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Medical practice success depends on a strong clinical team

Rosemarie Nelson
Physician
May 13, 2010
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Although every day can bring surprises in a medical practice, you can develop a clinical team that can optimize the efficiencies of your operation and make it easier for you to see your patients.

There are three key areas that lead to provider frustration in daily operations: preparation and anticipation; the daily dance; and being in the moment. Address these, and your days should go more smoothly.

Preparation and anticipation

Are your charts prepped so you have all the information you need? Do you have to leave the exam room to get a test result, previous note, referral, or lab requisition form or equipment on a regular basis? Are your exam rooms stocked with all the supplies you need? Why do you leave the exam room to retrieve samples for the patients?

Solution: Invest five-to-10 minutes at the beginning of each day in a huddle with your clinical support team. Stand at the hub of your clinical area and preview the day’s schedule. Use this huddle to anticipate each patient visit and the information, supplies, and equipment you’ll need for the visit. Whether you use a paper chart or an EHR, your staff can review the record so everything is in the right place for you. This brief communication session helps your nursing staff learn your needs and streamline the day.

The daily dance

Do you find yourself waiting for your support staff to begin, complete, and/or move on to another encounter? Does your clinical support staff take and record the patient’s history? Do you have to wait for your nurse to give them an order?

Solution: Simple techniques like staggered staffing and ramp-up scheduling can reduce the gaps in your work flow. Recruit and retain medical assistants (MA) for administrative functions and gain more flexibility to accommodate the peaks that are standard in every practice. Front-load your morning and the first half hour after the lunch break with “extra” rooming staff so that you are not waiting for patients to be roomed and your nursing staff is more available for those unanticipated needs. The MA who works the referral desk or staffs medical records also rooms patients for the ramp-up time each morning and afternoon. The result is you get a more efficient kick-off to the session and the MA’s job is enhanced with the variety of work.

Being in the moment

Do you have phone conversations with patients who have just been in the office but have questions about their visit? Do you spend more than an hour each day on the phone with patients giving them medical advice? Do you have phone conversations with patients about something your clinical support staff could answer?

Solution: Invest another five-to-10 minutes at the end of each day with your clinical support team reviewing the messages for the day. Together you can examine the reason for the call from the patient. As a team, analyze each call to determine how the call could have been prevented by addressing the patient’s needs during the visit. Also evaluate the level of license required to address the issue. By spending time communicating in the huddle you’ll be developing your staff’s skills and expertise so that they can more effectively assist you to your level of satisfaction. If you wait until everyone leaves for the day to attack that pile on your desk, you’re missing an opportunity to make that a smaller pile every day.

To sum up — just as there are three key problem areas, there are three key solutions:

• Invest your time to convey your needs.

• Develop your team.

• Make sure your support staff is always one step ahead of you.

Paradoxically, if the staff is always one step ahead of you, they’ll have your back every day!

Rosemarie Nelson is a principal with the MGMA Health Care Consulting Group.

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Originally published in MedPage Today. Visit MedPageToday.com for more practice management news.

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