high performing work teams can boost physician...
TRANSCRIPT
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High Performing Work Teams Can
Boost Physician Productivity West Virginia ACC Chapter Annual Meeting
Charleston, WV
November 2014
PREPARED BY:
Denise Brown, VP Business Intelligence Solutions/Senior
Consultant
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LEAN SIX SIGMA GEEK!
Disclaimer:
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High Performing Work Teams
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High Performing Work Teams
“A high-performance team can be defined
as a group of people with specific roles and
complementary talents and skills, aligned
with and committed to a common purpose,
who consistently show high levels of
collaboration and innovation, that produce
superior results.”
Hanlan: High Performance Teams: How to Make them Work, Praeger Press, 2004
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“It Takes a Village”
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Presentation Description
1. Specify how to build high performing work
teams.
2. Identify the most important teams requiring a
high degree of performance and coordination.
3. Identify the attributes and duties of those
teams.
4. Suggest metrics by which you can hold those
teams accountable for peak performance.
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HIGH PERFORMING WORK TEAMS
CAN BOOST PHYSICIAN
PRODUCTIVITY
How do you create and maintain an
environment of high performance?
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Keys to Building High Performance
Environment
• Create the right organizational structure
• Adopt contemporary and rigorous hiring
practices
• Embrace a culture of talent management
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Talent Management
• Alignment of human capital and
business strategies to support
organizational goals
• Belief that every individual in the
organization makes critical contributions
to the success of the organization, or
position is unnecessary
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Components of Talent Management
CULTURE
WORKFORCE
PLANNING
METRICS
PERFORMANCE
MANAGEMENT
PROFESSIONAL
DEVELOPMENT
90-DAY
EVALUATION
TRAINING
ON-BOARDING
HIRING
RECRUITMENT
HUMAN
CAPITAL
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Talent Management
Philosophy
• Best people who perform to the
highest evaluation standards
• Pay them as much as can be justified
• Have as few of them as possible
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More Keys to Building High
Performance Work Teams
• Create standard work for
all business segments
• Train rigorously
• Create expectations for performance
• MEASURE and provide feedback
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Description Evaluation System
Does not
meet
standards
Meet
standards/
learning
Exceeds
standards
Outstanding
Technical
skills
Productivity
Quality
Citizenship
Learning &
Development
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HIGH PERFORMING WORK TEAMS
CAN BOOST PHYSICIAN
PRODUCTIVITY
Which teams require high degree of coordination? What is their
role and what are attainable benchmarks?
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OFFICE PRACTICE
HIGH PERFORMING WORK TEAMS CAN BOOST PHYSICIAN
PRODUCTIVITY
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New Patient Office Visits
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Work RVU
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Staffing Expense
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Schedulers
• Are your providers schedules fully optimized?
• Are patient demographics and insurance accurately
captured at time of scheduling, MD orders?
• Are the providers schedules full?
• What is your no-show rate?
• Are patient recalls satisfied?
*METRIC: 50-75 calls per day
Woodcock: Mastering Patient Flow, Using Lean Thinking to Improve Practice Operations,2007
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Live Patient Registration
• Is live registration timely and accurate?
• Are patient co-payments and/or
balances collected?
• (“How are you taking care of your balance
today?”)
*METRIC: 50-75 full reg. w/cashiering
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Medical Records/Chart Prep
• Does a chart preparation standard exist?
• Are all electronic or paper chart requirements
available at the time of the visit?
• What is the value of a patient visit without
past medical history and/or results?
* METRIC: Strive for 2-day completion prior to
patient visit
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Patient Rooming
• Does a rooming standard exist between all
practice providers?
• If a standard exists, has it been taught and
measured?
• Is med reconciliation accurate?
• Are scripts teed up for renewal?
• Was the EKG performed?
*METRIC: 8-9 min w/EKG
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Rooming Time
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Nurse Triage
• How many patient calls come in daily?
• What does the virtual patient need most?
• Are some/most/all calls returned each day?
• Are some/most/all calls satisfied each day?
• Is there a trigger to schedule the patient
caller for a live visit or is there more
telephone medicine than
needed/appropriate?
