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How To Make Changes In Your Healthcare Organization
Posted by randy on: 2005-12-05 18:11:21
How To Make Changes In Your Healthcare Organization
Donald Bryant
For many of us change is a difficult process. In organizations
like healthcare it seems to advance at a snail's pace sometimes.
There is a need for change in healthcare, most agree, though we
would be hard pressed to agree upon the changes needed. One
incentive for change is pay-for-performance programs now
beginning in several areas. I would like to describe a couple
that affect primary care physicians and then give a few
suggestions as to how to adopt changes to take advantage of
these programs. Even if you are not in a primary care physician
program, the methods suggested for change will be helpful, I
believe.
In 2006 Medicare plans to institute a pay-for-performance
program at the primary care physician level. Right now a model
is being tested and seems to be doing quite well. In several
states Blue Cross Blue Shield organizations are testing pay-for-
performance programs. Here in West Michigan, Priority Health, a
healthcare insurer, has promoted such a program for over five
years. How does this work, you may ask? Priority Health, for
example, funds the program for each of its patients a set
amount. Doctors who meet a requirement of the program for a
patient are rewarded with extra money for that patient. Hence,
with many patients the income for the practice can be boosted
considerably. The fact is that many are not rising to the
opportunity. With planned cuts in Medicare reimbursements over
the next few years, this source of income cannot be ignored!
Healthcare programs need to change, no matter how difficult.
The impetus for change should rest with the leadership of an
organization, although the change should not be the sole
responsibility of the leaders. Representatives from all parts of
the organization should be involved. Once the need for change in
a process is agreed upon, either because of extra revenue from
pay-for-performance programs or other agents or data that
positively affect the bottom line, leaders should convene a task
force to plan the change. With input from all, leaders should
map the process as it currently exits and then should make a new
map of how they would like it to be to incorporate the positive
changes. The new procedure should be standardized for all to
adopt.
How do you go about adopting these changes on a daily basis?
This is probably the hardest part. Because humans learn in a
variety of ways, it will take a variety of ways to implement the
changes. The implementation of the changes should be based upon
the learning styles of the individuals involved. Let me provide
an example using the Medicare program. A patient who enters the
Medicare program is entitled to a paid initial physical. A
primary care physician should take advantage of this. Many
don't. If I were the manager of such an office, I would remind
my staff who set up appointments to be aware of this fact. I
would remind them at regular staff meetings. I would post
visible reminders in the office. I might even have a message
flashed on the computer screen once in a while. Then I would
review the appointments of patients who have become Medicare
qualified and see how many had their initial physical or were
booked for it. I would adjust my methods to remind staff of the
need for such examinations and continue to improve on this until
the office achieves 100% compliance with the goal.
Booking the exam is not the only needed change. Doctors who
perform the physical must accomplish examination details and
actions laid out by Medicare. Hence, to be paid for the exam,
each doctor must adhere to the exam details. I would help the
doctors accomplish this in a variety of ways, depending on the
doctor's learning style. For example, a checklist of the exam
details might be included in the patient history folder when the
exam is performed. That way the doctor will not miss any steps.
As the leader of the change, I would check with billing to see
that all the steps were performed and adapt new approaches or
reinforce existing ones to see that the changes are accomplished
100% of the time.
Changes such as these should be a part of a continuous quality
improvement program at every healthcare provider organization.
Let me quickly review the most important steps. First leaders
should identify the changes needed. Then, the leaders should
convene a committee of all affected staff to develop how to
accomplish the change. Once the staff agrees upon the approach,
the leaders should develop ways to implement the change on a
daily basis adopting methods that incorporate learning styles of
affected individuals. Then, they should continually analyze the
progress of the changes and make necessary adjustments until the
goals are accomplished. They should then audit the changes
occasionally to be sure that the organization doesn't fall back
into old habits.
I believe that adopting such a change process will dramatically
help at your site. You will see savings in time, increased
patient or client health and satisfaction, as well as an
improved bottom line!
About the author:
Donald Bryant helps healthcare providers meet their challenges.
If you liked this article and want more free tips, visit
http://www.bryantsstatisticalconsulting.com for a free article
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