Medical Director - Emergency Department

General

Mission: Partners with Intermountain to help patients live the healthiest lives possible.

Vision:

? Helps Intermountain Health work towards its vision of becoming a model health system" by providing extraordinary care and superior service at an affordable cost.

? Creates a vision for the local ED that integrates with System and Hospital leadership.

Values: Is a model physician who strives to live by Intermountain Healths values: integrity, trust, equity, excellence, accountability, and mutual respect. We are leaders in clinical excellence, we believe in what we do, we serve with empathy, we are partners in health, we do the right thing, and we are better together.

? Maintains and encourages professional appearance and conduct for self, physicians, and/or APPs. Fundamentals of Care: Provides physician (and APP, where applicable) oversight to ensure high safety, quality, and experience in the ED, which includes adherence to best practices.

Equity:

? Follows Intermountain Healths policies for diversity, equity, and inclusion (DEI) of all patients.

? If opportunities to improve DEI efforts are identified by local or system leaders, the ED medical director will work collaboratively to create a goal to address the opportunity and ensure its execution. ?

System

Alignment: Collaborates with system and nursing leaders to support system KPI goals. Where applicable, in larger groups, coordinates with hospital and system ED/Trauma leadership in the creation of incentive goals that align with system KPI or other initiatives pertinent to ED/Trauma operations. Communication & Execution: Annually presents to ED/Trauma leadership the process to ensure education from meetings and Job Description 09:56 AM 02/14/2024 Page 2 of 8 system emails is understood and followed by the frontline physicians and APPs.

Clinical Excellence:

? Is the point person for system Clinical Excellence representatives for patient complaints and grievances, peer review cases, and Harm Event And Learning (HEAL) cases. Meets with local and system Clinical Excellence representatives when requested. ? This responsibility cannot be delegated to another physician in the group.

CME: Attends ?2 Intermountain Emergency Medicine Journal Club or Grand Rounds CME events annually.

Local

Nursing Partnership:

? Partners with ED nursing leadership (manager and shared leaders) to ensure the ED care delivery model achieves high quality and safe emergency care.

? This includes scheduled time (i.e., not during a clinical shift) with ED nurse manager to review goals, department performance, finances, and to develop strategy.

? These efforts are then reported back to physician (and/or APP) colleagues.

? Work with nursing staff to allow for industry and system care standards, including those for support staff members (i.e., PRGs/standing orders).

Psychological Safety:

? Fosters a psychologically safe environment where staff feel safe to voice their opinions and ensures caregivers voices are heard.

? Achieves top tier performance in psychological safety, which is determined by local and system leaders, and is measured by the survey utilized by Intermountain Health.

? Promptly takes the lead on any behavioral issues with ED physicians or APPs. Document all interventions and/or meetings. Communicate all efforts with Hospital Medical Director and HR partner.

Caregiver Engagement: promotes and optimizes physician, APP, and all ED staff engagement.

Collaboration:

? As needed or requested, the ED Medical Director will coordinate with hospital department nursing managers and medical directors/department chairs (i.e., OR, MedSurg, L&D, Critical Care, Radiology, Respiratory, Lab, etc.).

? Strives to achieve collegial and professional relationships between departments

Recruitment:

? Takes the lead on recruiting and hiring in partnership with hospital administration for employed physicians. For affiliated groups, the recruiting and hiring will be the sole responsibility of the physician group.

? Group composition: coordinates hiring efforts to promote a diverse workforce and recruit and hire highly qualified candidates into their group practice

Onboarding:

? Participates in a structured physician orientation process, including introducing new physicians to the One Intermountain operating model and clearly delineating the expectations of a system collaborator while also being a member of a physician group.

Scheduling:

? Oversees the ED physician and APP schedule and works with the group to ensure all shifts are filled.

? Scheduling may be delegated to a physician(s) or APP within the group.

? Ensuring ED shifts are filled may NOT be delegated to hospital administration.

? Simulations: coordinates and participates in simulation trainings to improve provider education and skills

Debriefs: ensures optimal debrief opportunities occur following a traumatic event in the department (e.g., patient death or arrest, caregiver safety issue, never event, etc.)

Trauma Medical Director: collaborates with Trauma Medical Director to review cases as needed and attend trauma committee meetings.

Certifications: Ensures ED physicians remain board certified and up-to-date on other standards of care (e.g., ATLS for family medicine-trained physicians, EM ultrasound competencies).

Trauma Certification: collaborates with trauma medical director and nursing leadership to ensure the hospital achieves targeted trauma certification.

EMTALA: Ensure compliance with Medical Screening Exams (MSE), as well as all EMTALA policies and procedures

Stewardship: participates in the development of capital and operating budgets for hospital emergency department with hospital administration.

Advanced Practice Providers (APPs) - where applicable:

? Promotes and provides an environment conducive to APPs provision of appropriate emergency care

? Support APPs in correctly using backup physician(s).

