administrative and clinical competencies · chapter chapter 20 medical office management lesson 2:...

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Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 2/e

Beaman • Fleming-McPhillips • Routh • Gohsman • Reagan

Pearson's Comprehensive

Medical Assisting Administrative and Clinical Competencies

Second Edition

CHAPTER CHAPTER 20

Medical Office

Management Lesson 2:

Leadership and Team Accountability






Lesson Objectives

Upon completion of this lesson, students should be able to …

• Define and spell the terms to learn for this chapter.

• Describe time management principles and how a TO DO list would enhance office organization.

• Differentiate between the personnel policy manual and the office policies and procedures manual.






Lesson Objectives

• Describe ten responsibilities in assisting the physician to prepare for a medical meeting.

• Discuss how to assist the physician when preparing to make a presentation at a medical meeting.

• List five items that belong in a patient information booklet.






Attributes of a Good Leader

• Ability to make appropriate calls of judgment

• Willingness to learn new ideas

• Staying calm during stressful situations

• Always maintaining a professional attitude

• Demonstrating good listening skills






Authoritarian Leaders

• Very direct

• Make most decisions on their own without the input of others

• Probably not team players as much as solid leaders

• Want respect and obedience from their staff members

• Use fear to achieve staff obedience

• Motivated by power and absolute authority

• Work best in times of great stress and crisis situations






Democratic Leaders

• Concentrate more on the relations between staff members and emphasize teamwork within the office

• Motivated from within to provide a comfortable work environment for all

• Offer open communication






Democratic Leaders

• More receptive to new ideas from staff members, creating an atmosphere of cooperation among the staff and instituting greater participation in the decision-making process

• Style often leads to a contented staff






Permissive Leaders

• Tend to be very open with the staff

• Not strict with rules and policies

• Self-motivated

• Lead to disorganization and even hazardous conditions due to a lack of an ordered environment






Bureaucratic Leaders

• Very strong at enforcing rules

• Motivated from external means

• Rely on established management methods for office matters

• Rigid and set in their ways

• Have a level of insecurity because they do not trust themselves in making decisions that will affect the office

• Very distant and formal






Types of Power

• Power of rewards

– Incorporates rewards or some type of enticement in exchange for better job performance and teamwork

– One downfall is that employees can become reliant upon rewards

• Legitimate power

– Given to people based upon their titles

– Misuse leads to fear of the person with the title or even the title itself






Types of Power

• Expert power

– Given to those who have a great deal of knowledge

– When misused there is a perceived level of manipulation and intrusion among those affected

• Referent power

– Given out of high regard and respect

– Same effect with misuse as expert power






Types of Power

• Informative power

– Power wielded by those with information that others want or need

– Misuse of this power may result in avoidance, a sense of unfairness, and a bit of hostility

• Connective power

– The idea that if you know the right people you can get what you need

– Same effect with misuse as expert power






Factors that Help to Create a Successful Office Team

• Size – The smaller a team,

the better it will work together

• Team personalities – It is inadvisable to put

together a team made of the same personalities and similar mindsets






Factors that Help to Create a Successful Office Team

• Responsible team members

–All members of the team must be accountable for their actions

• Unified team approach

–Team members must come together to face the project with the same purpose and goals

Have you ever worked on a successful team?

If so, what do you think made the team successful?






Ways to Maintain Team Cohesiveness

• Treating all members of a team equally

• Manager showing that he or she is an integral part of the team

• Adopting the attitude “I would not ask the employee to do anything I haven’t already done myself or would be willing to do”

• Developing several levels of leaders on the office team






Characteristics of a Small Team

• Often will be very intimate

• Close bonds may form

• Because of the small group dynamics, they tend to be very unstable

• More relaxed atmosphere

• Similar to group size and structure, the smaller the office, the easier going it may be






Characteristics of a Large Team

• More stable

• Loss of intimacy found in small groups

• More rigid structure

• More formal and systematic as a whole

• Small groups may develop within the large team, such as a group of receptionists or clinical medical assistants






Ways to Create a Team Atmosphere

• Allow some staff members to be part of the hiring process when new team members are being selected

• Avoid filling an office with people who are of similar personality types and leadership styles






