How Does a Village Communicate Fluently? Whats a Manager to Do?! - - PowerPoint PPT Presentation

How Does a Village Communicate Fluently?

What’s a Manager to Do?!

Big Thanks to the board for inviting me to speak today. I’m honored and very excited to have the opportunity to share with you today. I attended these meetings as a Consultant for multiple practices in the Metro. Encouraged Managers to attend, enjoy the camaraderie of others in the trenches and enjoy a well- deserved break. You’ve seen my Bio so you know Why I’m here. It’s a small slice of my jobs and experience. Starting as an NA, to include lab, xr, etc, through to teach and consulting. Not tooting my horn, started at 14, so it’s not like I didn’t have time.

Dental / Legal rounded out my experience. The Patient/Client/ Documentation are similar. Looked for best ways to care for Patients, Staff and Liability. Managing liability is taking the best care of All our People. Basically, I am Risk Management. We’ll offer strategies for working together, speaking the same language, know our responsibilities and how to get questions answered appropriately. I talk fast but will try to slow down if you wave at me. We’ll try to take questions as we go but if necessary, will hold for after the

• presentation. Want to be sure to cover all the material we have for

this session.

Fluent Village Communication

• Our Goal: An organized flow of cooperative interactions

improving the success of daily tasks = Village.

• This requires clear, up-to-date communication in real time

= Fluency - Your Office Speak.

• My Premise: Patients (customers) the reason for our job,

pay the highest price for our lack of communication.

My Observation

• We are moving away from practicing medicine, to

practicing Insurance Protocol.

• Let’s humanize our offices, while maintaining

accountability for smooth functioning.

• This creates better service and care for our Patients and

more peace of mind for us.

Fluency Requires Everyone Knows:

• who is responsible in each area: medical,

administrative and corporate,

• their specific responsibilities so they can easily perform

their tasks as assigned,

• how to share information to get the job done, so
• ultimately, we are here to take care of our Patients.

Detrimental Communication ie daily aggravations:

✓ Meta Message – 80% of communication is non-verbal. ✓ Electronics are a blessing and a curse, even more difficult to be certain of ‘intent.’ ✓ Ever mis-read a text or an email? Oh it’s On! ✓ Intent is Everything! The more you defend an ‘off’ word, the deeper the underlying imprint of distrust.

✓ Regular patient reschedules ‘again.’ Receptionist: “of course

• Ms. Smith” in ‘sweet’ voice, double eye roll reveals her intent
• -- guarantee Ms. Smith Gets it – even over the phone.

✓ True for every interaction we have. ✓ Victims. Poor me, so unfair. Policy applies to all. ✓ Document! Ongoing issue, recommend ‘counseling for the employee’s benefit.’ ✓ All communication: verbal, written, text, email have potential for misunderstandings.

✓ Ever use cc: and bcc: and it went bad? BCareful! ✓ With all forms of communication, be vigilant about intent and meta-message. ✓ Communication must be a ‘Conscious’ process. We run multiple tracks of thoughts out of necessity – therein lies the rub. ✓ Office policy: person, on phone or in person, uses foul language directed at a staff member or patient? Never acceptable, Protocol for it is crucial. Back-up?

✓ Private phone use during patient hours? Legal is lunch & 2 breaks = private phone use. ✓ Employee states need phone for expected emergency, call to ‘back line’ or someone fill-in while they make a call until it’s resolved, or the person needs to leave. ✓ Gossiping, deal privately, immediately. True, Document, conclusion and signatures. Multiple

• incidents. Termination. Source of discontent, waste

time, and not doing their job. No Matter Who they are – You can live without.

✓ Patient Confidentiality, sacrosanct. Investigate. Breach, no quarter. Immediate dismissal, written and signed by employee. ✓ Patient complaint, ask them to put in writing, if they

• will. Investigate, Document.

✓ Severity of complaint, dictates what you do. ✓ Other annoyances – ‘who took my lunch’, leaves a mess in the kitchen, the lab, the waiting room, etc. Investigate, Document. Tell them Stop it! Really want terminated for being messy? 