? Ensures quality and patient safety via APP chart reviews. This may be delegated to a physician within the group, who reports to the medical director with trends, successes, or concerning findings.

Meetings

ED/Trauma Operations System Affinity Meetings:

? Held once per month. Critical to receiving updates and just-in-time information regarding policies, best practices, and system-wide initiatives.

? The ED medical director will ensure that all of her/his ED physicians (and/or APPs) are aware of and adhere to the policies, practices, and initiatives shared at this system meeting.

? At this system meeting, she/he should also come prepared to share successes, innovations, and best practices from her/his department with system leaders and other medical directors.

? ED Medical Director attendance of >80% annually. The Medical Director must be present for all or the majority of each meeting.

? Attendance of this meeting cannot be delegated to another physician. However, a designated proxy may attend in the Medical Directors absence (e.g., illness, vacation, clinical responsibilities) no more than 20% of these meetings. Please inform ED/Trauma leadership in advance when a proxy will be attending. Attendance by the ED medical director and/or her/his designee must be 100% annually. ?

Hospital Medical Executive Committee (MEC): attendance and participation is consistent with the hospital bylaws, where applicable.

Emergency Department Meeting:

? The ED medical director will hold regularly occurring department meetings in accordance with hospital rules and regulations

? The ED medical director creates the agenda and leads the meeting.

? The following individuals are invited: ED nurse manager, Hospital Administrator, Hospital Medical Director, as well as all the ED physicians and/or APPs. This can satisfy the monthly coordination meeting with the Hospital Administrator and Hospital Medical Director recommended in this document.

? ED nurse manager is invited to every ED group meeting and is given sufficient time on the agenda as determined by the nurse manager.

Coordination & Communication:

? At a minimum, monthly coordination with the following: ED Nurse Manager, Hospital Administrator, hospital ED Medical Director.

? The monthly department meeting wherein the Hospital Administrator and Hospital Medical Director attend may count towards completion of this requirement.

Hospital Trauma Committee:

? Ensures ED representation and works to improve opportunities identified in this meeting.

? Ensures ATLS standards are followed, as well as ATLS certification for those required by hospital or department rules and regulations.

? May delegate trauma committee meeting attendance to an ED physician or APP who practices in the ED. Ensure close-loop communication with the ED medical director (if delegated) and the ED group members regarding initiatives, practices, or policies discussed.

Resources

Reports & Metrics:

? The ED medical director will have access to data and reports for the following fundamentals of care: safety, quality, patient experience, stewardship, growth, and equity.

? She/he will have accountability to local and system leaders over these fundamentals of care.

Workspace: In conjunction with hospital leadership, ED director will determine an appropriate workspace to conduct ED operations, case reviews and have access to an Intermountain laptop to perform job duties.

Imail:

? Due to the ever-changing landscape in emergency medicine, communication is crucial. Similarly, time spent in meetings is minimized with regular communication via an Intermountain-sponsored email account.

? Therefore, expectations for the use of the ED Medical Directors imail or imail2 address are as follows:

? Reply to emails from system and local leadership within 7 days of receiving.

? Exceptions: vacations, illness, or clinical time. Please utilize the auto-reply function of Outlook in these instances (exception: illness).

? May not rely on personal email account (non-imail) for communications with hospital and system leaders.

Leadership training: such as Continuous Improvement, leadership courses, quality improvement (e.g., ATP), etc. is strongly encouraged. Funding for leadership courses/trainings will be coordinated with local hospital leadership and may include the ED Directors Academy Course (EDDA) through ACEP.

Mentoring:

? If opportunity for improvement is identified by ED/Trauma operations leadership, shadowing another high functioning ED medical director will be strongly encouraged.

? Will consider shadowing opportunities for other ED medical directors as identified by system ED/Trauma operations

Performance & Metrics

Physician & APP staffing: At a minimum, annually reviews physician and APP staffing model with hospital and system leadership, along with the associated metrics that reflect patient and caregiver experience with the staffing plan.

Left Without Being Seen or Left Without Treatment rates: are regularly evaluated and discussed with local/hospital and with ED/Trauma leadership.

Workflow: ED medical director engages with nursing and hospital leadership, as well as Continuous Improvement (CI) representative (if available locally) to optimize patient throughput and wait times

Returns to ED:

? Reviews the 3, 7, and 30-day reports and works with system and local resources to address ED frequent utilizers.

? May delegate to another ED physician, who reports back to ED medical director and who work to address opportunities for improvement.

Patient Experience:

? Collaborates with system ED/Trauma leadership to create an annual goal to improve patient experience, or a key driver thereof, as determined by the patient experience survey utilized by Intermountain systemwide. Components to this includes the following:

? ED Director will work to ensure that door-to-provider times are meeting system and national benchmark standards.

? Utilizes system tools or resources designed to optimize patient experience (e.g., AIDET, communication boards, etc.)