Research Question: For interdisciplinary clinicians in a large health network, does a physician-led, agile collaborative framework, compared to a traditional top-down approach, lead to accelerated adoption of evidence-based standards, implementation of new patient safety initiatives, and increased physician engagement?

Significance: Fragmented clinical expertise hindered interdisciplinary collaboration on care standards, leading to marked variability in clinical practice¹. This disconnection, a known barrier to complex processes such as advanced care planning², combined with a lengthy policy process, fostered a culture of physician mistrust and disengagement from system-wide quality improvement efforts.

Data/Methods: Seven Specialty Collaboratives of physician representatives were convened to co-design solutions within an agile framework. Program effectiveness was measured by tracking the adoption of new standards, quantifying physician engagement using a custom rating scale, and the time to policy approval.

Results: The physician-led framework yielded a 75% reduction in policy approval time, cutting the process from over 1.5 years to 1.75 months, and achieved an average physician effectiveness rating of 87%. Targeted interventions demonstrated measurable improvements in population health: Pediatrics: Launched a “Developmental Autism Sprint” to improve care access; Behavioral Health: Standardized a PRN order set for adult agitation to improve safety and equity; Pulmonology: Implemented a mandatory consult policy for high-flow oxygen use to ensure expert oversight.

Conclusions/Implications: This physician-led model, applying an agile framework, is a proven method for accelerating evidence-based standards and overcoming physician disengagement caused by traditional top-down approaches. The framework offers a scalable solution for leveraging clinical expertise to improve population health.

References:

1. Al-Jardani A, Al-Abri I, Al-Sinani M, Al-Bahlani H, Al-Dughaishi T. The Impact of Interdisciplinary Team-Based Care on the Care and Outcomes of Chronically Ill Patients: A Systematic Review. Sultan Qaboos Univ Med J. 2024;24(1)
2. Fanta, L., & Tyler, J. (2017). Physician Perceptions of Barriers to Advance Care Planning. South Dakota medicine : the journal of the South Dakota State Medical Association, 70(7), 303–309.