Brooke Klatt, RN, EMTP

Those, Aug and Sept,  are actually very good months to look at.  Let’s look at adjustments.  Those are the discounts from the charged amount that are calculated based on fee schedules for different payers.  The August charges is lower than Sept, but the adjustment amount is higher.  Usually payer mix is relatively consistent, why the much high…[Read more]

Another example of old style medicine screwing up a current medical practice.  I know a radiation oncologists in a 3 person group within a 13 person radiology group.   When the radiologists were making more money that the radiation oncologists the radiologists insisted on making them a separate cost center, segregate the revenue cycle, live off wh…[Read more]

Sabir, this is one of the best posts in the entire program.  It is pretty amazing what we do to each other.  Why?  I think the overwhelming response is that we do not know any other way.  Another may be too much attention on short term goals.  The hire is the key, not how long they last or how they feel about their job a year later.  As physi…[Read more]

Hi Stephen, thanks for the contribution.  I find that practice improvement and strategy get mixed up all the time.  Improvement technique does not work so well when you are dealing with a strategy issue.  Improvement takes an inefficient process and changes it to fulfill the original goal of that process.  Strategy looks at a problem and dev…[Read more]

So true Ralph

So much of how we organize our work in medicine is continuation of practices from long ago.  The “Rounds” as a team/meeting dynamic is something that should be unlearned.  The goal is to learn but also to provide care for a patient.  I know my rounds were often pressure cookers for the junior residents and not much learning was ac…[Read more]

I wanted to comment on the mentoring aspect of your contribution.  Mentoring has to be a formalized process.  The selection of a mentor is individualized but everything else is by the book.  You meet every 3 months in the first year, set a specific meeting time (no longer than 1 hour), have it be in the office of the mentor.  The mentor should can…[Read more]

Thanks Omar

It really is amazing at the lack of decision making technique we use in some of the most important decisions in our career.  Simple strategy planning techniques can help on both ends of the hiring equation.  For the employer, what is the state of our practice (SWOT)?  What is our mission, vision?  Who do we need to hire to move for…[Read more]

Be careful here.  You have already jumped to the solution before you understand the problem.  You may be expending resources determining that you have a perfectly functional phone system.  First assess the Problem itself, how big a problem is it.  Often time perception and reality do not match up.  Maybe that should be most of the time.  You don’t…[Read more]

I get your point Joe.  You are trying to do idea generation and then ranking all in one session.  It will seem a bit rushed to all.  It might be better to subdivide the meeting.  Part a is idea generation.  Part B is consideration of project logistics.  Part C is something else.  Next meeting Part A is idea ranking and decisions on which idea(s) to pursue.

I think that is a great idea Katie.

When the team is first formed, at the top of the initial agenda should be a description of team operations.  Included is this process for idea generation, you get an email, you return the email in 72 hours, no excuses, everyone participates.  You complete a whiteboard with all of the ideas before the meeting, s…[Read more]

I was just reviewing the discussion boards and found this incredibly insight.  I always love the character I introduced to you, Edwards Deming.  Every employee wants to do a great job when they have the opportunity to do so.  The key to our role as the leader is to provide them the opportunity and then the recognition when they perform.  If you…[Read more]

When I hear about this I go in two directs.  First meeting size.  Decisional meeting, no more than 8, anything over is strictly information distribution.  For creativity try to go 6 or less.

The second thing is meeting dynamics and idea generation.  Depending on the team, you may want to go with “Brain writing” on this issue.  Lots of strong pers…[Read more]

I moved this comment from Ralph that I found in the comments.

“For many of us ,our first experience with “teams ” are the rounding teams during our later years of medical school and early years of training. Whether or not those teams were functional by the standards presented in the video is not the issue. The issue is unlearning many of the pre…[Read more]

Thanks for the great insight into your organization.  You know I am always talking about transparency.  One of the problems with transparency is the level of knowledge of the people accessing the information.  When you have a staff that has little understanding  of financial statements, transparency could be problematic and create mis…[Read more]

Thanks Ralph

True that, it is easier to decide for people that to try to reach a consensus. It is easy to fish for someone and then just give them the product that it is to teach them to fish for themselves. Engaging providers and employees in general, is teaching them to fish and the consequences of that activity can be immense for the organization.

This came in from the comment section from
Ralph Salvagno
and I thought I would move it to the discussion forum.

“Bottom up leadership is difficult if your don’t have engagement from the bottom. You have to assess the barriers to engagement … are they created or self imposed? Without engagement we fall to an authoritarian style of decision mak…[Read more]

I was in a negotiation with the local hospital and they told me they did not track departmental level income statements.  I asked them how they follow the financial performance of any department and their reply was that they only collect those numbers organization wide.  Of course, I did not believe it, but that was the extent they were willing t…[Read more]

“One way to determine metrics of this is a survey of patients and to do random testing of the system.”

This is your data collection method.  What key quality characteristic will be be measuring?  I see two already.  One could be percentage of endless rings.  Another could be messages not received.  A more general could be missed contacts whic…[Read more]