Managing Physician Performance

1
Managing Physician Performance

• An online physician evaluation tool
• Leeor Sommer CCFP(EM)
• St Josephs Health Centre, Toronto

2
Disclosure
? I do not have an affiliation (financial or
otherwise) with any commercial organization that
may have a direct or indirect connection to the
content of my presentation.
3
My Work Environment

• Honestly, I think, the most functional and
  supportive ED in the country.
• NO workplace is without its problems
• Everything can be improved!

4
The Real Issue

• To identify problem behaviours in individuals
  conduct
• Communicate them to the physician in a
  non-threatening manner

5
The solution

• Behaviour change through peer evaluations
• Gathering data from peers in an anonymous manner
• Compilation of data into useful report
• Maintain anonymity of respondents
• Provide comprehensive feedback to individual
  physicians
• Secondary goal - professional development

6
The Questions

• Questions designed to address areas that we felt
  required review or improvement
• 24 questions
• Written by and reviewed by the EP group
• Dynamic and malleable
• 7 point scale comments field
• Simple and pointed
• Directed specifically to physician behaviours
• NOT humanistic properties, personal attributes...
  etc

7
The Questions

• Up to date medical knowledge.
• Promotes patient satisfaction.
• Sharing With Colleagues
• Shares when slow
• Calls for help when appropriate
• High quality handovers
• No room blocking in Ambulatory
• Communicates during shifts for work flow
• Reliable call-ins and start times
• Appropriate departure times
• Keeps office tidy
• Promotes patient flow.
• Prompt reassessments.
• Avoids unnecessary tests.
• Takes initiative to get equipment fixed, supplies
  re-stocked, rooms cleaned.
• Teaching students, residents, colleagues.
• Departmental contributions audits, clinical
  days, hospital committees, research, projects
  etc.
• Charts legibility and usefulness.
• Overall evaluation and comments.

8
(No Transcript)
9
Gathering data

• Anonymity key
• Specifically requested that physician be
  brutally honest

10
Complete data set

• All fields in form must be completed for data to
  be accepted
• Small group of physicians (12 FT 5 PT)
• Need as many data points as possible to get
  useful info and maintain anonymity
• Self assessment also requested
• Allowed comparison of physician self perception
  to group highlighted disconnects
• Important that all physicians have their say
• Policing completion of surveys can be onerous!

11
(No Transcript)
12
Technical stuff

• Website hosted on private site
• Webpage written in html/ASP
• Data captured in MySQL database (hosted online)
• Data exported to MS Access
• Final reports and queries generated in MS Access

13
Final reports

• Data presented numerically
• Self assessment, peer assessment, dept mean
• Qualitative fields scrambled from question to
  question to maintain anonymity
• Data also represented graphically

14
(No Transcript)
15
Graphically
16
Does it work?

• Anecdotally, absolutely!
• No hard numbers to back this claim up (yet!)
• Maybe through repeat evaluation
• Maybe through physician self assessment
• Much of this will be hard to define

17
The future

• Input from other sources
• True Multisource Feedback (360)
• From RNs
• Cognitive skills
• Manual skills
• Interpersonal relations
• Teamwork
• Department management

18
The future

• Input from consultants
• Patient treatment
• Referral pattern
• Collegiality

19
Summary

• Identify problem behaviours and allow them to be
  opportunities for positive change.
• Peer evaluation is an effective tool in doing so
• Online, SIMPLE, format
• Anonymous output
• Potential for extensive future growth and
  application

20
Thank You

• Questions?

l.sommer_at_utoronto.ca