Cathi Lyons, MHA, COT, COEascrs16.expoplanner.com/handouts_asoa/001054... · 4/12/2016 2 Check it again and again! Avoid past failures Assist with Memory Recall Ensure success Outline

4/12/2016

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Cathi Lyons, MHA, COT, COE

Member – Care Credit OSC

4/12/2016

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Check it again and again!

Avoid past failures Assist with Memory

Recall Ensure success Outline individual

responsibilities Easy to track progress

Breaks it down –general outline and then incremental baby steps

Minimum steps necessary

Share with staff to ensure success – get their buyin!

Dry Eye – Center of ExcellenceOculoplasticsContoura tm Vision

Or – I have got the itchy burny eyes and I don’t know what to do….

DRY CENTER OF EXCELLENCE

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Use Excel Keep minutes and send communication

Procedure – name?◦ Dry Eye Center of

Excellence

Provider – which doctor is most passionate or involved?◦ Meet with the provider and

discuss steps Staff – start a committee◦ Meet with them – get their

opinion

Equipment needed:◦ Cost◦ Financing◦ purchasing

Resources needed◦ Staff (tech, admin,

counselor, provider)◦ Rooms (space needed)

Design the flow of the procedure◦ Footsteps through the office◦ Front desk, Techs, Doctors, Counselors, procedure,

checkout – time necessary to perform all functions◦ Will it happen all at once?◦ Series of visits – time and footsteps needed for each

one◦ Will it occur in the same space each time or various

areas of the office◦ How does that effect the flow of the clinic?

Contact Malpractice Carrier (if necessary to add service)

Determine CPT codes to be used◦ (office visits and procedures)◦ Look at ASOA list serv – anyone talking about this?◦ What issues have they encountered – make it easier

on yourself! Forms needed◦ EMR – Paper charts◦ Consent forms◦ Payment agreements

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Advertising/Marketing◦ Patient information – education◦ Staff information – education (inservices!)◦ Brochure◦ Website & social media◦ Videos – animation (Eyemaginations or your own)◦ More staff education◦ Provider training – certification◦ How best to promote service externally to your

community?◦ More staff education

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Where are the patients coming from?◦ Current patient base?◦ Outside Referrals?◦ Advertising?

Cost Analysis◦ Reimbursement◦ Cash versus Insurance◦ Cost of Goods – Time – Space◦ Competition pricing - & and numbers competing

Getting the Facility Ready◦ Plans◦ Construction◦ Equipment Installation Space Electric Data

Equipment Training Educate, Educate and more Education Set up Maintenance Schedule – who’s in

charge of what

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Launch Day Educate Staff – Re-educate Staff Role Playing with Staff Listening to staff discuss procedure Ask them to explain it in their own words Afterwards – Discuss with patient’s, providers

and staff – how was your experience? Modify as necessary Continue to check in

Patty Casebolt, Clinical Director

Member – Care Credit OSC Casebolt Consulting

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Checklist for success – How to add a new procedure or service and be successful beforeduring & after!

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“We are all plagued by failures- by missed subtleties, overlooked knowledge, and out right errors. For the most part, we have imagined that little can be done beyond working harder and harder to catch the problems and clean up after them”

Quote from The Checklist Manifesto

Physician Mentoring Program

PHYSICIAN

MENTOR

Our goal is to help all new providers become productive and efficient in delivering high quality patient care.

Basic Orientation

Goal By When Steps Complete Date/Initials

Becomefamiliarwith MECpolicy and procedures.

Demonstrate knowledge of our Employee Handbookand Provider Handbook by answering questionsrelated to:

Appropriate dress code

Who is MEC Org Chart

Requesting time off

Reimbursement requests

MEC website and history of MEC

Your preference on how you’d like to be addressed by staff

HR

Shadowing and exams/treatments

Have an eye exam with Dr. ____ or Dr. _____

Have a treatment with Jennifer

Observe PA ‐ laser treatment and clinic

Shadow each provider with 5 patients

q Dr. ______Jorizz

q Dr. ______

q Dr. ______

q Dr. ______

q Dr. _______

q Dr. _______

Dr. ________

q Dr. _____

q Dr. ______

Attend a public seminar

Attend an OD seminar

Observe surgery scheduling ‐ review consents and packet

Complete online infection control training

Laser safety with Keith

ClinicalDirectororMentor

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Surgery


Become a

Meet with ASC director and leads to discuss processes

MentororSurgicalDirectorcompetentandconfident Twomeetings with LSEC staff discussing preferences for‐

surgeon. pre/post& OR, review instruments,microscope,Infiniti ,sutureswith OR lead tech & Jessica