Task-Oriented Roles that Team Members Can Assume

• Information seeker

• Information giver

• Coordinator

• Energizer

• Evaluator or critic

• Recorder






Nurturing Roles that Team Members May Assume

• Encourager

• Harmonizer

• Compromiser

• Follower






Holding Team Members Accountable

• The team must come together to locate and fix the problem

• The team should not attack or try to blame a problem on any one member

• The team must decide together how they lost track and how they can prevent a similar problem from reoccurring






Ways to Help a Team Be Successful

• Ensure the correct personalities and talents have been brought together

• Encourage team members to concentrate on a single goal

• Have the team work with the same purpose in mind and approach a problem or task using similar means

• Monitor the progress of the team to ensure they are on the right track and working together






Ways to Help a Team Be Successful

• Have members of the team switch roles when possible in order to experience the duties and responsibilities of the office as a whole

• Use team-building exercises to gain cohesiveness within the team






Critical Thinking Question

1. What team building exercises can you think of that might be worthwhile for a team?






Methods of Advertising Open Staff Positions for the Medical Office

• Newspapers

• Trade journals

• Professional organizations

• Internet

• Formal training programs

• Employment agencies

• Local training programs in colleges






Methods for Obtaining the Job Application

• Send to the applicant by mail and have them bring it with them to the interview

• Provide the link for them to access the online version

• Have the applicant fill out the form at the time of the interview






Benefits to Having the Application Completed at the Interview

• Ability to see how the applicant handles filling out forms under a time constraint

• Obtain a visual of the applicant’s handwriting

• Learn how adept the applicant is at completing a requested task

– Do they follow directions, take shortcuts, or do they complete every line?

– How does she/he handle on-the-spot tasks that may need to be resolved quickly and efficiently?






Areas to Assess at the Time of the Interview

• Is the applicant dressed appropriately?

• Does he or she reflect a professional appearance?

• Is the resume neatly prepared?






Contents of Questions Prohibited by the Equal Employment Opportunity Act

• Race

• Color

• Sex

• Religion

• National origin






Information to Obtain About Applicants

• Past office experience

• Types of physicians the applicant has worked with before

• Test applicant’s ability to think on their feet






Possible Office Requirements for an Applicant

• Post-offer drug screen

• Acceptable credit report

• Acceptable criminal background check

• Pre-employment physical (which may include tuberculosis (TB) testing and hepatitis B immunization)

• Body mechanics testing and training






Purpose of Probationary Period

• Time frame allows the supervisor to observe the new employee at work and to determine if he or she is suited to the position

• During the probationary period an employee can be terminated without cause.

• After 90 days, the employer must show just cause, or reason, to dismiss an employee






Contents of an Orientation Checklist

• Work hours and schedule

– Includes overtime and call-in procedures

• Office layout

– Includes the location of the restroom, break room, employee parking, and employee entrances)

• Dress code

• Smoking policy

• Lunch break time and location

• Job description







• All employment records

– Including I-9s, emergency contact information, affidavit of citizenship, insurance enrollment, and so on

• OSHA Bloodborne Pathogens Standards and Universal Precautions

– Including request for a waiver form for hepatitis B vaccine.

• Health Insurance Portability and Accountability Act (HIPAA) training







• Fire safety

– Locations of fire extinguishers, exit procedures, stairwell locations

• Signature on confidentiality statement

• Policy and Procedure Manual

– Employee should read and sign a statement that the document has been read and understood







• Physician’s work preference

– Explains the way the physician prefers to work; if a team approach is used, examples should be provided to help the MA understand his or her role






Considerations for a Job Performance Evaluation

• Appraisal should be given in a nonjudgmental manner

• Appraisal should focus on the entire covered review period, not just recent events

• The manager should be open to understanding any problems the employee may be experiencing







• Discussion of the job description and required duties should allow the employee to voice any frustration

• The manager should reinforce what is expected of the staff member

• Teamwork should be emphasized

• The manager needs to look at the employee’s performance as a whole







• The employee's job description should be reexamined and the most important aspects of the position should be identified

• Look at whether the employee’s performance was outstanding, good, average, poor, or unacceptable






Questions to Consider When Rating an Employee

• What factors determine outstanding performance?

• What determines good versus poor performance?

• How are the employee’s social interaction skills, many times referred to as their “soft skills”?

