This episode of our award-winning podcast concludes our discussion on a new approach for medical groups in this time of drastic change. Only those models undergoing change will succeed.   Host:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient   Guest:Michael StrileskySenior Principal, Care Delivery TransformationStrategy ConsultingVizient   Show Notes: [01:11] Academic medical centers and the need for innovation [02:46] Meeting the physician shortage challenge [04:51] Resistance to a new care model [06:23] Reimbursement, technology and consumer desires will drive the new model [07:06] The physician compensation factor in the new model   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Michael Strilesky’s email: michael.strilesky@vizientinc.com “Grow hospital market share by integrating ambulatory care across acute service lines” (Vizient publication): Click here   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

All the drastic changes occurring in healthcare, particularly in the way it is delivered, necessitate corresponding changes in how we structure medical groups. This episode of our award-winning podcast continues the discussion on the need for a new strategy for medical groups, and an expert returns to consider what that strategy might be.   Host:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient   Guest:Michael StrileskySenior Principal, Care Delivery TransformationStrategy ConsultingVizient   Show Notes: [01:11] Academic medical centers and the need for innovation [02:46] Meeting the physician shortage challenge [04:51] Resistance to a new care model [06:23] Reimbursement, technology and consumer desires will drive the new model [07:06] The physician compensation factor in the new model   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Michael Strilesky’s email: michael.strilesky@vizientinc.com “Grow hospital market share by integrating ambulatory care across acute service lines” (Vizient publication): Click here   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

The huge flurry of changes in how we deliver healthcare have brought into question the viability of the conventional medical group model, whether it’s sustainable and gives us a competitive advantage or whether we need to invest in something else. On the next three episodes of this award-winning podcast, an expert joins Tomas to consider the future of medical group practices.   Host: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Performance Improvement Consulting Vizient   Guest: Michael Strilesky Senior Principal, Care Delivery Transformation Strategy Consulting Vizient   Show Notes: [01:46] Current medical group model [02:58] Impact and role of medical groups [04:12] Drawbacks and limitations of current model [06:13] Different care and practice models emerging [07:49] The disruptors have been fantastic [09:47] Different approach for medical groups affiliated with academic medical centers   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Michael Strilesky’s email: michael.strilesky@vizientinc.com “Grow hospital market share by integrating ambulatory care across acute service lines” (Vizient publication): Click here   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

On this final episode of a three-part series, Tomas finishes his discussion with two experts on high-reliability organizations who examine the crucial role of learning areas in the success of top performers. High-performing organizations take care of not only their patients but their staff and indeed enable staff to be at their best.   Host:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient   Guests:Suzanne Miller, MSN, RNSenior Consulting Director, Reliability and Management SystemsVizient   Katerie Chapman, MHASenior Principal, Safe and Reliable HealthcareVizient   Show Notes: [00:54] Need for change-ready units in the organization [01:32] Overcome the perception “this is one more thing” [03:17] Example: skeptical ICU nurse – “This is going to fail” [04:56] Taking a phased approach [05:37] Measuring success of learning areas: the benchmarks to use 06:22] Excited staff members   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Vizient Safe and Reliable Healthcare site: Click here Suzanne’s email: suzanne.miller@vizientinc.com Katerie’s email: katerie.chapman@vizientinc.com   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

On this episode, Tomas continues his discussion with two expert guests about learning areas and how they are proving effective and essential in developing high-reliability organizations.   Host:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient   Guests:Suzanne Miller, MSN, RNSenior Consulting Director, Reliability and Management SystemsVizient   Katerie Chapman, MHASenior Principal, Safe and Reliable HealthcareVizient   Show Notes: [00:41] Who engages in learning areas? [03:17] A flood of kudos in the ED – an example of lifting morale [05:10] Team participation in barcode scanning – an example of improving compliance [07:02] A resource for senior leaders [07:55] A safety concern that, once identified, was quickly corrected [08:44] Real-time nature of rounding and issue resolution   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Vizient Safe and Reliable Healthcare site: Click here Suzanne’s email: suzanne.miller@vizientinc.com Katerie’s email: katerie.chapman@vizientinc.com   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