Observe Dr. ____ in OR for 1 day with at least 5 cases

Use the standard visco‐elastic agent (Duovisc)

Utilize the standard IOLs provided by MEC (Alcon SN60WF)

Utilize MEC standard surgical tray

Learn personal setting of phaco unit – Jessica set up visitw/Alcon reps to discuss and set‐up preferences

Calculate/select lenses for surgical day using lens list

Calculate/select custom IOL – Toric, ReStor, Crystalens

Conduct post‐surgical day huddle for feedback

Patient Encounter


Seepatientsefficientlyand

Demonstrate knowledge of reading your schedule

Make sure a follow up is scheduled at the end of the exam

Mentor

confidently. Review no show/cancellation policy

Demonstrate clinical flow ability: See a minimum of 30

clinical patients per day (or 15 patients per half day) for 5days usingone technician/scribe

Electronic Medical Records (EMR)


Becomeproficientwith EMR.

Demonstrate competency on EMR system: Chart 50 clinicpatients seen with mentor and score in excess of 90%accuracy in internal coding audit on 25 of 50 (see coding)

MentororCodingAuditTeam

Review Meaningful Use

Demonstrate knowledge of ASC Nextech program

Trainer

Understandhow OP reports are created and revised

Trainer

Hospital training Epic system

Coding


Accuratelycode. Demonstrateappropriatecoding skills by completing

codingon 50 clinic patientswith mentor, and scorein excess of 90% accuracy in internal coding auditon 25 of 50 notes (see EMR)

Demonstrateappropriatecoding skills by completingcoding on 20 surgicalpatientswith mentor, and scorein excess of 90% accuracy in internal coding audit

Reviewlast Corcoranaudit

Meetwith chart auditors to reviewfirst 20 patients

Consequencesof miscoding

CodingAuditTeam

Referral Building


Developinternalandexternalreferralrelationships.

Meetwith all externalreferringOptometristsand 10referringPrimaryCare Physicians(MD’s)

Meetwith outof areaOD’s/MD’s

q Coastq Grants Passq Klamath Fallsq Roseburg

Instructreferringdocson how to contactour referraldepartment

Demonstrateknowledgeof howour referraldepartmenthandlesreferrals

Visit referring office.

Presentat an areaeducationalactivitywithOptometrist/PCP(i.e. MEC sponsoredCE seminar)

Discuss with doctor MEC philosophy onworkingwithOD’s ‐ personalbasis, relationshipswith referralsources

Sendpatientreport to referringOptometrist/PCP(EMRgeneratedor dictate)

Send thank you/followup letters to externalreferringOptometrist/PCP

surgical patientsby workingwithmentor and establishedI nternalproviders

Discuss levelof comanagementfrom referring OD’s andcorrespondencepre/post‐op

Mentor

Comanagement and On ‐Call


Learn tocomanage. Workwith internalOptometristson comanagement

protocols

Workwith internalOptometristsand instruct themonwhen you want to be contacted on yoursurgical patients

Workwith outside referringOptometristoncomanagementand their preferred time to see theirpatient back for comanagement

Mentor instructionon on‐call, ER and office call protocols

Serve in the office call and on‐call rotation

ACHorientation/credentialingto performsurgerythere

Mentor

ObserveDr. y performingsurgeryat ACH

Refer to internal surgeonsfor procedures.New providerisawareMECoffers:blepharoplasty, trabeculectomy, cornealtransplants,retinal lasers, etc.

Optical


Meetpatients’needs forglasses and contacts.