• How does the employee get along with the other members of the office team?

• How does he or she interact with the patients?







• Mention areas in which the employee may want to improve work performance and ways to help them achieve the suggested goals

• If possible, end the evaluation meeting on a good note

• In situations where employees are not performing up to the standard set for them, the performance evaluation may satisfy the legal requirements for documentation of rightful termination







• If giving an employee a poor evaluation, it is a good idea to warn the employee at the start of the meeting






Types of Reviews

• Orientation or training

– Involves observing the new employee and every few days asking the employee how they think the training is going

• Routine performance review

– Normally performed at 90-day, six-month and yearly intervals.






Types of Reviews

• Poor performance reviews

– Conducted when there have been obvious deficiencies in the performance of the employee

• Salary reviews

– A review of the employee’s salary when a shift in job responsibility occurs






Actions that Require Discipline and Probation

• Intoxication

• Drug use

• Breach of patient or office confidentiality

• Sleeping on the job

• Frequent tardiness or absenteeism






Critical Thinking Question

1. What should you do if you know that a coworker is breaching patient confidentiality?






Possible Disciplinary Actions

• Providing a verbal and/or written warning

• Sending the employee home on suspension while the incident is investigated

• Placing the employee on probation and telling the employee that if the situation occurs again within a set period of time (i.e. 30 days or 3 months), the employee will be discharged






Possible Disciplinary Actions

Every incident should be documented with time, date, and an objective statement regarding what

happened.






Considerations for Establishing a Time Management System

• Defining the office goals with the physician. For example:

– Collecting all payments at the time of delivery of services

– Reorganizing or computerizing billing

– Limiting the practice

– Writing a textbook

• Creating a priority list of the goals

• Placing the priority list onto a TO DO list






Information Found in an Employee Handbook

• Employer-employee relationship

• Work environment and expectations of the particular medical facility

• General information about office policies

• OSHA guidelines and standard precautions

• Information related to benefits and time off






The Office Policies and Procedures Manual

• Contains detailed descriptions of the standard operating procedure (SOP) and how to perform both administrative and clinical tasks

• Policy refers to:

– A plan of action, such as “It is office policy that all employees receive hepatitis B (HBV) vaccinations.”






The Office Policies and Procedures Manual

• Procedure describes:

– The steps to be performed to carry out the policy

• The terms policy and procedure are used interchangeably in many offices






Primary Functions of a Policies and Procedures Manual

• Lists the tasks to be performed within the office, including equipment needed in order to complete the procedure

• Standardizes the procedure for each task

• Describes job responsibilities and titles

This manual is an excellent reference tool for new employees since it provides guidelines for performing

specific tasks.






Contents of a Patient Information Booklet

• Office hours

• Payment guidelines

• Appointment and cancellation policy

• Telephone answering service information

• Information about the physician(s)

• After-hours availability

• Directions to the facility

• Parking information






Benefits of an Effective Patient Information Booklet

• Reduce the number of questions by telephone from patients

• Enhance the office’s image

• Reduce the number of patients who fail to remember instructions

• Used either for patients with special needs or to teach methods of disease prevention






Steps to Developing a Patient Information Booklet

• Make the booklet as appealing as possible.

• Allow a white border around all the edges.

• Use large print for the elderly reader’s benefit.

• Make small enough that it will fit easily into a pocket or purse.

• Write the booklet with the reader in mind and at a reading level appropriate for your target audience.







• Avoid the use of technical medical terms.

• Avoid long paragraphs of explanation. Keep the sentences short and concise and use as many bulleted points as possible.

• Provide a listing of the regular office hours.

• List any special services offered by the practice or clinic such as patient education classes or blood pressure testing programs.

• Explain the procedure for having a prescription refilled.







• Explain the procedure for processing medical insurance forms.

• Include a general statement about payment of fees.

• Provide information about the physician and the staff, the name and telephone number of the office manager, the personnel responsible for insurance processing, and the patient educator.







• State what procedure to follow in case of an emergency.

• Provide a 24-hour emergency telephone number.

• Include a telephone number at the end of the brochure in the event there are additional questions.

• End by thanking the patient for taking the time to read the literature.






Questions?

administrative and clinical competencies · chapter chapter 20 medical office management lesson 2:...

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