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How To Make Changes In Your Healthcare Organization

For many of us change is a difficult process.provide an example using the Medicare
In organizations like healthcare it seems toprogram. A patient who enters the Medicare
advance at a snail's pace sometimes. There isprogram is entitled to a paid initial
a need for change in healthcare, most agree,physical. A primary care physician should
though we would be hard pressed to agree upontake advantage of this. Many don't. If I were
the changes needed. One incentive for changethe manager of such an office, I would remind
is pay-for-performance programs now beginningmy staff who set up appointments to be aware
in several areas. I would like to describe aof this fact. I would remind them at regular
couple that affect primary care physiciansstaff meetings. I would post visible
and then give a few suggestions as to how toreminders in the office. I might even have a
adopt changes to take advantage of thesemessage flashed on the computer screen once
programs. Even if you are not in a primaryin a while. Then I would review the
care physician program, the methods suggestedappointments of patients who have become
for  change  will  be  helpful,  I  believe.Medicare qualified and see how many had their
initial physical or were booked for it. I
In 2006 Medicare plans to institute awould adjust my methods to remind staff of
pay-for-performance program at the primarythe need for such examinations and continue
care physician level. Right now a model isto improve on this until the office achieves
being tested and seems to be doing quite100%  compliance  with  the  goal.
well. In several states Blue Cross Blue
Shield organizations are testing pay-for-Booking the exam is not the only needed
performance programs. Here in West Michigan,change. Doctors who perform the physical must
Priority Health, a healthcare insurer, hasaccomplish examination details and actions
promoted such a program for over five years.laid out by Medicare. Hence, to be paid for
How does this work, you may ask? Prioritythe exam, each doctor must adhere to the exam
Health, for example, funds the program fordetails. I would help the doctors accomplish
each of its patients a set amount. Doctorsthis in a variety of ways, depending on the
who meet a requirement of the program for adoctor's learning style. For example, a
patient are rewarded with extra money forchecklist of the exam details might be
that patient. Hence, with many patients theincluded in the patient history folder when
income for the practice can be boostedthe exam is performed. That way the doctor
considerably. The fact is that many are notwill not miss any steps. As the leader of the
rising to the opportunity. With planned cutschange, I would check with billing to see
in Medicare reimbursements over the next fewthat all the steps were performed and adapt
years, this source of income cannot benew approaches or reinforce existing ones to
ignored! Healthcare programs need to change,see that the changes are accomplished 100% of
no  matter  how  difficult.the  time.
The impetus for change should rest with theChanges such as these should be a part of a
leadership of an organization, although thecontinuous quality improvement program at
change should not be the sole responsibilityevery healthcare provider organization. Let
of the leaders. Representatives from allme quickly review the most important steps.
parts of the organization should be involved.First leaders should identify the changes
Once the need for change in a process isneeded. Then, the leaders should convene a
agreed upon, either because of extra revenuecommittee of all affected staff to develop
from pay-for-performance programs or otherhow to accomplish the change. Once the staff
agents or data that positively affect theagrees upon the approach, the leaders should
bottom line, leaders should convene a taskdevelop ways to implement the change on a
force to plan the change. With input fromdaily basis adopting methods that incorporate
all, leaders should map the process as itlearning styles of affected individuals.
currently exits and then should make a newThen, they should continually analyze the
map of how they would like it to be toprogress of the changes and make necessary
incorporate the positive changes. The newadjustments until the goals are accomplished.
procedure should be standardized for all toThey should then audit the changes
adopt.occasionally to be sure that the organization
doesn't  fall  back  into  old  habits.
How do you go about adopting these changes on
a daily basis? This is probably the hardestI believe that adopting such a change process
part. Because humans learn in a variety ofwill dramatically help at your site. You will
ways, it will take a variety of ways tosee savings in time, increased patient or
implement the changes. The implementation ofclient health and satisfaction, as well as an
the changes should be based upon the learningimproved bottom line!
styles of the individuals involved. Let me



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