Meetwith Tamito reviewoptical orientation,productsandservices

Meettheopticians/establishrelationships/observetheirknowledgeandabilityto problemsolve

Go through the processof selecting glasses and beingfitted for them

Contact lensprocess

Dr. to reviewverbiageon glasses, contacts & prism

Mentor

Review productionreportswith Tami

The Business of Ophthalmology


Understand

Receive a copy of John Pinto’s book

CEObusinessandpersonal Review of blue book

finance Criteriato becomepartnerside of ourpractice. Importanceof taking charge of your own teams’ efficiency

andproductivity

Income expectations

Financialplanning‐importanceof, resources(Ferg‐Wellman)

Role of doctors in staff management

Reviewpurchasingauthority (who can purchasewhat)

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Meetings


Understandour com‐municationstructureandexpectations.Put all meetings inyourcalendar.

Board

Peer review

All provider

Introduceyourselfw/presentationat next All Staff

Department

Business development

Operations/Senior Management

Managing partners/mentors‐ once amonth for each

Regular check‐ins with your lead

Reviewblue book financial summary (within 1st month)

Re‐reviewblue book financial summary (2ndmonth)

Mentor

Accountable Communication Training


SupportAttend New Employee ACT

Mentorour cultureof account‐able open‐

AnnualMD retreat

ness and Teambuilding (6 monthsafter starting)review theprocess Review ACT articles

used. Triangulation

Making and keeping agreements

Stop / start / continue

Risk Management


How topracticesafe

Reviewof MECrisk management(customer care team) andpeer reviewprogram including peer reviewforms

DrImperia&PattyCasebolt

medicine. Surgicalplanning;PARQdiscussion,physiciansurgorder, etc.

ReadOMIC article on cataract surgery risk management

15min meetingw/Tom to discuss peer review

What to do if you get sued ‐ what to expect ‐ don’t think itwon’t happen to you

OregonMedicalBoard/comanagementguidelines

Review of Dr. and Dr. a cases

Reviewprocess for new procedures including codes,pricing, TDC, equipment& supplies

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Phone Call How easy is it to schedule an appt by phone? How long did you wait on hold? Did you feel the person was knowledgeable about the

services asked for on the phone? When inquiring about a treatment or procedure, did

the staff have a good idea of what treatments are provided?

Did they credential the providers

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Office What are your first impressions of the spa/office? Upon arrival …., Were you greeted warmly? Did the receptionist make eye contact? How long did it take to get greeted? Were you offered water, tea, coffee? Did the staff look and perform in a professional way? Does the office seem inviting or too busy? Spa only-Do you feel overwhelmed with products, or is it easy to shop? Did the technician call you by name? Did the technician walk alongside of you? Was the pre-testing explained to you, ie why it was being performed? Did the provider review your goals with you? Did the provider explain his/her findings and clearly outline the treatment plan? Were you given a new glasses prescription? Did the provider make a glasses recommendation? Were you offered written information to take home regarding your diagnosis? Did the provider answer all of your questions or concerns? Do you feel the provider was competent, why or why not? Did the provider “credential” themselves or the other providers? Were you told about LASIK? Were you told about the medical Spa? Were you asked to schedule a follow up appt at check out? Were your insurance benefits explained? Were you offered Care Credit?

Optical Did the optical staff assist you in a professional manner? Did the optical staff make a specific recommendation for

frame/lenses and explain the benefits? Were you insurance benefits explained? Did the optical staff describe the difference in quality

between brand x and what we offer? Did you feel the selection of frames/lenses was

satisfactory? Were you told about a budget line of frames/lenses? Did the staff explain the optical warranty policy? Were you offered Care Credit?

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1990-2014 Very successful LASIK program and A+ tracking system. 75-98% call to consult conversion

2015- Upgrade to new PM system- unable to get reportable numbers for one year.

??? LASIK call to consult conversion rate?

Review of 2015 conversion rates revealed call to consult conversion had slipped from 75% to 35%.

Surgical Volume had stayed the same.

Leads had increased, but because we weren’t able to measure, we didn’t realize the significant opportunity cost of our decreased conversion rates.

Secret to success….Prepare- checklistsVerifyMeasure

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Cathi Lyons MHA, COT, COEAdministratorGordon Schanzlin New Vision Institute858-455-6800 [email protected]

Patty CaseboltClinical DirectorMedical Eye [email protected]

Documents

Cathi Lyons, MHA, COT, COEascrs16.expoplanner.com/handouts_asoa/001054... · 4/12/2016 2 Check it again and again! Avoid past failures Assist with Memory Recall Ensure success Outline