Practice Exercise $-$ Managing Change and Planning for Growth in the ED $-$ Case Study

Background: More than half of the emergency departments $($EDs$)$ in the US are managed thr Physician Practice Management contract $($PPM$).$ In these situations, a management company, with the hospital, assumes responsibility for certain aspects of ED operations. These function include employment of physicians and staffing the ED with physicians and sometimes physic assistants $($PAs$)$ and nurse practitioners $($NPs$),$ and coding and billing for their services. Ofte physicians they employ are from the community, and sometimes it is necessary to bring prov from other places to fill gaps in the schedule. The other ED non$-$physician staff are employe hospital, and the department is often managed by a leader from the hospital, as well as a phy leader. These contracts can last for many years, and sometimes the hospital decides to make often because of issues related to quality, efficiency, or some other operational issue. When change contracts, the physicians must either join the new group $($if invited to do so$)$ or chan Either way, the impact on the ED physicians is significant, and push$-$back from the physici

Case: Lakeview Hospital, a private hospital with a $45-$bed ED$,$ located in a mid$-$sized subu community, is planning to terminate the contract they have had with Superior ED Manage Company for $10$ years, and enter into a new agreement with Quality ED Management Cor Efficiency, revenues and patient satisfaction have been decreasing in the ED for the past $2$ Superior ED Management Company has not been able to turn things around. This transiti o occur over the next $4$ months.

lthough the hospital has good reasons for making the change, it is likely that this news sistance and negative pushback from physicians, staff, and the community. The curren id staff will feel very uncertain about their futures, and feelings of job security and trus pacted. Operations are likely to change. The culture is likely to change. Some current cide to leave, rather than begin with a new management company with different empl

ur challenge, as the executive in charge of the ED and of this transition, is to anticip: riers to a successful transition, and create a plan that mitigates as many of the likely ssible. You will want to consider all the stakeholder groups that are likely to be affec pare your department, staff and physicians for the change, and how you plan to mar ing all of these changes.