The assessment of clinicians depends increasingly on data and metrics. How do leaders measure the success of teams and teamwork?
At The MetroHealth System, where Akram Boutros is President and CEO, teamwork is measured across three areas of focus: operations, outcomes, and cost structure. For operations, they ask questions such as: Are we getting more efficient? Are we moving X number of steps? Can we do the process more consistently? Outcomes are objective but measurable. Time-driven, activity based costing or proxies for it can be used for cost structure. “It’s directional in nature,” says Boutros, “so we know that we’re getting better or we’re not getting better.”
Vivian Lee, the CEO of University of Utah Health Care, describes a new area for the health organization: patient-facing integrated practice units. “They’re a little like service lines but [offer] even more,” says Lee. For example, in a traditional fertility clinic, urology is separate from the OB/GYN. But it would make more sense to bring everyone together. “We’ve created these integrated practice units that have shared governance, shared financial, shared bottom line, shared quality and outcomes measures,” explains Lee. “I think that model is very helpful for driving team approaches, and they really do help us shift to a much more patient-focused model of care and center a whole business around the patient.”
One intangible that MetroHealth has measured in the past is asking team members, “How readily will you admit your mistake?” and, “How readily will you offer help to a colleague who’s about to make a mistake?” “These are two really critical issues: you saying ‘I’m fallible’ and you helping someone who you know is fallible who’s about to make a mistake,” says Boutros. On a scale of 1 to 5, one team at MetroHealth improved from a 1.8 to 4.6. One of the reasons for this change? The team started going to lunch together every day. When you eat around a table together, you get to know each other a lot better.
From the NEJM Catalyst event Leadership: Translating Challenge to Success at Mayo Clinic, June 2, 2016.