high performing work teams can boost physician...
TRANSCRIPT
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
LEAN SIX SIGMA GEEK!
Disclaimer:
3
High Performing Work Teams
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
“It Takes a Village”
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.
HIGH PERFORMING WORK TEAMS
CAN BOOST PHYSICIAN
PRODUCTIVITY
How do you create and maintain an
environment of high performance?
Keys to Building High Performance
Environment
• Create the right organizational structure
• Adopt contemporary and rigorous hiring
practices
• Embrace a culture of talent management
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
Components of Talent Management
CULTURE
WORKFORCE
PLANNING
METRICS
PERFORMANCE
MANAGEMENT
PROFESSIONAL
DEVELOPMENT
90-DAY
EVALUATION
TRAINING
ON-BOARDING
HIRING
RECRUITMENT
HUMAN
CAPITAL
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
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
Description Evaluation System
Does not
meet
standards
Meet
standards/
learning
Exceeds
standards
Outstanding
Technical
skills
Productivity
Quality
Citizenship
Learning &
Development
HIGH PERFORMING WORK TEAMS
CAN BOOST PHYSICIAN
PRODUCTIVITY
Which teams require high degree of coordination? What is their
role and what are attainable benchmarks?
OFFICE PRACTICE
HIGH PERFORMING WORK TEAMS CAN BOOST PHYSICIAN
PRODUCTIVITY
New Patient Office Visits
Work RVU
Staffing Expense
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
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
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
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
Rooming Time
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
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
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
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?
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
Days in AR
CV TESTING
HIGH PERFORMING WORK TEAMS CAN BOOST PHYSICIAN
PRODUCTIVITY
OP Stress Studies
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
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
CV Testing –SOP (Standard Operating Process)
CATH LAB
HIGH PERFORMING WORK TEAMS CAN BOOST PHYSICIAN
PRODUCTIVITY
Catheterizations
Cath Lab Metrics
Summary Slide
• Variation Exists
• High Performing Work Teams are Necessary
• Standard Production is Required….and NOT
distasteful
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!!
Questions/Comments?
• Denise Brown, VP MedAxiom
• 904-349-6468