*METRIC: 65-80 live calls/day
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Nurse Triage Initial Results
0
400
800
1200
1600
2000
2400
2800
3200
Med
icat
ion
Que
stion
Sym
ptom
Que
stion
Test R
esults
Pat
ient
Que
stion
Follow U
p Plan
Rx Ref
ill
App
oint
men
t Que
stion
Lab
Res
ult
Pro
cedu
re Q
uestion
Med
icat
ion
Instru
ction
Sur
gica
l Clear
ance
Lab
Ord
ers/Que
stions FY
I
Sch
edule
Pro
cedu
re
SBE/D
enta
l
Insu
ranc
e Aut
h Nee
ded
Sch
edule
App
oint
men
t
Disab
ility
Insu
ranc
e Que
stion
Sch
edule
Testin
g
3032
2618
16831537
1062970702656
478455419390330142129110 94 80 63 58
Reason Types
Co
un
t o
f C
all
s
Primary Call ReasonNovember 1, 2008 to Current
0
400
800
1200
1600
2000
2400
2800
3200
Med
icat
ion
Que
stion
Sym
ptom
Que
stion
Test R
esults
Pat
ient
Que
stion
Follow U
p Plan
Rx Ref
ill
App
oint
men
t Que
stion
Lab
Res
ult
Pro
cedu
re Q
uestion
Med
icat
ion
Instru
ction
Sur
gica
l Clear
ance
Lab
Ord
ers/Que
stions FY
I
Sch
edule
Pro
cedu
re
SBE/D
enta
l
Insu
ranc
e Aut
h Nee
ded
Sch
edule
App
oint
men
t
Disab
ility
Insu
ranc
e Que
stion
Sch
edule
Testin
g
3032
2618
16831537
1062970702656
478455419390330142129110 94 80 63 58
Reason Types
Co
un
t o
f C
all
s
Primary Call ReasonNovember 1, 2008 to Current
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Physician Extenders
• How and where are your extenders used?
• Are your extenders able to see stable return
patients for office follow-up?
• Are your extenders able to see hospital follow-
up patients requiring prompt return to office
consults?
• How are you selling the use of the extenders?
• Can you afford to add more docs?
*METRIC: Billing twice annual salary + benefits
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Device Clinic
• How many device clinic checks are your staff
performing? (Face-to- Face and Remote)
• How many, if any, does industry perform?
• What is your device check process?
• How many holters/events downloads does
the staff perform daily and how much time
does it take?
• Is device clinic recall up to date? Are all
patients being managed optimally and what
is your protocol?
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Business Office
• Are your coders up to date and optimizing
your work?
• Are your billers prompt in dropping the bill?
• Do you have a written process with set
expectations on working denials?
• Where does the buck stop on pre-auth and
insurance verification?
• METRIC: Claims work standard 40-50 per day
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Days in AR
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CV TESTING
HIGH PERFORMING WORK TEAMS CAN BOOST PHYSICIAN
PRODUCTIVITY
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OP Stress Studies
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CV Testing - Staffing Ratios
STRESS
ECHO
Patient Prep
15 minutes
Pre-Echo
20 minutes
GXT Time
15 minutes
Recovery
10 minutes
11:00-11:15 11:15-11:35 11:35-11:50 11:50-12:00
PA ------------------ ------------------ GXT, EKG Recovery,
BP
MA Prep/Demo ------------------ ----------------- ------------------
TECH Data Entry Ultrasound Assist PT,
Data Entry
Recovery,
Complete
Data Entry
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CV Testing Schedule
PT Arrival
8:00
Rest
8:30
GXT
9:00
Stress
9:45
Read Time
10:15
8:15 8:45 9:15 10:00 10:30
8:30
8:45
9:00
9:15
9:30
9:45
10:15
10:30
10:45
11:00
9:00 9:30 10:00 10:45 11:15
12:15 12:45 1:15 2:00 2:30
12:30 1:00 1:30 2:15 2:45
12:45 1:15 1:45 2:30 3:00
1:15 1:45 2:15 3:00 3:30
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CV Testing –SOP (Standard Operating Process)
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CATH LAB
HIGH PERFORMING WORK TEAMS CAN BOOST PHYSICIAN
PRODUCTIVITY
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Catheterizations
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Cath Lab Metrics
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Summary Slide
• Variation Exists
• High Performing Work Teams are Necessary
• Standard Production is Required….and NOT
distasteful
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Solutions Slide
• Hire the right people
• Create standard work
• Apply efficiency efforts to every
environment
• Measure performance to benchmarks
• Create a culture as a team for
productivity!!
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Questions/Comments?
• Denise Brown, VP MedAxiom
• 904-349-6468