Emergency Department Directors Academy Phase I …...Emergency Department Directors Academy Phase I...

Emergency Department Directors Academy Phase I Fall 2019 New Physician Recruiting and Orientation DESCRIPTION Does your system consist of a) "You want to interview, OK come see me during my shift tomorrow" b) “Now that you have completed the tour, here is a copy of the chart. Good luck!"? The presenter will describe the successful and effective recruitment and orientation processes to ensure success. Successful recruitment requires an elaborate organization of reviews and interviews and a thorough understanding of the candidate’s capacity and aspirations. Effective orientation incorporates substantial exposure to the EDs processes, policies, support systems, and operations prior to beginning clinical activities. The participant will be given a case study guidebook to help you develop orientation materials for your own emergency department. OBJECTIVES

• Develop and implement an effective recruitment process. • List necessary recruitment reviews and interviews. • Explore candidate’s capacity and aspirations. • List necessary components of practitioner orientation. • Design orientation checklists and materials. • Define and give examples of physician orientation plans. • New Physician Recruiting and Orientation

11/11/2019, 12:30 PM - 1:30 PM FACULTY: Stewart Ross Coffman, MD, FACEP BIOGRAPHY: Dr. Coffman attended the California State Polytechnic University and the Universität Tübingen, in Tübingen, Germany, majoring in Microbiology. He attended Baylor College of Medicine in Houston, Texas and graduated with his medical degree in 1991. After completing an internship in Internal Medicine at Baylor, he headed to California to finish his residency in Emergency Medicine at UC San Diego. Dr. Coffman joined the faculty at UT Southwestern Medical School in Dallas as they began their Emergency Medicine Residency program in 1995. Questcare Medical Services started up in 1997. In addition to the full-time practice of emergency medicine, he took on various leadership roles over the next 18 years including Questcare Partners Chief Medical Officer and President of Questcare DFW EM before the company’s acquisition by Emcare in 2015. Dr. Coffman attended UT Dallas and received his MBA with a focus in Healthcare Management in 2010. Dr. Coffman is the EMS Medical Director for the Lewisville Fire Department as well as the Public Health Officer for the City of Lewisville. He has served as Medical Director and Tactical Physician for the FBI in Dallas/Fort Worth for 20 years and is attached to the DFW FBI Healthcare Fraud Unit. Dr. Coffman now serves Envision as Senior Vice President for the Questcare Operating Unit. DISCLOSURE: (+) No significant financial relationships to disclose

Stewart Coffman, MD, MBA, FACEPEmergency Department Directors Academy

New Physician Recruiting and Orientation

What do you want as a Medical Director?

• Fill a staffing hole• Hire the Best and Brightest• Hire ‘B’ team player…get ‘B’ team

results.

Recruiting

Recruiting…and Retention

• It takes you away from your FAMILY!• It takes your TIME!• It costs MONEY!• It causes MANAGEMENT ISSUES!

25

By the numbers…

• 25% of newly hired physicians leave within 3 years

50

By the numbers…

• 25% of newly hired physicians leave within 3 years• 50% of physicians list “poor cultural fit” as their reason for voluntary

separation

72

By the numbers…

• 25% of newly hired physicians leave within 3 years• 50% of physicians list “poor cultural fit” as their reason for voluntary

separation• 72% of the physicians that put geography first start looking for a new

job within 2 years

400,000

By the numbers…

• 25% of newly hired physicians leave within 3 years• 50% of physicians list “poor cultural fit” as their reason for voluntary

separation• 72% of the physicians that put geography first start looking for a new

job within 2 years• Each departure costs ~ $400,000*

*NEJM Career Center, Jan/Feb 2015; “The Staggering Costs of Physician Turnover.”

Where to now?

Finding the perfect fit…

How do you spot the ‘A’ team?

Successful Recruiting

• Robust hiring process• Communicate Mission, Vision, Values early• Consider cultural fit throughout process• Use Behavioral Based interviewing to bring out misalignment• Recruiting should flow seamlessly into onboarding

Cultural fit- What are you really looking for?

• Long term player• They add value• Team player• Quick learners• They don’t add

management work• Responsive*• Follow through*• Humble• Coachable

Behavioral Based Interviewing• Behavioral competencies critical in excelling in

a particular position

• Important in jobs that have high turnover and costs

• Time consuming• Takes practice

• Select questions based upon most important characteristics you’re recruiting for:• Patient-centered care• Clinical quality• Collaboration and communication• Flexibility• Create a positive environment

Patient-centered care

Advisory Board Behavioral-Based Interviewing Toolkit

Clinical quality

Advisory Board Behavioral-Based Interviewing Toolkit

Collaboration and communication

Advisory Board Behavioral-Based Interviewing Toolkit

Flexibility

Advisory Board Behavioral-Based Interviewing Toolkit

Create a positive environment

Advisory Board Behavioral-Based Interviewing Toolkit

Come on down…

Medical Directors

• Participate in recruiting process• Introduce orientation and onboarding

program • Identify mentor• Schedule check-ins with new hires within

30 days of start• Identify and groom young stars for

leadership • Conduct exit interviews to assess for issues

Orientation and Onboarding

Onboarding- Mechanism through which new employees acquire necessary knowledge, skills, and behaviors to become successful employees

Orientation- Part of the onboarding process in which new employees are introduced to coworkers and receive information about topics such as working hours, performance standards, company benefits, IT systems, billing, and their specific facilities

Orientation and Onboarding

Shadow shift• Combine with facility orientation• Familiarize the new provider with ED processes

and nuances• Observational only without direct patient

interaction

Orientation shifts• Time spent as additional provider• Must have clinical privileges and IT access• Schedule alongside MD or AMD• Takes patients, makes dispositions, not

responsible for patient flow• Schedule 2 orientation shifts prior to 1st regular

shift

Orientation and Onboarding• Orientation Checklist• Ensures comprehensive orientation

• EMTALA• Key quality initiatives• Patient experience expectations• Productivity and metrics• Landmines?• Documentation• APP supervision• Scribe efficiency• Workflow efficiency

• Memorializes completion in case of future “issues”• Facility Handbook• Hardcopy of facility nuances• Virtual “Phone a friend”

Physician Mentors

Exchange CVs

Contact info

Clear mentor expectations r.e. touch points (7, 30, 60, 90, 90+ days)

Suggested mentor criteria:

• 2 years experience at the facility• Excellent job performance• Strong interpersonal skills• Role model • Committed to mentor role

Putting it all together…

Robust hiring process…think retention now!

Communicate Mission, Vision, Values early

Is this physician a good fit?

Use Behavioral-Based interviewing to bring out misalignment

Recruiting should flow seamlessly into onboarding

Comprehensive Onboarding

Facility Orientation with ChecklistShadow Shift & Orientation ShiftsFacility HandbookMentor program

Questions

New Physician Recruiting and Orientation