The Ultimate Guide to Implementing Change in Your Healthcare Facility

Many of us find it challenging to adapt to new situations. Sometimes it feels like things move at a snail's pace in healthcare companies. Everyone acknowledges that healthcare must undergo transformation, but consensus on what those transformations should be is unlikely. Pay-for-performance initiatives, which are just being started in a number of sectors, are one incentive for change.

A handful of these programs directly impact primary care physicians, and I'd want to discuss them and offer some advice on how to adapt your practice to make the most of them. I think the transformation strategies offered will be useful even if you are not enrolled in a school to become a primary care physician.

Medicare is planning to launch a pay-for-performance initiative for primary care physicians in 2006. Currently, a model is being evaluated, and thus far, results look promising. Blue Cross Blue Shield plans are experimenting with pay-for-performance models in a number of states. For almost five years, Priority Health, a local health insurance provider, has advocated for just such an initiative in West Michigan. You may be wondering, "How does this work?" For instance, Priority Health provides funding to the program on a per-patient basis.

Additional payments are made to the doctor for each patient for whom they fulfill a program criterion. As a result, the practice's income increases dramatically with the addition of new patients. The truth is that many people aren't making the most of this chance. With Medicare reimbursements set to decrease in the next few years, this revenue stream is essential. No matter how challenging, healthcare programs must evolve.

While an organization's leadership is responsible for providing the impetus for change, they are not responsible for carrying it out on their own. It's important to have input from across the board in this process. Extra money from pay-for-performance programs or other agents or data that favorably affect the bottom line are good reasons for leaders to assemble a task force and start planning a process overhaul. Leaders should get everyone involved in mapping out the existing process and then mapping out how they want it to be once the improvements have been made. The revised process needs to be universally adopted.

How do you practically incorporate these adjustments into your life? This is most likely the most challenging part. Changes will require a wide range of approaches since people learn in diverse ways. The learning styles of those who will be implementing the changes should be taken into account. Let me illustrate with the Medicare system. When enrolling in Medicare, a patient is eligible for a free initial physical exam.

This is something a primary care doctor ought to use. Many people don't. If I ran such an office, I'd make sure the people in charge of making appointments knew this. I would bring it up in our weekly staff meetings. I would put up notes throughout the office as a gentle nudge. Once in a while, I may even have a message pop up on my screen.

After that, I would check the schedules of newly eligible Medicare patients to see how many of them had already had or were scheduled to have their first physical. To ensure that everyone in the office is on board with this policy, I would modify my approach to periodically remind them of the need for conducting such audits.

Scheduling the exam is not the only thing that must be altered. Physical examiners must follow Medicare's guidelines for the examination in terms of both content and procedure. Therefore, in order to get payment for the exam, all doctors must follow the exam's specifications. Depending on the doctor's preferred method of instruction, I would provide assistance in a number of different ways. When a patient's exam is completed, for instance, a checklist of the exam's specifics can be filed away in the patient's history folder. This ensures that the doctor won't miss a beat. As the change agent in charge, I would double-check with billing to ensure all necessary actions were taken, and I would develop fresh strategies or redouble my efforts to ensure the changes were implemented successfully every time.

Every healthcare provider institution must have a program in place for the ongoing improvement of quality that includes such adjustments. Let me sum up the key points quickly. The first step for leaders is to recognize the need for change. Next, the bosses should get together a group of the affected workers to figure out how to implement the shift.

Once the team has settled on a strategy, leaders should devise means for incorporating the change into daily operations, taking into account the various learning styles of those who may be impacted. Then, they need to monitor the modifications' development and make any necessary adjustments until the objectives are met. They should then periodically conduct an audit to ensure the organization has not reverted back to its previous ways.

In my opinion, your organization would greatly benefit from using a transformation process like this. Time is saved, the health and satisfaction of patients or customers are improved, and profits are boosted.