Addressing the Implementation Itch; Scratching the Traditional!

December 12, 2018

Three years ago, I made an exciting career move, leaving an academic career to join an innovative Post-Acute care organization, Signature HealthCARE. Much credit to my mentor Malaz Boustani, who made me realize that I had a chronic "itch to implement”, and I believed him instantly because he seemed to suffer from the same “diagnosis”. He had responded to it by creating the Center for Healthcare Innovation & Implementation at Indiana University.

For me, being part of the Center had only intensified the itch. The Center primarily focused on healthcare solutions for the acute care, whereas, my goals pertained to innovations in the Post-Acute setting, and hence the decision to move. So far, the move has worked really well, as we are working on several outside-the-box solutions. But nothing has been more satisfying than the design and implementation of the physician engagement platform, CareAscend.

It was 15 years ago that I first stepped into the medical director role for a skilled nursing facility. Asked to attend the monthly quality assurance meetings, the next three months I sat quietly, listening to discussions that I could not contribute to. Strategies to find lost laundry or to fix TV remotes were not my cups of tea! It needed a heart to heart with the facility administrator before I started bringing value to the team.

Physician leaders have a lot to learn from other team members, but that can’t happen without setting formal expectations, and a clear communication strategy with their facility leaders. Medical directors need to know their priorities, their purpose on the team and also need feedback on their performance.

Meaningful feedback on one’s performance and impact prevents physician burn-out. Material motivators are important but are insufficient to garner engagement and internal motivation; the key ingredients to high performance. Traditionally, health care systems lack such structures as clearly shown by the fascinating research done by Dr. Dan Ariely, concluding that physician engagement requires a strategic focus on enhancing mastery, autonomy and purpose at work (https://advanced-hindsight.com/).

In my early days at Signature HealthCARE, our CEO Joe Steier challenged me to energize our medical director force. Accepting the challenge, I met dozens of medical directors, administrators and other team members, whose input helped to formalize a framework for physician engagement. A consistent rise in our company engagement scores, clearly validated this approach. At Signature, we strive for revolutionizing healthcare not just settling for local impact, so this question emerged: how could we use technology to broaden the impact of this framework?

Our team partnered with MavenSphere (www.MavenSphere.com) to transform the medical director engagement framework into a digital application. After 18 months of experimentation and beta testing, we have CareAscend (www.careascend.com) that represents the first medical director engagement solution. Over the next few months we will be busy implementing this across 10 states, empowering and engaging medical directors. Many thanks to several of my AMDA (www.paltc.org) friends & colleagues who contributed to this project, particularly Chris Laxton and Dr. Rich Feifer.

Addressing medical director engagement is just one step in the right direction. Yes, CareAscend will help nudge medical directors to perform key tasks, log their hours to facilitate PBJ compliance, provide professional development resources and hopefully improve their impact, but many other critical areas still need solutions. Well, truth is that CareAscend may have dulled it temporarily, the itch remains, and that is alright, as we have just begun scratching the surface of possibilities!


Arif Nazir MD 

Chief Medical Officer and Co-founder at CareAscend, LLC.

Other Articles you might like

We have streamlined and automated the regulatory compliance workflows that aligns your teams.

Test drive CAREASCEND today!