✓ If they are silly enough to lose a job over repeating this nonsense and being annoying, so be it. However, your Documentation of the issues and repeated counseling MUST be impeccable! Unemployment Cases! ✓ Don’t ever let me see employee having a private conversation on their phone, while a patient is waiting. ✓ Or Denigrating a person based on ethnicity, 2nd language, citizenship status or any personal prejudice. Unacceptable! No Quarter.

Here’s a tough one: ✓ Dr. scribbles 10cc, You see 1cc. You Know it’s odd. Depending on Doc’s mood, several responses: ‘Thanks for catching that’, ‘You Know what I meant’, ‘It’s 10 cc are you blind!’ ✓ Endless possibilities. What do you do? ✓ Look twice and ask any way. In our environment a mistake can be life threatening. ✓ Always err on the side of clarity and patient safety. 

Important Reminders: Flow Chart with Chain of Command, Office Personnel (Hierarchy) Auxiliary Services, if any Monthly Meeting Schedule Emergency Procedures and Numbers These should be posted in the lunchroom or similar joint gathering place, as well as, P&P. Reminder for all : good Documentation that Important Information was Given and Accessible.

Knowing that you ‘Know’ is a great leveler. No reason to be defensive or feel uncomfortable speaking and doing what is needed appropriate, when we are sure we’ve understood and are following accepted protocol. Besides Knowing, we must act congruently in each interaction by: ✓ communicating respectfully with everyone, ✓ communicating with the authority of our job, and ✓ communicating decisions based on our knowledge, not our personal preference! ✓ Know your Chain of Command

Knowing : Fluency : Our Office Speak, must be inclusive: ✓ receptionist who sets up / checks out Our Patient, ✓ nursing staff who prepares / treats Our Patient, ✓ physician who diagnoses / prescribes for Our Patient, ✓ administration that runs the system for Our Patient. ***Everyone is part of the Healing Process; from the moment they answer the phone, every interaction through check out and billing. Each person interacting with a Patient, is part of Healing that Patient. It is our greatest responsibility. This is our Bottom Line.

Making people feel like family has a practical aspect, as well as doing the right thing, people seldom sue their family. OK – lottery not withstanding… $$$ Medicine is not only a Science, it’s also Healing Art. We all have jobs, but if our work is helping people, we also have a Calling. Fluency in the Village means we treat Every person we encounter as if they are our own, beloved family.

TiSS

Managers are tasked with creating Fluency – ▪ successful daily operations within the Village (office) of your Responsibility. Speaking from Your point of view: ▪ Where does your Village begin? ▪ Ownership: Private, Hospital or Corporate ▪ What’s their Hierarchy? More removed = more layers between You & Them Why Communication is Vitally Important!

Whether you do new employee intake; or if corporate, trains and you send to their area to be trained. Usually a day or two orientation:

• paperwork, benefit information, paydays
• hopefully, Policy and Procedure Manual (P&P)
• Important to Know COC,
• go to person,
• what order,
• process for escalating an issue, careful to handle

issues in proper order.

▪ job description/summary, salary, tour facility, training schedule, time clock, schedule, lunch / break times, breakroom / lunch facilities, restrooms, where to park. Signed Acceptance Letter they Understand and Agree to Everything above! Important to get their Agreement at the Beginning Accountability is built into the system. You MUST Document. Does this sound fairly standard for your facility?

New employees, where Our Village and Fluency- Our Office Speak, begins. These very basic processes begin new employee

• integration. If we haven’t done At Least this, what

can we reasonably expect the outcome to be? If you don’t train but have a great office, few transitions of personnel and smooth operations; you are either hiring very experienced people or you are really lucky.

Staff using previous office speak, you have a problem. Weren’t trained in the new Office Speak, it’s not their fault, but they will take a lot of heat. Job turnover is high in these offices. Lack of consistency in staff training causes errors and is a constant drain on everyone, especially the Manager. Thinking about that process, haven’t mentioned long- term employees. If their training is not part of this experience, retrofitting is in order. This may cause a change in personnel. Sometimes we have great workers who not people oriented. This is not always a good fit.

