative organization. All names have been changed to preserve the privacy of the individuals and the organization. The original article is followed by excerpts of my cover letter to my contact in the marketing department, and my revised version of the article.
What’s New [title]
I have been in the role of VP of Operations for almost 2 months, and I have an increased respect for Willie Joel M.D. and his ability to manage a few hundred MDs for over 15 years. It has been a hectic 2 months if nothing else. Let me try to summarize some of the events of the past 60 days.
Probably the biggest and best news is the CCH (Caring Curing Hospital) West Bay contract. We have increased our presence with CCH by being awarded two new contracts in the West Raritan Bay region. This is unique in that there is one contract for all 5 emergency departments in this region. They included the current JEH contracts: Hall,Popular Religious Name, St. Mark’s as well as the new contracts of Bayside and Riverside . Many people put in a lot of work for this to succeed, but a special thanks to Jerry Beaver M.D. for really being the force that kept pushing this forward. I also want to congratulate John Dough, M.D. who is the new Regional Director of this CCH region.
I have worked to increase our reimbursement by raising the bar, so to speak, for managed care contracts and to put energy into dealing with our “problem payors.” JEH has had some good results getting payment from these “problem payors.” Again, many others have participated in this and have done more than I.
JEH has always been interested in providing quality care and patient satisfaction. We are trying to quantify the patient experience. This way, we can learn from “customers,” improve upon this, and also use this information as a differentiation point with hospital administrators, and IPAs, which are also interested in patient satisfaction. To this end, we will be expecting all sites to establish some method of measuring patient satisfaction (most already do).
As part of the new JEH management reorganization, there is a new committee in town. They are called CPIC (Contract Performance Improvement Committee), chaired by Mark Fitz M.D.. The role or charge of this committee is to focus on operational issues of local contract sites. Therefore, JEH Medical Directors that have dealt with a variety of issues at their local sites mainly staff the committee. The old QI Committee and Practices Management committee goals are incorporated in this new committee.
Kaiser has expressed a strong desire to jointly staff some of our emergency departments (Hillside and Bayview to start with) in order to see their own patients, while we get to see all the indigent patients. This could lead to all sorts of problems besides management,and reimbursement issues and could lead to even more issues on maintaining the same standard of care for all patients. So, the dually staffed emergency department is obviously something we are fighting. And if we are forced to incorporate dual staffing of Kaiser and JEH, we are trying to put systems in place to protect both the patients and the interests of JEH Partnerswhile allowing Kaiser docs to achieve their goals.
In an attempt to learn more of the partnership, I have attended Regional Medical Director meetings. I have found these meetings valuable. There has been networking of the Medical Directors assessing the regional problems. I discovered this manner of communication a terrific idea—allowing interaction of others with myself in a small group. There was much more sharing back and forth of information, ideas, and questions in theses small groups than a large Medical Director or Partnership meeting.
In conclusion, I am energized by the experiences I have had in the past 2 months as the new VP of Operations. The creative energy of our group is amazing! We have a whole lot of outstanding physicians in our partnership who are committed to serving our group needs. I look forward to more ideas, more creativity, and more challenges.
Rocky Nelson MD, VP of Operations
From My Cover Letter
My redone article follows. I have several questions for you and Dr. Nelson. In a couple of cases, his intent was unclear. Also, I wasn’t sure if the fourth and fifth paragraphs were related. I would have Dr. Nelson review the article before publication. Once I’ve established the confidence and trust of managers, I usually find that they can produce a more effective product by having me interview them and then write the article.
I tried to accomplish two objectives with the organization of the article: (1) put the most important items first, and (2) be consistent with Dr. Nelson’s goals as stated in your March publication. Otherwise, I did not deliberately change the content. I tried to preserve his flavor and personality as much as possible, while maintaining consistency with style shown in your publications.
Strategically Edited Article
Operations Initiatives [title]
by Rocky Nelson, M.D.; V.P. of Operations
During my hectic first two months as V.P. of Operations, I have participated in many projects and strategies to improve our operations. I have also gained increased respect for my predecessor, Willie Joel, M.D., and his ability to manage several hundred doctors for more than 15 years. To keep you informed, I will summarize the status of my initial activities in the new position.
Our top new accomplishment is the contract with Caring Curing Hospital (CCH). We have expanded our relationship with CCH by adding two locations in the West Raritan Bay region. We had existing contracts with Hall, Popular Religious Name, and St. Mark’s, and added Bayside and Riverside. All five emergency departments are now covered under one contract. Many people contributed to the successful completion of this contract, especially Jerry Beaver, M.D., whose persistence was vital. I also want to congratulate John Dough, M.D., who is the new Regional Director of this CCH region.
The Contract Performance Improvement Committee (CPIC), chaired by Mark Fitz, M.D., was established as part of the JEH management reorganization. The role or charge of this committee is to focus on operational issues of local contract sites. Thus, most of the CPIC members are JEH Medical Directors who have dealt with a variety of issues at their local sites. The goals of the former QI and Practices Management committees are incorporated into the CPIC.
Providing high-quality care and patient satisfaction have always been JEH objectives. We are now implementing strategies to evaluate patients’ experiences. Most of our sites already have a method of measuring patient satisfaction; others will be expected to establish a program. By learning from our “customers,” we can improve our service. We can also use the collected data to differentiate ourselves in the eyes of hospital administrators and IPAs who are also interested in patient satisfaction.
I have participated in the successful efforts to increase our reimbursements from managed-care contracts and “problem payers.” Increased standards and staff resources are resulting in better collections.
Kaiser has a strong desire to jointly staff some of our emergency departments, initially Hillside and Bayview. Kaiser wishes to see their own patients, while we get to see all the indigent patients. A dually-staffed emergency department could lead to a wide variety of problems, including management and reimbursement issues, and even more issues with maintaining the same standard of care for all patients. We are trying to prevent dual-staffing, but if those efforts are unsuccessful, we will implement systems to protect the interests of both patients and JEH partners, while allowing Kaiser doctors to achieve their objectives.
I have been attending Regional Medical Director meetings to learn more about the partnership. Medical Directors assessing regional problems have been networking to share ideas and seek solutions. These small-group meetings are a terrific and effective way for the Medical Directors and I to communicate and plan to increase standardization.
In conclusion, I am energized by my experiences during the past two months. The creative energy of our group is amazing! We have many outstanding physicians in our partnership who are committed to serving our group needs. I look forward to more idea-sharing, creativity, and challenges.