How to Make Positive Progress with Your Executive leadership: The Power of the P’sStephanie Van Zandt, MD, CHCQM-PHYADV Like many of you, I find myself amidst the chaos of a post-pandemic era, grappling with rising observation rates, soaring denials, challenging patient throughput, and scheming MA plans - issues plaguing health systems across the country. My executive leadership has made it very clear that our health system needs an all-hands-on-deck approach to address these challenges. Our primary objectives for this year are to achieve 3 short-term, immediate solutions, while also initiating 3 long-term strategies to right-size our length of stay and observation rates. Senior executives have enlisted the expertise of outside consultants and engaged various VPs and CMOs to champion pilots and projects. Occasionally, they remember to invite me or my clinical physician analyst to the meetings. (It’s not as if we haven’t been advocating the same message since before the pandemic.) As with most healthcare systems, our most significant deficiencies lie in the entrance and departure processes within our acute care space. Rectifying these transitions of care necessitates an upfront investment of resources to combat the utilization management nightmare we currently face. But when you don’t get a seat at the table, how can you ensure that your boots-on-the-ground, sage advice reaches the ears of the C-suite? The answer lies within the power of the Ps! First, it’s about PERSEVERANCE: recognizing that effectively conveying an impactful plan to your executive leadership is a long process filled with setbacks and disappointments. Resist the urge to succumb to despair when your polished presentation on observation solutions or proformas regarding the ROI of a physician advisor program gets derailed by irrelevant questions and sidelined. Stay determined and try again. Find the right audience who will appreciate and understand your message. Moving on to PURVIEW: Utilize your expertise to gain trust and influence. Find an analyst to help you leverage data and create metrics-driven action plans. Usually, data talks but if that does not work, then find a champion among the executive leadership who understands your message. Next is PERSUASTION: Keep reiterating your message and they may hear you after the third time! And proactively invite yourself to important meetings where you know your message needs to be heard. Leverage your champion to secure a seat at the table, if necessary. Moreover, PERCEPTION matters: Make sure you deliver transformative and relevant value. Be easily accessible and readily available. Aim to provide services to a wide range of stakeholders, making yourself indispensable so that they cannot operate without you. Collaborate with finance to establish a common ground for sharing information, allowing both parties to feel connected and aligned. Additionally, engage with managed care leadership during contract negotiations to advise on favorable language for avoidance of excess denials and readmission penalties. However, never lose sight of your primary team—the utilization review nurses and their leaders—together you can drive meaningful change. The key is to maintain a POSITIVE outlook despite the challenges and cut yourself a little slack. It’s important to occasionally take a moment to reflect on your accomplishments and ensure that executive leadership is aware of them. Remember, we are more than just a secondary review! Demonstrate your PASSION by emphasizing and showcasing your value as a skilled negotiator, analytics wizard, compliance expert, documentation and coding specialist, and educator. Above all, remember you are the only one who can truly determine medical necessity. And always bear in mind, the power of the Ps is at your disposal. Dr. Van Zandt is Medical Director Physician Advisor Services/Utilization Management/Complex Managed Care Denials at BayCare |