Transcript Engagement Session_AF Williams - PCMH e

UPDATE YOUR STATUS TO ENGAGED :
HOW TO ENGAGE YOUR
STAFF DURING A TIME OF
TRANSFORMATION
Kathy Cebuhar, Practice Coach
Justin Emerick, Practice Manager
Corey Lyon, Medical Director
AF Williams Family Medicine
Center
University of Colorado Department
of Family Medicine
University of Colorado Health
SESSION OBJECTIVES
1. LEARN IMPLEMENTATION STRATEGIES THAT CAN IMPROVE STAFF
ENGAGEMENT AND SATISFACTION
2. IMPROVE COMMUNICATION WITH AND AMONG STAFF
3. IDENTIFY AND RECRUIT PRACTICE TRANSFORMATION CHAMPIONS FROM
WITHIN YOUR PRACTICE
POLL QUESTION
Text “COREYLYON” to 37607
SUPPORT STAFF SHIFT
Care By Design model
 University of Utah
Process changes to increase support role of Medical Assistance
 Also increase provider to MA ratio
MORE WORK?
More work per patient; not more patients
GOALS OF OUR MA NEW MODEL
•Ensure all team members are functioning at the top of their scope and ability: right job; right
person
•Improve patient, provider, and staff satisfaction
•Improve access
•Build on the culture of quality and team based care
•Improve the health and health care of our patients and their families
MODEL BRIEF OVERVIEW
•2-2.5 MAs to 1 provider ratio
•Expanded rooming process
•MA stays in room to assist with documentation, and implementing plan
•MA completes post-exam tasks, provides after visit summary (AVS)
•Increase MA scope to help care for patient
GOALS OF NEW MODEL FOR MA’S – INCREASE
RESPONSIBILITIES
•MAs collect/update patient information
•Sets the agenda
•Medication reconciliation
•Utilize standing orders for patient care
•Identify gaps in care, tee up orders
•Documentation assistance
•Greater In-Basket support
•Reduce patient waiting time
•Everyone practices at top of scope
IMPLEMENTATION STRUGGLES
LARGE STAFFING CHANGES
 20 MAs hired between November 2014 – September 2015
 Extended orientation (6-8 weeks)
INCREASED MA RESPONSIBILITIES
 Complaints regarding unbalanced workload distribution
 MA disengagement
 Spectrum of MA skill level
 MA concerns around compensation
INCREASED PATIENT VOLUME
CHALLENGES FOR PROVIDERS
METHODS FOR ENGAGEMENT AT AF WILLIAMS
FAMILY MEDICINE
BOOK CLUB
 Crucial Conversations
 Leadership and Self Deception
CLINIC-WIDE CELEBRATIONS




Annual Award Ceremony
Cake
Potlucks and movies
Cook-off challenges
BI-ANNUAL STAFF AND PROVIDER SATISFACTION SURVEYS
CINCO DE MAY0 CELEBRATION
Golden and Silver Spoon Winners:
Gaby B. & Maria P.
METHODS FOR ENGAGEMENT AT AF WILLIAMS FAMILY
MEDICINE
FOCUS GROUPS AND LUNCH &LEARNS
 Medical Assistants
 Registered Nurses
 Providers
WHITE BOARD
 Weekly questions
 Quotes
 Info sharing
STAFF INPUT ON CLINIC WORKFLOW ADJUSTMENTS
 Lead MA Position
 Clinic Flow Position
IMPROVING COMMUNICATION CLINIC WIDE
COMMUNICATION SERIES
 Styles of communication
 Effective vs. ineffective methods of communication
 What’s Your Work Style?
 Professionalism development
 Conflict resolution skill building
FACILITATED CRUCIAL CONVERSATIONS
 Mediated conversations between staff members with support from CNC or practice coach
SESSION HUDDLES
 Staff/Provider Changes
 Procedures/Staff Visits
 Workflow adjustments
 Fun Facts
CLINIC WHITE BOARD & HUDDLE WHITE BOARD
IMPROVING COMMUNICATION CLINIC WIDE
REAL-TIME FEEDBACK LOOPS
 Leadership to Staff/Staff to Leadership
 Staff to Staff/Leadership to Leadership
 Staff to Providers/Providers to Staff
TEAM BUILDING EXERCISES
 Staff only
 Providers only
 Both staff and providers
MONTHLY POD MEETINGS
 Adjust workflows
 Discuss what’s going well/what needs improvement
PRACTICE TRANSFORMATION CHAMPIONS
PCMH QI TEAM PARTICIPATION
 Identify inefficiencies in current workflows
 Part of NCQA application process
 Establish improved workflows
 Disseminate information
 Monitor dashboard data for improvements/adjust as necessary (PDSA)
 Dedicated time (paid time)
ESTABLISHED LEAD MA POSITIONS
 Advocates for change
 Workflow experts/super users
CURRENT STRUGGLES
UNINTENDED CONSEQUENCES OF THE LEAD MA POSITIONS
COMPENSATION
CONTINUED STAFF TURN-OVER
PERSONALITY CONFLICTS
NEXT STEPS
CONTINUED TEAM BUILDING
STAFF “SUPPORT GROUP”
 facilitated by clinic psychologist or practice coach
QUESTIONS & IDEA SHARING
CONTACT INFORMATION
[email protected] – AF Williams Family Medicine Medical Director
[email protected] – AF Williams Family Medicine Clinic Manager
[email protected] – CO Dept. of Family Medicine Practice Coach