Episodios
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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.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior PrincipalPerformance Improvement ConsultingVizient
Guest:Michael StrileskySenior PrincipalCare Delivery TransformationStrategy ConsultingVizient
Show Notes:
[01:09] Current state of medical groups
[03:12] Issues around the surgical practice model
[05:01] Sustainability of the group practice model
[06:35] Finding a medical group strategy
Links | Resources:
To contact Modern Practice: [email protected]
Michael Strilesky’s email: [email protected]
“Grow hospital market share by integrating ambulatory care across acute service lines” (Vizient publication): Click Here
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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.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guest:Michael StrileskySenior PrincipalCare 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: [email protected]
Michael Strilesky’s email: [email protected]
“Grow hospital market share by integrating ambulatory care across acute service lines” (Vizient publication): Click Here
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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.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guest:Michael StrileskySenior PrincipalCare Delivery TransformationStrategy ConsultingVizient
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
Resources:
To contact Modern Practice: [email protected]
Michael Strilesky’s email: [email protected]
“Grow hospital market share by integrating ambulatory care across acute service lines” (Vizient publication): Click Here
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In this re-air of our two-part, award-winning podcast series, we discuss how physical violence in the healthcare workplace is on the rise. Healthcare workers are more in danger of violence than are police officers or prison guards. Looking at the labor force in general, healthcare workers have five times the likelihood of facing violence than workers across all other industries. And that doesn’t include the verbal abuse. Clinicians need skills to defuse conflict and hopefully settle down hostilities before they get out of hand. On this episode, Tomas and Cecilia finish their discussion with some helpful tips.
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] Influences and attitudes from culture/media
[02:45] The pandemic factor; example from CoxHealth
[04:45] Prevalence of incivility
[06:23] Paying attention to the signs; observation skills to use; actions to take
[09:30] Give the situation the same importance that patients and families give it
[10:16] Tools clinicians can use – Marpe’s role in alleviating violence
[12:05] A symptom of the healthcare crisis
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Cruz’s email: [email protected]
Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website: https://www.marpejourney.com/
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Hermes award-winner!
In a special re-air of this award-winning episode, we discuss how the hospital is increasingly becoming a hostile environment, with clinicians facing verbal abuse and physical violence from patients and their families. Clinicians need skills to defuse conflict and hopefully settle down hostilities before they get out of hand. If calming hostilities is not possible, they need to know what to do in the face of violent confrontation. Tomas discusses patient hostility with a leading expert on the topic.
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:
[02:15] Patient hostility on the rise
[03:16] Verbal violence is most prevalent, and the most unreported
[04:05] Cleveland Clinic: violence four times more prevalent in health care
[04:40] Health care workers more exposed than prison guards and police officers
[05:12] Higher risk of assaults for nurses
[05:59] Biggest risk in high-acuity settings – ambulances, EDs, ICUs, psych units
[06:44] Reasons/origins
[09:25] Patient families as source of conflict
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Cruz’s email: [email protected]
Dr Cruz’s Linkedin page: Cecilia Cruz - Founder and CEO - MARPE, LLC | LinkedIn
MARPE, LLC website: https://www.marpejourney.com/
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This episode of our award-winning podcast finishes our discussion on the state of research today. Despite proven benefits, enrollment in clinical trials is sparse across the country, but participation can positively impact patients and organizations alike. Two experts in research lay out all the facts.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guests:
Dylan Steen, MD, MSChief Executive Officer and Co-founderHigh EnrollCardiologist, UC HealthAdjunct Associate Professor, UC College of Medicine
Daniel Flora, MD, PharmDMedical Director, Oncology ResearchHematologist/OncologistSt. Elizabeth Healthcare
Show Notes:[01:32] Market research at St. Elizabeth Healthcare
[02:58] Benefits and advantages of clinical research to practices and organizations
[04:50] Background for High Enroll and the program’s value: opportunities offered
[06:20] Getting High Enroll started
[08:39] Vision for research at St. Elizabeth Healthcare – approaching a cure
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Steen’s email: [email protected]
Dr. Flora’s email: [email protected]
High Enroll website: https://www.highenroll.org
(513) 993-0330
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Despite proven benefits, enrollment in clinical trials is sparse across the country. This episode of our award-winning podcast continues our discussion on the state of research today and how participation can positively impact patients and organizations alike. Two experts in research lay out all the facts.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guests:Dylan Steen, MD, MSChief Executive Officer and Co-founderHigh EnrollCardiologist, UC HealthAdjunct Associate Professor, UC College of Medicine
Daniel Flora, MD, PharmDMedical Director, Oncology ResearchHematologist/OncologistSt. Elizabeth Healthcare
