high performing work teams can boost physician...

41
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

Upload: others

Post on 13-Jul-2020

1 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 2: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

LEAN SIX SIGMA GEEK!

Disclaimer:

Page 3: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

3

Page 4: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

High Performing Work Teams

Page 5: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 6: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

“It Takes a Village”

Page 7: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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.

Page 8: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

HIGH PERFORMING WORK TEAMS

CAN BOOST PHYSICIAN

PRODUCTIVITY

How do you create and maintain an

environment of high performance?

Page 9: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

Keys to Building High Performance

Environment

• Create the right organizational structure

• Adopt contemporary and rigorous hiring

practices

• Embrace a culture of talent management

Page 10: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 11: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

Components of Talent Management

CULTURE

WORKFORCE

PLANNING

METRICS

PERFORMANCE

MANAGEMENT

PROFESSIONAL

DEVELOPMENT

90-DAY

EVALUATION

TRAINING

ON-BOARDING

HIRING

RECRUITMENT

HUMAN

CAPITAL

Page 12: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 13: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 14: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

Description Evaluation System

Does not

meet

standards

Meet

standards/

learning

Exceeds

standards

Outstanding

Technical

skills

Productivity

Quality

Citizenship

Learning &

Development

Page 15: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

HIGH PERFORMING WORK TEAMS

CAN BOOST PHYSICIAN

PRODUCTIVITY

Which teams require high degree of coordination? What is their

role and what are attainable benchmarks?

Page 16: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

OFFICE PRACTICE

HIGH PERFORMING WORK TEAMS CAN BOOST PHYSICIAN

PRODUCTIVITY

Page 17: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

New Patient Office Visits

Page 18: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

Work RVU

Page 19: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

Staffing Expense

Page 20: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 21: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 22: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 23: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 24: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

Rooming Time

Page 25: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 26: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 27: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 28: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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?

Page 29: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 30: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

Days in AR

Page 31: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

CV TESTING

HIGH PERFORMING WORK TEAMS CAN BOOST PHYSICIAN

PRODUCTIVITY

Page 32: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

OP Stress Studies

Page 33: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 34: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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

Page 35: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

CV Testing –SOP (Standard Operating Process)

Page 36: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

CATH LAB

HIGH PERFORMING WORK TEAMS CAN BOOST PHYSICIAN

PRODUCTIVITY

Page 37: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

Catheterizations

Page 38: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

Cath Lab Metrics

Page 39: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

Summary Slide

• Variation Exists

• High Performing Work Teams are Necessary

• Standard Production is Required….and NOT

distasteful

Page 40: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

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!!

Page 41: High Performing Work Teams Can Boost Physician Productivityaccwv.org/wp-content/uploads/2015/01/Brown_presentation14.pdf · Presentation Description 1. Specify how to build high performing

Questions/Comments?

• Denise Brown, VP MedAxiom

[email protected]

• 904-349-6468