Learning areas have become an effective aspect of high-reliability organizations in healthcare. Employing floor or departmental huddles as the focal point for these learning areas, the experience of the huddles has been augmented and reinforced by bulletin boards and whiteboards. Even more effective is the newest wrinkle in the experience – LENS (Learning & Engagement System) boards, which are dynamic, digitally-based visual boards that can transmit messaging on a 24/7 basis in a designated learning area. On the next three episodes, Tomas discusses learning areas with two expert guests, who will share the rationale behind them and how to make them work for you.   Host:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient   Guests:Suzanne Miller, MSN, RNSenior Consulting Director, Reliability and Management SystemsVizient   Katerie Chapman, MHASenior Principal, Safe and Reliable HealthcareVizient   Show Notes: [01:58] Developing and sustaining learning areas [03:02] Elements employed in a learning area [05:00] The cornerstone of high reliability [06:07] The visual management role [07:37] Advantages of the LENS board [09:07] Selecting a unit to be a learning area   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Vizient Safe and Reliable Healthcare site: Click here Suzanne’s email: suzanne.miller@vizientinc.com Katerie’s email: katerie.chapman@vizientinc.com   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

The healthcare workforce is in a state of crisis: shortages of healthcare workers, rampant burnout, schedules in flux and outbreaks of violence in the workplace. On this episode, Tomas continues his discussion with a leading expert on the healthcare workforce on steps organizations can take to alleviate this crisis. Host:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient   Guests:Eric Burch, MBA, RN, FACHEExecutive Principal, Operations and Workforce ServicesVizient   Show Notes: [00:32] Need for collecting and leveraging data [02:12] Reflecting the community in recruiting and retention [03:28] Addressing regulatory issues [06:10] Unions [07:06] Taking the pulse [07:35] Expanding the pipeline [09:23] Fostering wellness and resilience [10:52] Short- and long-term strategies   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Eric’s email: eric.burch@vizientinc.com   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

Before the Covid outbreak, the healthcare workforce was already in a state of crisis. Covid made it much worse. On this new series of our award-winning podcast, we examine the varied causes behind workforce challenges and shortages of nurses, physicians and other related disciplines. We’ll also explore steps we can take to alleviate this crisis. Joining is us a leading workforce expert to provide an overview.   Host:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient   Guests:Eric Burch, MBA, RN, FACHEExecutive Principal, Operations and Workforce ServicesVizient   Show Notes: [01:21] The workforce issue and the pandemic [02:04] Drivers of the crisis [04:19] Changing the traditional model [05:48] Potential technology role in alleviating the crisis [08:47] Recruitment and retention approaches [11:22] Leadership and retention   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Eric’s email: eric.burch@vizientinc.com   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

On this episode, Dr. Tomas Villanueva and a leading clinical documentation expert finish their discussion on the need to correctly document everything involving spial surgery. Spinal surgery represents a complex challenge for documentation specialists and clinicians alike, and this episode will clear up what is needed to be successful in coding and documenting these procedures.   Host:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient   Guest:Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting Director, Clinical Documentation ImprovementVizient   Show Notes: [00:31] Query opportunities and low-hanging fruit [01:53] Blood loss and the whole clinical picture in querying [02:50] Using that “magic word” can make a difference – coding to an MCC [03:43] Other query opportunities [10:36] When the documentation is wrong [12:44] Reconciliation and feedback needed   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Rachel Mack’s email: rachel.mack@vizientinc.com   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

On this episode, Dr. Tomas Villanueva continues his discussion with a leading clinical documentation expert on the need to correctly document everything involving spial surgery. Spinal surgery represents a complex challenge for documentation specialists and clinicians alike.   Host: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient   Guest: Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC Consulting Director, Clinical Documentation Improvement Vizient   Show Notes: [00:41] Rise in spinal surgeries [01:23] Coding challenges and parameters [01:53] Predicaments for coding and CDI specialists [07:22] Common DRGs for spinal surgeries – the need to use the “magic words”   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Rachel Mack’s email: rachel.mack@vizientinc.com   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