Show Notes:[01:31] Lack of inclusivity in trials – need for “real-world” participants
[04:05] Research organizations give standard of care that is lacking elsewhere
[04:50] Background for High Enroll and the program’s value: opportunities offered
[07:40] Latest generation of technology and information availability
[08:20] Improvement over other research sites (such as clinicaltrials.gov)
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Steen’s email: [email protected]
Dr. Flora’s email: [email protected]
High Enroll website: https://www.highenroll.org
(513) 993-0330
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The truth is: patients enrolled in clinical trials fare better than patients who are not. Participating in research can be a boon to a practice or organization and its patients. Yet, enrollment in clinical trials is still sparse across the country and part of the reason is organizations don’t realize the value research can bring. On the next three episodes of this award-winning podcast, two experts in research lay out the benefits in participating in clinical trials.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guests:Dylan Steen, MD, MSChief Executive Officer and Co-founder High EnrollCardiologist, UC HealthAdjunct Associate Professor, UC College of Medicine
Daniel Flora, MD, PharmDMedical Director, Oncology ResearchHematologist/OncologistSt. Elizabeth Healthcare
Show Notes:
[02:16] Research marketing
[03:20] Background: how High Enroll got started
[04:05] Number one problem in research
[05:20] Problem is still unsolved
[07:07] Need for cancer research at community level
[08:18] Look at research as a valuable product for the organization/practice
[09:03] Moving medicine forward: the value of clinical trials to the patient
[09:52] How to boost research participants for an organization
Links | Resources:
To contact Modern Practice: [email protected]
Dr. Steen’s email: [email protected]
Dr. Flora’s email: [email protected]
High Enroll website: https://www.highenroll.org
(513) 993-0330
Subscribe Today!Apple PodcastsAmazon PodcastsAndroidSpotifyRSS Feed
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On this episode of our award-winning podcast, we continue discussing the impact and benefits of the latest generation of single-use endoscopes, which promise a revolutionary role in surgery.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guest:Andrew Bruenderman, MHACategory ManagerSurgical ServicesVizient
Show Notes:[00:44] Circumstances calling for single-use scopes[03:19] Financial considerations[04:37] ROI possibilities[06:05] Environmental impact[07:17] Final thoughts to consider
Resources:To contact Modern Practice: [email protected]
Andrew’s email: [email protected]
Vizient TechWatch article on single-use ureteroscopes:Vizient TechWatch Medical Device Vol. 3 (Single-Use Ureteroscopes).pdf
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The latest generation of single-use endoscopes promises a revolutionary role in surgery. On this episode of our award-winning podcast, we discuss the impact and benefits of single-use ureteroscopes.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guest:Andrew Bruenderman, MHACategory ManagerSurgical ServicesVizient
Show Notes:[01:48] Early models were lacking; new models are advanced and improved[02:49] Cross-contamination and adverse events from multiuse scopes[04:15] Safety approaches with single-use scopes[05:21] Wave of the future?[06:20] Shelf life of single-use ureteroscopes and associated efficiencies[07:37] Problems with early models may cause reluctance to use later models
Resources:To contact Modern Practice: [email protected]
Andrew’s email: [email protected]
Vizient TechWatch article on single-use ureteroscopes:Vizient TechWatch Medical Device Vol. 3 (Single-Use Ureteroscopes).pdf
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On this episode, we finish the discussion about the challenges and issues involving documenting elective surgeries in order to improve care and maximize reimbursement.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guests:Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting Director, Clinical Documentation ImprovementVizient
Show Notes:[00:37] Anticoagulation – often overlooked in documentation[01:30] PSI 9[02:20] Thrombocytopenia[03:57] Antiplatelets and elective surgeries [05:56] Every PSI reported means money lost to the practice
Links | Resources:
To contact Modern Practice: [email protected]
Rachel Mack’s email: [email protected]
“Costs of Postoperative Sepsis: The Business Case for Quality Improvement to Reduce Postoperative Sepsis in Veterans Affairs Hospitals” (JAMA): Click Here
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This episode continues the series on challenges and issues involving correctly documenting elective surgeries. A leading expert provides practical guidance and considerations that enable you to be correct in documenting these patients in order to improve care and maximize reimbursement.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guests:Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRCConsulting Director, Clinical Documentation ImprovementVizient
Show Notes:
[00:34] Dealing with preoperative infections
[01:56] Percentage of elective surgery patients who develop sepsis—with 25% mortality
[03:45] Accurately coding to avoid a PSI 13 being charged to your practice/organization
[05:34] Do not miss a Present on Admission case
[07:30] Need for CDI specialists to collaborate with quality (the “dotted line”)
[08:50] Issues around PSI 7
Links | Resources:
To contact Modern Practice: [email protected]
Rachel Mack’s email: [email protected]
“Costs of Postoperative Sepsis: The Business Case for Quality Improvement to Reduce Postoperative Sepsis in Veterans Affairs Hospitals” (JAMA): Click Here
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Elective surgeries are on the rise again following a downswing during the COVID era. Yet, with this rise in these procedures, there are challenges and issues involving correctly documenting elective surgeries that practices and organizations need to consider and address. On this episode, a leading expert on clinical documentation covers this difficult area.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Performance Improvement Consulting