If you can, move them to billing, insurance or the records where they’ll be great. If that’s not possible or they ‘don’t want to’. Then they either adhere to job by its description

• r they leave. If they aren’t people oriented and don’t

want to change positions, it is likely they’ll leave of their

• wn volition. Document the choices offered and their

responses. I’m sharing processes that must be in place for you to have a smooth operation, not pull out your hair AND take care of Patients and yourself. Still with me?

A Consultant is called because there are problems. When I enter an office, this is what I look for:

• Awareness that Patients are the reason we’re here, have

a paycheck and benefits (if available.)

• No one, from corporate administrators to the

housekeeper would have a job without Patients.

• No matter if self-pay, top of the line insurance or social

services --- they pay our salaries.

My goal is to help you create a mutually beneficial environment that is, Your Village.

• I meet Staff, starting with Managers, then employees

in their various job positions.

• Tour the office, observing flow and function from

Reception - in person and on phones,

• to Office Assistants filing, copying and meshing

‘middle’ things,

• medical assistant, nurse, nurse practitioner / physician

in their environment.

• How are they all interacting with one another and

with the Patients? If needed, train Managers to hire, train, discipline, terminate and handle unemployment issues.

Tour the facility:

• how are Patients greeted, given directions and wait

times,

• general office, front desk and clinic set up, clean and

presentable,

• are other auxiliary services sharing space with the

clinic, and

• restroom facilities, entry / exits, safety of parking lots

– handicap spaces. As the Manager, these are all areas you should review

• n a daily or at least weekly basis.

This is Your Village. Corp, Med Staff, Employees and Patients. Also, auxiliary services, if part of office, lab pick up, deliveries, anyone outside, who interacts with your facility. They are also part of Your Village. Manager’s job is overwhelming without information, training, foresight and backing of your Employer. Without Backing – is a rough go. It’s your job to keep all phases of the Practice running efficiently and profitability, so no stress! This is why we require well trained employees. You a Manager, not a babysitter.

Requirements for employee success: ❖ Knowing what their job is: responsibilities and detailed procedures for getting the expected outcome. ❖ Most don’t even know what the ‘expected outcome’ is. Where do they fit in the group? ❖ Proper training from Day One: See one, Do one, Teach one, as well as explicit written instructions for each job they are expected to accomplish.

Employee Policy & Procedure Manual and Job Description, covering each of their areas of responsibility.

• One for Job and One for Corporate P&P is ideal.
• These are also your sources for creating job training

lists, don’t reinvent the wheel.

• Ask HR for copies of all the job descriptions if you

don’t have them.

• You should have your own current copies of these in

your office.

Copy forms from manuals / job description, make job responsibility list with place for trainer/employee to initial and date.

• My rule of thumb - retrain up to 3 times (if not grievous

issue), notate each retraining, initial. With Patience.

• Not ok after 3 times, either blocked, may need different

trainer or decide not your person for the job - Terminate.

• Perfect Documentation needed. If you ‘know’ they aren’t

person for your job, terminate well before the 90-day probation – not 20 minutes before!

Training requires patience, not every person proficient at their job, is a good trainer. Ever take Math 101 from a Math PhD? NO political or religious debates or conversations with Anyone in the office; not staff, nor Patients. Everyone has the right to their opinion; not our job to change, engage, analyze or critique. Our job, is taking care of Patients. I know that people often share a ‘Bless you’ or High Five the Chiefs or they are members of the same or similar group. A greeting, thank you and a smile is appropriate; long discussions are not.

Sadly, Violence in the workplace is a real issue. HealthCare is currently a hotly debated topic, we are a target. Trainers come to offices – Jess has a great reference if you need it. Not the time for head in the sand. Go directly up the COC. Federal Workplace Discrimination, Mar 12, 2018 – it’s the Law. Employees who cross the line, require written personal reprimand. Repeat offenders are terminated, they need to know up front.

