Imagine how it must be to have your income held up because of someone else’s failure to perform. Imagine how frustrated you would be if your paycheck was held up because a nurse had not finish charting. A proactive stance on this mission-critical issue for the hospital demonstrates the group’s commitment to its partner. Taking a proactive stance on this often leads to reorganizing and reworking the medical records department processes. Taking the first step demonstrates your interest in the needs of others. It may lead to an electronic medical record or new systems. A partnership starts to evolve.
Patient satisfaction is a tricky item. It varies greatly and is based on how and when information is collected. We can take the stance that these are flawed results and of no interest to us, or we can choose to identify the key elements that we can affect. By choosing to participate in a project, our partnership can grow. This may mean learning a great detail about something non-medical and then figuring out how to best communicate that to the physician team. It may involve learning from other experts: risk management specialists, skilled executives, and statisticians. It may result in changing the system of collection, reporting, and feedback. This change benefits all parties, not just one over the other.
A project that has great value for our partners is to improve their financial performance by collaborating on documentation. A hospital is paid very differently than a physician. The hospital’s income depends on what physicians write in the chart. This puts them in a position of dependence on physician handwriting! The difficulty for doctors is that the term definitions in some cases do not correspond to medical terms. By creating a program where the physicians meet weekly with a facility expert, dialogue can foster a partnership. The physicians provide the willingness to learn and the facility provides the expertise and time in a supportive manner. The physician gains an appreciation for the idiosyncrasies of hospital payments and can assist in improving the case mix index and diagnosis capture. When hospitalists and the hospital work together the facility becomes more financially stable and, therefore, the future jobs of the hospitalist group become more secure.
Everyone likes working in a happy and safe environment. As part of that environment, we have responsibilities to our fellow workers. We can complain about performance of our non-physicians colleagues or we can proactively partner to improve our relationships with them. In addition to the obvious—treating them with respect and as part of the team—we can create processes to improve their daily work.
How much variation is there among the way your group approaches diagnoses? Can the nursing and pharmacy staff assume a consistent approach for each patient? Our goal—to create care for patient populations not individual patients—must address this. Do you extract their expertise when designing these care programs? It can be of great value to us in assisting our patients and redesigning care. It creates an environment of value and satisfaction that leads to retention. Why do we care about retention? A stable nursing, therapy, social work, and case management staff adds to our daily satisfaction. We can’t get there alone. We need to partner with our co-workers with inclusion and education.
How about the emergency department? There is often a strain in our relationship with these important colleagues. Are we creating programs, process, and guidelines with our professional colleagues that work for everyone? There are many important points of collaboration, and sometimes we need to extend a hand first to get forward momentum.