Vizient
Guests:
Rachel Mack, MSN, RN, CCDS, CDIP, CCS, CRC
Consulting Director, Clinical Documentation Improvement
Vizient
Show Notes:
[01:21] Planned surgeries
[02:26] Five most common elective surgeries and who has them
[04:15] Why elective surgeries are unique
[05:44] What you need to document – examples
[09:13] Obesity and documentation—capturing a CC
Links | Resources:
To contact Modern Practice: [email protected]
Rachel Mack’s email: [email protected]
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A safe culture is a key factor in developing a highly reliable organization, or HRO, and ensuring a healthy workplace. It means fostering psychological safety in that culture. On this episode, we continue our discussion on psychological safety and a healthy workplace.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guests:Kristina Kelada, PHR, CHRE, CHRSAssociate Principal, Reliability and Management SystemsVizient
Elizabeth Mack, MD, MSPrincipal, Reliability and Management SystemsVizient
Show Notes:[00:47] Psych safety and fostering recruitment and retention[03:33] What to do to develop safety in the workplace[04:35] Culture of safety and return on investment: what the data shows[06:17] Bad culture: a “thief in the night”[09:09] Design systems that make sense for patients and families
Links | Resources:How to interpret and use your SCORE survey results (Safe and Reliable Healthcare): SCORE Interpreting and Using Results
To contact Modern Practice: [email protected]
Dr. Mack’s email: [email protected]
Kristina Kelada’s email: [email protected]
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A healthy culture is a key factor in developing a highly reliable organization, or HRO. For a culture to be healthy depends on the existence of psychological safety in that culture. In this new series of our award-winning podcast, we discuss how to develop a healthy workplace as we continue our examination of HROs and the practices that lead to them.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guests:Kristina Kelada, PHR, CHRE, CHRSAssociate Principal, Reliability and Management SystemsVizient
Elizabeth Mack, MD, MSPrincipal, Reliability and Management SystemsVizient
Show Notes:[02:28] Importance of building a culture on trust and respect[03:38] Psych safety defined[05:30] It is dangerous when employees are quiet[07:18] How to know you have psych safety in your practice[09:19] What leaders can do[10:14] We’re in healthcare, for goodness sakes!
Links | Resources:How to interpret and use your SCORE survey results (Safe and Reliable Healthcare): SCORE Interpreting and Using Results
To contact Modern Practice: [email protected]
Dr. Mack’s email: [email protected]
Kristina Kelada’s email: [email protected]
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On this episode, we continue our discussion about the need to provide a transition for advanced practice providers (APPs – nurse practitioners, physician assistants) from the academic setting to clinical practice, similar to the residencies and fellowships provided to physicians. You’ll learn how this transition can be a huge benefit to your practice or organization.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guest:Christen Hunt, DNP, FNP-C, CPNP-ACAssociate Vice President, Workforce ConsultingVizient
Show Notes:[00:41] Fitting organizational needs – no cookie-cutter[02:25] Provide a safe space; provide what the organization needs[03:37] Not a burden but an opportunity [04:42] Bringing APPs fully into the organization for greater productivity[05:51] Example: ROI and a cost avoidance of over $2 million[06:52] More ROI examples
Links | Resources:
To contact Modern Practice: [email protected]
Christen Hunt’s email: [email protected]
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Advanced Practice Providers, or APPs, have taken on an increasingly important role in patient care over the years. Comprised of nurse practitioners and physician assistants, APPs receive advanced education and clinical training for performing a wide range of care services, many of which were traditionally carried out by physicians. Yet, there are no residencies or fellowships to transition APPs from the academic to the clinical realm. On the next two episodes, this award-winning podcast examines how organizations and practices can address this gap.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Performance Improvement ConsultingVizient
Guest:Christen Hunt, DNP, FNP-C, CPNP-ACAssociate Vice President, Workforce ConsultingVizient
Show Notes:
[02:02] Residencies and fellowships and what they mean for APPs
[04:41] APPs and orientation – need for a deeper dive
[05:13] Growth of APP positions and necessity for new care models
[06:44] Fostering the business side of healthcare
[07:14] Integrating APPs into the team
[08:13] Bringing APPs into the culture
Links | Resources:
To contact Modern Practice: [email protected]
Christen Hunt’s email: [email protected]
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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.
Moderator: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: [email protected]
Vizient Safe and Reliable Healthcare site Click here
Suzanne’s email: [email protected]
Katerie’s email: [email protected]
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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.
Moderator: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: [email protected]
Vizient Safe and Reliable Healthcare site Click here
Suzanne’s email: [email protected]
Katerie’s email: [email protected]
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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.
Moderator: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: [email protected]
Vizient Safe and Reliable Healthcare site Click here
Suzanne’s email: [email protected]
Katerie’s email: [email protected]
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