• a. Another document for the Lunchroom.
• b. Required part of your P&P, review it often.
• c. Must be in new employee’s intake and discussed at least on

quarterly basis in the Monthly Meetings.

Store notes in a Binder for that purpose, in date order. Save them year to year. Be sure YOU, follow all guidelines. The notes and lists are your protection and proof in unemployment disputes. Documentation wins. Only write the manuals once, and revise. Golden in employee retainment, quality service and to win unfair unemployment disputes.

• Terminology. Biggest difference in medical/legal from other

businesses, is terminology. Keep medical dictionaries in several places. Receptionist need to know some basic

• terminology. Village Fluency.

Why is training necessary? Reimbursement and Liability. Bottom line. Processes must be done, documented and billed correctly to be paid. If protocol is Not followed, they won’t be paid, medical liability increases. It could indicate we were responsible for injury to our Patient. No One wants responsibility for a potential lawsuit; emotionally or financially. Not all lawsuits are warranted, but if we take good care of our patients, follow written protocol and document; we significantly increase the

• dds of a good outcome.

Monthly Employee Meeting. Pick a day, Wed have few holiday or with patients aren’t seen.

• Order lunch if budget, set topics, share agenda few days ahead.
• Everyone gets copy. Absent (frowned upon), give them one.
• You are always the moderator and in-charge.
• Sometimes it’s helpful to have a Dr, Nurse or Auxiliary person

come speak to the group.

• At least one topic from Manual not being followed.
• Complaints from patients, staff or administration, addressed.
• Team Building. Fun they can do together, isn’t time consuming.

• Give Kudos whenever possible. Look for opportunities to spread

them around.

• Give time for questions or concerns. Personal or divisive issues are

NOT for group discussion. Nip it in the bud.

• Have a private meeting with the employee(s), document discussion

and get signatures.

• If a conclusion is reached that affects the whole group, be sure to

address it in an open meeting.

• Do not give details or allow he said/she said conversation (gossip).

Just the outcome and any changes to P&P, if any.

Self-Care vitally important. We’ve actually been talking about it all along. Inclusive, harmonious Village supports one another, changes our outlook. Increases positivity and brings more joy to the fact we Help People Heal Everyday! ❖ Peace of Mind is #1 gift of Fluency in your Village. Invaluable. ❖ Gentle Self-Talk, especially when you’re upset. ❖ Know that you Know that you Know. You got this. Take a breath and let the answer come. ❖ As much as possible, try to only have ‘healthy’ foods at work, no sodas,

• etc. (I laughed) I know for some, seems impossible. I’m acutely aware of

how food assuages our feelings. (Worked clinic, on my feet, w133. Management w173- it’s a curse.)

❖ You don’t have to use a device, but once an hour, walk for 5 to 10

• minutes. Had to do that while I was working on this. Easy to go

for hours without moving from chair, we’re driven with so many

• projects. It’s very detrimental to our body, mind and home life.

❖ There is great benefit to small breaks, for your body, your mind. Return, see you’re work with new eyes, a different priority. ❖ It is Optimum your staff see you out and about during the day. You will see where things get bogged down, private phone calls, poor attitude to others. ❖ Keeps people on their toes.

❖ Also, see lovely things happen to be rewarded with Kudos in the Monthly meeting. ❖ Don’t go the same time or direction every time. Another mind break for you and it keeps employees on their toes. ❖ When you start mobilizing your body, you’ll naturally feel better. ❖ Your motivation rises, giving you renewed sense of strength. That’s good for Your Village and your home life. ❖ You’ll take in more oxygen, clears brain fog, which helps lift depression.

❖ You find many symptoms resolve and you have a better outlook

• n your job, which makes life better in general.

❖ Go home feeling better, worrying less at night about what the next day will bring. ❖ If there is music that uplifts you or other cues for your heart, play quietly in the background in your office. ❖ This is how creating Fluency in Your Village can make work better and that makes our lives better!

This concludes our program. We covered a lot of ground! I hope each of you found something helpful . I will answer as many questions as I can. ❖ Thank you NW MGMA for inviting me. I’ve have enjoyed meeting you!