Acute Care Chief Medical Officer Updates
In my last Physician Source letter, I spoke about thankfulness for what has been. This January, I would like to focus on what lies ahead for 2022. While January has been one of the most challenging months in healthcare I have ever seen, it looks like we are “over the hump” with Omicron. I continue to be amazed at how physicians, APCs, nursing, ancillary staff, and ThedaCare Administration/Executives pull together to assure we can care for our patients.
One exciting innovation that came out this month is virtual triage in our CAH EDs. One week from concept to going live at ThedaCare Shawano is an amazing accomplishment! We are now live at TCS, TCW, TCNL with plans to go lie at TCB and TCWR imminently. We are also working through the opportunity to offer this service at TCA and TCN. Briefly, once a patient is registered in the ED, they will either be taken back to the ED if emergent need exists or guided to an iPad with a virtual APC or physician who will complete the requisite Medical Screening Exam. The four potential outcomes of this encounter would be patient taken back to ED emergently, complete a tele-health encounter with prescribed therapeutic and discharge to home, be directed to a lower level of care (urgent care, primary care office, respiratory HUB, etc.) or if they do need to be seen in the ED for a lower acuity complaint, initial workup orders can be placed which will facilitate assessment and treatment decisions once they are taken back to the ED. There are many additional benefits to using this tool beyond just surge mitigation and will keep everyone informed as we learn more!
Unfortunately, our Greeley Bylaws work had to be postponed this month but we will be looking to reschedule in March. We will start with creation of System Bylaws (including conversation around a System Credentialing Committee) and then proceed with review of individual site Rules and Regulations. Greeley has completed their review of the Medical Staff Services Department and appreciate all the leaders who participated in interviews.
Finally, I wish to share some good news! Since coming to ThedaCare nearly 2 years ago, I have partnered with the CAH Medical Directors. Their leadership was critical in navigating the ever-changing strategies around COVID mitigation for ThedaCare. They have all worked tirelessly in assuring the highest standard of care is delivered at all of ThedaCare’s 5 CAHs! In recognition of their dedication, ThedaCare will advance their position and title into Associate Chief Medical Officers (ACMOs). Dr. Craig Batley for TCB, Dr. Dorrie Happ for TCW, Dr. Chandler Caves for TCWR, Dr. Mindy Frimodig for TCS, and Dr. David Hale for TCNL. Attached is a document summarizing some of the differences between ACMOs and a Medical Staff Presidents. We have had many conversations about the differences in these responsibilities and thought it would be helpful to share with all. Please join me in welcoming these exceptional five physician leaders into their new role!
Michael Hooker, DO
| Associate Chief Medical Officer | Medical Staff President | |
| Accountability | System CMO/Hospital VP | Medical Staff |
| Selection | Employed | Elected |
| Who do they answer to? | ThedaCare CMO/Hospital VP (CCO and CEO ultimately) | The Board—delegates responsibility for monitoring patient safety, quality of care and provider compliance with ThedaCare governance that depends primarily on providers granted their privileges by the Board |
| Areas of leadership | Improve ThedaCare quality and safety; support regulatory requirements (TJC surveys); provide input and assist in execution of system initiatives | Oversees Department Leaders (Department Chair, Counsel Chair); oversee quality metrics and OPPE, overall performance of all department members |
| Behavioral concerns | Supports Medical Staff president; cannot suspend, cannot mandate FPPE, cannot restrict privileges; represents ThedaCare as employer with ThedaCare employed providers | Leads conversations with disruptive providers; empowered to suspend or discipline medical staff within confines of Bylaws/MEC |
| Quality | Supports RCAs and Sentinel Event investigations | Supports Peer Review/Case Review Process |
| Policies | Guides creation of policies as needed | Works with MEC/medical staff to pass and implement new policies |
| Appointment | Holds position for many years; can be terminated by ThedaCare | Elected position for 2 years; can be terminated by MEC and/or the board only |
| Credentialing | Oversee Credentialing Process; Regulatory oversight; Assures unbiased review | Chairs MEC which is the official recommending body of credentialing/privileging of providers |
| MEC Meetings | Ex-officio (or may be voting member based on Bylaws); cannot call an MEC meeting | Call, preside at, and responsible for agenda for all meetings of MEC |
| Call Responsibilities | Works with Medical Staff President/MEC to assure coverage and compliance with Bylaws | Through MEC, has ultimate authority on Department Call Schedules |
| Escalation of concerns (most typical) | Ability to escalate to medical staff president as well as System leaders/CMO | Ability to escalate to MEC and Board primarily |
| Utilization Management/Clinical Documentation Improvement | Partners with UM and CDI teams/committees (Code 44, Downgrades, One Day Stays, etc.) | Supports efficient patient care and appropriate documentation; Enforces medical records policies |