Changing Physician Hierarchy

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Physician hierarchy can be a barrier in creating a culture of safety, however when they are leveraging physicians and involve them in collaborative efforts, they can very powerful in moving meeting expectations. Physicians have many pressures on them; rather they are regulatory or legal. Getting them engaged should not be pushed or create a nuisance, but rather a positive experience. When changing physician behavior is the focus, Kenneth Cohn (2009) recommends the following:
• Establishing a physician champion that focuses on physician outcomes, creates a positive learning environment, and improves hospital-physician relationships.
• Supporting positive deviance. Which supports the thinking that solutions and expertise to improve processes exist within the organization and professionals should be supported in their problem solving.
• Helping independent and employed physicians by creating physician task forces that are focused on process improvement and improving access to vital information.
As previously stated, Anand et al. (2012) found that leadership development is essential when creating an environment that is engaged in continuous improvement. As Cohn (2009) states, Physician leadership is also vital in this journey toward a
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Bunch (2007) explores the relationship between failed training interventions and subcultures (hierarchy, gender, function, etc.) that are often overlooked as having an impact on organizational culture. Training interventions can be an expensive lose if not implemented properly. Without clear goals and leadership support, hierarchical constraints can put stress on new processes. Also, effectiveness is not always communicated in terms of improved business outcomes. Finally, this research concludes that training failures cannot simply be tied to just organizational culture. Training professionals should adequately assess the culture before implementing any interventions, leadership should be involved to support training

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