angela siler fisher, md, facep associate chief for operations and public affairs, baylor college of...
TRANSCRIPT
![Page 1: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/1.jpg)
Angela Siler Fisher, MD, FACEPAssociate Chief for Operations and
Public Affairs, Baylor College of Medicine
Medical Director, Ben Taub General Hospital Emergency Center
![Page 2: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/2.jpg)
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.
![Page 3: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/3.jpg)
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??
![Page 4: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/4.jpg)
![Page 5: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/5.jpg)
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
![Page 6: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/6.jpg)
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??
![Page 7: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/7.jpg)
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
![Page 8: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/8.jpg)
Patient Satisfaction TipsMake the customer service diagnosis
CP=MICough=Lung CA
Address all concernsWork noteTransportation
![Page 9: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/9.jpg)
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
![Page 10: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/10.jpg)
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
![Page 11: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/11.jpg)
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)
![Page 12: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/12.jpg)
![Page 13: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/13.jpg)
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!!
![Page 14: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/14.jpg)
![Page 15: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/15.jpg)
Clinical Decision Making80% History10% Physical Exam10% Diagnostics
![Page 16: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/16.jpg)
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.
![Page 17: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/17.jpg)
High Risk CasesReturn patientsPsychiatric patientsSign-out
![Page 18: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/18.jpg)
![Page 19: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/19.jpg)
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
![Page 20: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/20.jpg)
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
![Page 21: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/21.jpg)
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!”
![Page 22: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/22.jpg)
![Page 23: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/23.jpg)
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
![Page 24: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/24.jpg)
No
Yes
Patient Evaluation
SICK NOT SICK
Admit
Early Consult
– Normal vital signs
– Eat/Drink
– Pain management
– ADL’s
– Appropriate Follow-upDISCHARGE
![Page 25: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/25.jpg)
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
![Page 26: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/26.jpg)
![Page 27: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/27.jpg)
Become a well rounded emergency physician- The Triple Threat
![Page 28: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/28.jpg)
Credibility is a MUST!Honor Integrity Trust
![Page 29: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/29.jpg)
Challenges facing Leaders in EMBoarding / overcrowdingHealthcare ReformOn-call specialistsReimbursementEMTALAHIPPA
![Page 30: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/30.jpg)
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
![Page 31: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/31.jpg)
Know Thyself:FatigueIllnessFamily IssuesMoney ProblemsRelationshipsCompetence
![Page 32: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/32.jpg)
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
![Page 33: Angela Siler Fisher, MD, FACEP Associate Chief for Operations and Public Affairs, Baylor College of Medicine Medical Director, Ben Taub General Hospital](https://reader038.vdocuments.us/reader038/viewer/2022110207/56649d215503460f949f712f/html5/thumbnails/33.jpg)