Spinal surgery represents a complex challenge for clinical documentation. Difficult to code and representing query situations that can be demanding, this is the area of focus for this episode of Modern Practice. Joining Dr. Tomas Villanueva is a leading expert returning to the podcast to talk about the challenges of spinal surgery documentation.   Host:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient   Guest:Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting Director, Clinical Documentation ImprovementVizient   Show Notes: [01:26] Around 1.62 million procedures per year [02:22] Procedures on the increase (2.4 times the level of 15 years ago) [03:54] The most common spinal diagnoses [05:15] Often not caught by primary care [06:20 Less common reasons for spinal surgery [07:09] Reasons for planned surgeries—often a last resort [08:45] Risks for avoiding surgery   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Rachel Mack’s email: rachel.mack@vizientinc.com   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

Years of medical school, residency and fellowships have proven to do little in teaching physicians how to care for themselves. Physician burnout is at an all-time high. On this episode, a physician who is a leading expert on physician stress discusses how to improve mental fitness in those who’ve given their lives to the care of others.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient Guest:Cecilia Cruz, MD, MPH, CPCC, ACCFounder and Chief Executive OfficerMarpe, LLCBoard-certified emergency medicine physicianFormer co-chair of QualityDivision of Emergency MedicineNorthShore University HealthSystem   Show Notes: [00:34] Physician suicide [02:44] Need connection [04:03] What organizations need to do [06:20] A learned skill and resource [06:37] Mental fitness [08:20] The Marpe approach   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. Cruz’s email: ceciliacruz@marpejourney.com Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn MARPE, LLC website: https://www.marpejourney.com/   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed        

This episode of our award-winning podcast continues the discussion on why mental fitness is so crucial for physicians and other clinicians today and yet is a concept that physicians still tend to avoid or downplay. Physician training and medical school have not helped. Join us for this gritty discussion.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalClinical Operations and QualityVizient Guest:Cecilia Cruz, MD, MPH, CPCC, ACCFounder and Chief Executive OfficerMarpe, LLCBoard-certified emergency medicine physicianFormer co-chair of QualityDivision of Emergency MedicineNorthShore University HealthSystem   Show Notes: [01:00] The in-box, EMR documentation and authorizations have only gotten worse [01:40] If we don’t change, it’s all going to fall apart [03:23] Examples from medical school and training—a lack of respect [06:45] The EMR and the need for a 27-hour day [08:05] Deficit of 40,000 primary care physicians by 2030 (AAMC) [08:30] Emerging mental health issues and workplace violence   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. Cruz’s email: ceciliacruz@marpejourney.com Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn MARPE, LLC website: https://www.marpejourney.com/   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed    

Though physicians spend years in medical school, residency and fellowships to learn how to care for patients, they spend little time learning how to care for themselves. Physician burnout, leading to physician turnover, is skyrocketing. On this episode, a physician who is a  leading expert on physician stress, having gone through that stress herself, discusses how to improve mental fitness in those who’ve given their lives to the care of others.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient   Guest:Cecilia Cruz, MD, MPH, CPCC, ACCFounder and Chief Executive OfficerMarpe, LLCBoard-certified emergency medicine physicianFormer co-chair of QualityDivision of Emergency MedicineNorthShore University HealthSystem   Show Notes: [01:10] Physician heal thyself? Not happening! [02:35] Weakness means not being the best [03:31] An ingrained culture of perfectionism [04:20] The burnout crisis [06:40] Physician types affected the most [07:30] Bigger burden on specialists [09:13] Overcoming – awareness is only 20% of progress   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. Cruz’s email: ceciliacruz@marpejourney.com Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn MARPE, LLC website: https://www.marpejourney.com/   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

On this episode of our award-winning podcast, Dr. Tomas Villanueva concludes his discussion on how organizations can approach quality metrics today – what metrics to choose and how to apply them.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient   Guest:Rick May, MDSenior Principal, Consulting SolutionsVizient   Show Notes: [00:38] The burden of reporting [02:09] Surgical quality and outcomes – technical vs. medical [03:41] A focus on the systems [05:00] Systems changes and results [05:42] Engaging the physicians   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. May’s email: rick.may@vizientinc.com   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

