Leading Organizational Change At Ballad Health

In constantly evolving healthcare environments, physician leaders are key in managing change efforts, however, developing leaders across a large system can in itself be a difficult change to lead. Consequently, it’s important to recognize that organizational leaders can be catalysts of change by simply supporting clinicians so they can participate and improve within a shared learning community.  Jeffrey Merrill, MD, Lead Physician, The Clinician Experience Project at Ballad Health, has dynamically lead a crusade to help his clinical colleagues and leaders impact organizational change and revive inefficient meetings.

The Ballad Health Clinical Council and a number of its subcommittees utilized the Clinician Experience Project as a go-to skill-building resource to both manage change efforts through a significant merger and achieve organizational objectives. Renee Oinonen, RN, Senior Consultant at Practicing Excellence, spoke with Dr. Merrill about how he has come alongside leaders and provided the right tools for transformation.



Renee: Tell us about your background and what led you to dedicate your experience and time to helping physicians and leaders.

Dr. Merrill: I’ve been with Ballad Health going on 19 years and in a variety of different positions. I’m board-certified in family medicine and sports medicine. Over the past 10 years I’ve transitioned into a full-time administrative role in which half of my time is spent on my work with the Clinician Experience Project across Ballad Health and the other half is spent as a medical director for our Allscripts EMR implementation and optimization. I have been focused on implementing different aspects of The Project across the health system both within the medical group and on the hospital side. I’ve done a lot of work over the last 10 years moving the medical group from volume-based to value-based care. 

Renee: Share with us how the Clinician Experience Project has been a resource that’s both changed the way you lead and empowered your colleagues.

Dr. Merrill: To give you some backstory, I’ve struggled personally with burnout during my medical career. And as I went through those struggles, I felt alone and didn’t feel that I had the tools or resources to solve my own problems. As I learned more about the Clinician Experience Project and was introduced to Dr. Stephen Beeson and his journey, I realized that there was tremendous value in learning and development to not only take on challenges, but help me find joy in my work again. It struck me how much my fellow physicians were struggling on a day-to-day basis and feeling more and more overwhelmed and disconnected from why they chose to be in this caring profession. 

I see a tremendous amount of value in the skills and resources that are contained within the Clinician Experience  Project. Physicians don’t have to wait for somebody else to come in and fix the things that they’re struggling with day in and day out. For those who aren’t necessarily struggling, but want to improve through skill-building, they can improve on connecting with patients, the dynamics of their team, and their efforts to lead. The Project puts the control squarely within the clinician’s domain to improve whatever matters most to her or him. In fact, since April of last year, we have seen more than 1,100 content completions from clinicians in the Project, so I’m thrilled that they have invested in themselves in learning how to leadcollaborate, and connect to patients more effectively.

Renee: How did you take your philosophy behind building strong patient relationships and apply it to the Ballad Health Clinical Council to both engage them to buy in and believe in the value of the Clinician Experience Project?

Dr. Merrill: I realized that the approach of “leading with the metrics” was not connecting with physicians. And as I looked around at most health systems, it didn’t seem like there was much focus on improving the well-being of the people that were actually caring for our patients. If we focus on creating a better environment for our caregivers, we are going to create the very best situation for our patients. Because in the hands of burned out, stressed, under-resourced physicians and care teams, good things don’t happen for our patients. So if we set physicians up for success and if we do that through the three learning lanes  of the Project–connecting better with patients, collaborating better in teams, and leading well–we’re going to create a place that supports clinicians to be their best. Part of the commitment I shared with the Clinical Council was to spend a small amount of time each month within the Clinician Experience Project learning skills, trying them myself, and sharing learning experiences.

Renee: In terms of engagement within the Clinical Council, what were the action steps once physicians started engaging in the content? What kind of transformation have you witnessed?

Dr. Merrill: One of the first things I did was encourage our High Value Care Subcommittee to standardize a change management template as well as integrate evidence-based change management steps to increase the likelihood of success for all of our combined efforts to try to improve things. Secondly, I realized that there were some big opportunities across Ballad Health to help improve physician performance reporting and to better align, resource, and recognize efforts around performance reporting. The High Value Care Subcommittee has worked on creating a strategy that really identifies an infrastructure and process around physician performance. 

Beyond this, I sought to improve the format, frequency, and agendas of our meetings. We showed the “Better Meetings” video from the Clinician Experience Project at the beginning of one of our meetings several months ago and this helped the subcommittee to think about new meeting rules. We have since created and implemented their new meeting rule recommendations, and now a week before each meeting, an action based agenda is sent out with specific items we want people to prepare for ahead of time to be able to participate more actively in the meeting. I’m proud to say we’ve decreased the meeting time from 90 minutes to 60 minutes. 

Clinician Experience Project | Better Meetings Tip

We activated a very similar change with the Physician Executive Committee meeting. That group comprises 14 physician executives across Ballad Health and they were originally meeting every two weeks for two to two and a half hours.  That meeting was not always well attended there and it typically was not very clear what we were trying to accomplish. We’ve now decreased that meeting time from 4 to 5 hours per month to 1 to 1 ½ hours per month. We’ve saved those physician executives anywhere from 420 to 580 hours per year to focus on other things. We also changed the format of that meeting to focus on physician leadership development and tapped the team’s intelligence to brainstorm important clinical issues. There was tremendous power in learning skills together on running effective meetings, then taking action to make change based on our new learnings.

Renee: What are you hearing from physician leaders who have been part of improved meeting outcomes? 

Dr. Merrill: To highlight one specific testimonial we heard, I’ll share what Dr. Jocelyn Medina stated. “The Better Meetings Tip video has helped us transform our High Value Care meetings.  Our meetings are becoming exciting and action-packed. We are also getting awesome, fresh ideas from committee members who used to never talk, and those ideas are making our committee smarter and more innovative than ever before.” She has been a great supporter of the Clinician Experience Project and she’s applied her skills to so many of the things that she’s leading on that subcommittee. 

Renee: It’s clear that you’ve seen a lot of value from the use of the Clinician Experience Project with the physician leaders of Ballad Health. So tell us, what’s next in your journey of caring for the caregiver?

Dr. Merrill: To both improve the patient experience and clinician experience, we want to grow physician-nurse rounding to help physicians and nurses realize the benefits for themselves and for the team. These improvements can dramatically enhance the care that patients are receiving. To illustrate the true impact of a change like this, we want to leverage the phenomenal stories that are happening right here within Ballad Health. There seems to be quite a bit of interest from our nurse leaders becoming more active inside the Clinician Experience Project. What better way to do this than partnering physicians with nurses so they quickly and easily apply tips from the Project together! We’re so honored to be a part of such an incredible organization as Practicing Excellence and can’t thank you, Dr. Beeson, and all the team members from The Project for all you’ve done to help us in our journey.

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