angela siler fisher, md, facep associate chief for operations and public affairs, baylor college of...
Post on 18-Dec-2015
215 Views
Preview:
TRANSCRIPT
Angela Siler Fisher, MD, FACEPAssociate Chief for Operations and
Public Affairs, Baylor College of Medicine
Medical Director, Ben Taub General Hospital Emergency Center
ObjectivesA- Always satisfy. Patient Satisfaction.B- Be Safe. Patient Safety and Risk
Management.C- Communication and Negotiation.D- Disposition efficiently.E- Excel in your career.
What’s in it for you?? (WIIFY)Hard work??
Everyday is an interview for your next jobEvery group wants to hire the resident sought
after by their own programWho wants to be average??
Average job, average life with average number of lawsuits??
Are Patients our Customers?Business modelYou will be hired and fired on Patient
SatisfactionGolden Rule: “Patients do not remember
all of what we say but they always remember how we made them feel
Patient Satisfaction Tips Under promise—over deliver
This helps with wait time perception Assess and manage patient and family
expectations Does the patient expect admission or tests??
Time MappingExplain your focused differential, planned
management, diagnostic tests and the anticipated length of stay
Take the extra time to ensure that your patient agrees with your plan of treatment—it will save you time in planning disposition!!
Discussions should optimally include all family/friends
Patient Satisfaction TipsMake the customer service diagnosis
CP=MICough=Lung CA
Address all concernsWork noteTransportation
Staff Satisfaction• Communicate with staff regarding
pending tests and anticipated disposition
• No unnecessary double dipping• Manage/Talk up your staff• Be Human, Humble, Empathetic and
Polite/ Respectful
Number 1 Reason to do Customer Service in the ED:
It makes your job EASIERLess stressLess liabilityPatients more complaint
It makes your Administrators happy too!More volumeMore Money
Customer Service is a Skill Set much like ACLS/PALS, but it applies to Many More Patient Encounters!
(and it can help save/ resuscitate your career)
Patient Safety and Risk ManagementBelieve your patients—don’t minimize
or rationalize their complaints!!Always suspect the worst!!!No Gold stars for sending home sick
patients!!A patient that returns a second time with
a similar complaint deserves a much closer evaluation!!
Clinical Decision Making80% History10% Physical Exam10% Diagnostics
Patient Safety and Risk ManagementDon’t be fooled by the triage level
or area of evaluation!!Doing the right thing for your patient will
always ensure that physicians are rewarded.
Always document pertinent positives and negatives in your history and physical.
High Risk CasesReturn patientsPsychiatric patientsSign-out
Be an Effective NegotiatorSeparate the people from the problemFocus on interest, not your positionUse “I” StatementsActive ListeningThe power of “Yes”Work together to create options that will
satisfy both parties
Communicating Concerns:Culture of blame versus systems errorDon’t just complain—OFFER
SOLUTIONS!! Fundamental belief that everyone is doing
their very bestNo one is out to get youEveryone is here to do what is best for the
patient
Other Ideas to Try:Handle complaints by using the “LAST”
TechniqueListenApologizeSpecifyThanks
Use Scripts “My goal is to control your pain, so you let me
know how we are doing!”“Come back any time- we never close!”
The ChallengeAfter initial evaluation of the ED patient,
be able to identify:Know who the sick patients areFocused differential diagnosisAppropriate diagnostic work-upImplement initial managementDisposition
No
Yes
Patient Evaluation
SICK NOT SICK
Admit
Early Consult
– Normal vital signs
– Eat/Drink
– Pain management
– ADL’s
– Appropriate Follow-upDISCHARGE
Coding and BillingKnow documentation requirements and E&M
levelsKnow your RVUs/hr and how you compare to
your peersExpected productivity:
Medical Students: 0.5 patients per hourPGY-1: 1 patient per hourPGY-2: 1.5 patients per hourPGY-3: 2 patients per hour
Become a well rounded emergency physician- The Triple Threat
Credibility is a MUST!Honor Integrity Trust
Challenges facing Leaders in EMBoarding / overcrowdingHealthcare ReformOn-call specialistsReimbursementEMTALAHIPPA
WellnessYour career is only one aspect of your
identityYou can’t grow as a person if you neglect
your personal needs and your family/ friends
Know Thyself:FatigueIllnessFamily IssuesMoney ProblemsRelationshipsCompetence
Become a leader: Leadership OpportunitiesGet Involved
Medical School/ HospitalSpecialty Societies
ACEP, EMRA, SAEM, AAEM, ABEMState
TMA, County Medical SocietyNational
AMALet the best job find you through networking
top related