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Authors William F. Jessee, MD and David Rowlee, Ph. D. from Integrated Healthcare Strategies, discuss the evolution of hospital/physician relationships from alignment to engagement and integration as a critical path for the improved performance necessary to achieve greater value. They focus on the important role of culture as a driver of greater engagement and suggest that the board's role will encompass ensuring that robust systems are in place to measure, analyze and improve performance, including the areas of culture and engagement.

This monograph includes examples of instruments that measure culture in health care organizations and medical groups. It discusses key factors that influence physician engagement with hospitals and the types of improved performance that stronger engagement fosters. The authors also discuss nine steps that organizations and their governing boards can take to improve performance:

  • Assess organizational culture
  • Measure engagement of employees, physicians and volunteers
  • Deploy clinical integration tools
  • Recruit physicians and employees for cultural fit
  • Actively manage culture conflicts
  • Set clear behavior and performance expectations
  • Provide regular feedback on individual and organizational performance
  • Don't tolerate cultural misfits or poor performers
  • Align compensation with performance measures
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