May 2016 Joint Statement, Doctors Council SEIU & New York City Health + Hospitals System-Wide Collaboration Council

Executive leadership from all NYC H + H facilities and their Doctors Council SEIU member counterparts convened at NYC H+H/Gouverneur for our System Wide Collaboration Council (SWCC) meeting.  The focus of the System-Wide meetings continues to be to learn about the progress of each of our Facility Based Collaboration Councils (FBCC) who are charged with the development and execution of improvement initiatives designed to improve the experience of our patients and physician engagement.

The meeting was co-chaired by Dr. Ross Wilson, system CMO and Dr. Aycan Turkmen of Coney Island Hospital who is Doctors Council SEIU 2^nd Vice President.

A Time of Change

Dr. Wilson opened the meeting with an important framing for the work of the Collaboration Councils:  “NYC Health & Hospitals is open for business in a difficult financial time. City leadership has committed help but has directed that there will be no hospital closures and no layoffs.  You’ll be hearing a lot of planning and announcements from leadership…so we may look different as change occurs but we continue committed to our mission”  Dr. Wilson concluded: “These discussions of the SWCC make large contributions to the changes we need to make. “

Dr. Frank Proscia, President of Doctors Council added: “We are in a time of crisis but also a time of opportunity.  We are going to save H + H, legislatively and financially.  The most important thing we can do is right here in Facility Based Collaboration Councils and the SWCC to increase Doctors Council member engagement in Quality Improvement.”

Presentation from Henry J. Carter, Drs. Bruno and Sur

Dr. Wilson remarked that in today’s meeting our purpose is  to understand where each of the FBCC’s are in their work  and determine what needs to be done.  “It is clear that our FBCC’s are beginning to go beyond the initial discussions and digging into improvement initiatives.”

Dr. Turkmen added that “it is evident that we are really listening to one another.”

Dr. Bruno opened the presentation on the progress at Henry J. Carter by stating that the doctors were very surprised at the low Press Gainey scores on communications with patients. In response, the FBCC members engaged in structured brainstorming around rounding and interventions to improve the content and frequency of information to patients’ families.  The facility is beginning its first PDSA cycle by using a “cheat sheet” with all patients and families to have consistent and thorough communication.  This is particularly important as patients may have different doctors caring for them over the course of their stay.  The AIM statement of the project is directly related to the Press Gainey scores.

After the presentation by the HJC FBCC, all participants in the SWCC broke into small groups to discuss progress at their facilities.  These small group discussions provide an opportunity for cross-facility learning.  Some of the highlights of these discussions are:

• Many projects are developing in the realm of improved doctor/patient communication
• Others are focused on improving wait times
• Another project will be to improve rate and accuracy of consent forms

Some important themes and successes emerged from these discussions, which include:

• Use of the IHI Open School mini-courses on developing AIM statements and the Divergent/Convergent exercise on brainstorming are aiding FBCC’s in the initiation of projects and starting PDSA cycles
• The best projects at this initial stage of our work are those which:
  • Are small in scale and scope
  • Are confronting issues that the doctors can actually impact directly
• Projects may begin to confront old ways of doing things and policies that cannot be changed. (e.g. patient scheduling) To make change, we are learning that “everything is on the table”.

The meeting concluded with plans to bring all SWCC and FBCC members together for a system-wide learning session.  All Collaboration Council members (administration and doctors), both on the SWCC and FBCC, are asked to SAVE the DATE of Tuesday, August 2^nd from 2-5 PM, with a social hour to follow at Baruch College.

NYC H + H and Doctors Council SEIU leaders look forward to supporting the work of all of our FBCC’s.  With deep collaboration and focus on jointly determined projects taking off… improvement is inevitable.