On this episode of our award-winning podcast, Dr. Tomas Villanueva continues his discussion on how organizations can approach quality metrics today – what metrics to choose and how to apply them.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient   Guest:Rick May, MDSenior Principal, Consulting SolutionsVizient   Show Notes: [00:54] Importance clinical documentation [02:40] Is it possible to eliminate all CLABSIs (or other infections)? [04:40] Length of stay as quality metric [05:10] Surgical complications and length of stay [05:55] Length of stay and complication rates [06:40] The most heavily weighted metric   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. May’s email: rick.may@vizientinc.com   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

Concerning quality measures in healthcare organizations, a common complaint is, “I've got so many people looking over my shoulder, pulling our data in, ranking me, rating me, everything else, and there is no way I can keep track of literally the hundreds of metrics for which we’re accountable.”   On this episode of our award-winning podcast, Dr. Tomas Villanueva welcomes back a leading quality expert to discuss how organizations can approach quality metrics today – what metrics to choose and how to apply them.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient   Guest:Rick May, MDSenior Principal, Consulting SolutionsVizient   Show Notes: [01:49] Why measuring quality is crucial [02:17] If you do quality well, financial success follows [02:57] Quality attracts staff [03:46] Has quality improved overall in healthcare? [04:42] Choosing the right metrics – 500 metrics exist overall [05:58] Mishmash in timing of measures – complex and “all over the map” [08:03] Realistic rate of improvement (hint: it’s not 10%!) [08:53] Impact of under-capturing documentation   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. May’s email: rick.may@vizientinc.com   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

This episode of the award-winning podcast examines the importance of risk adjustment. Dr. Tomas Villanueva leads the discussion on the impact of this crucial aspect of documentation that can affect hospital outcomes.   Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient   Guest: Erica Braun, MS, RN, CCDS Senior Consulting Director, Clinical Documentation Improvement Vizient   Show Notes: [01:29] Defining risk adjustment – maintaining an apples to apples comparison [02:41] Capturing comorbid conditions to the highest level of specificity [04:08] Capturing the low-hanging fruit [05:47] Case mix index issues [07:44] Severity of illness and risk of mortality [08:52] Addressing query fatigue   Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Erica Braun’s email: erica.braun@vizientinc.com   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

Screening for colorectal cancer (CRC) has seen a lot of innovations, but there is still the conventional gold standard. On this episode of our award-winning podcast, Dr. Tomas Villanueva welcomes Dr. Aziz Aadam to discuss the need for early colorectal cancer (CRC) detection, and the options available to patients.   Moderator: Tomas Villanueva, DO, MBA, FACPE, SFHM Senior Principal, Clinical Operations and Quality Vizient   Guest: Abdul Aziz Aadam, MD Interventional Gastroenterologist Director, Interventional Endoscopy Medical Director, International Patient Services Northwestern Medicine   Show Notes: [01:05] CRC screening options [02:40] Colonoscopy advantages and disadvantages [03:35] Virtual colonoscopies [04:14] Artificial intelligence enhancement [04:54] Improvements in the future [07:10] No tests are foolproof [07:50] Need to improve access   Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. Aadam’s email: abdul.aadam@northwestern.edu   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed

In this episode of the award-winning podcast Dr. Tomas Villanueva welcomes Dr. Aziz Aadam to discuss the need for early colorectal cancer (CRC) detection, which drastically increases the rate of survival, and how improvements in CRC screening are giving patients better options.   Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient   Guest:Abdul Aziz Aadam, MDInterventional GastroenterologistDirector, Interventional EndoscopyMedical Director, International Patient ServicesNorthwestern Medicine   Show Notes: [01:11] Endoscopic submucosal dissection [02:10] Prevalence of colorectal cancer [02:38] Risk factors [05:10] Reason for the need of early detection [06:35] Challenges for screening [07:56] Rise in younger patients [09:11] Screening of the elderly [09:54] Increasing screening rates [11:09] Additional screening options   Links | Resources: To contact Modern Practice: modernpracticepodcast@vizientinc.com Dr. Aadam’s email: abdul.aadam@northwestern.edu   Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed