The Journal of medical practice management : MPM最新文献

Value in healthcare must focus on accessibility, quality, and affordability. This article describes how a healthcare team provides value by meeting the needs of a rare disease patient and underscores the importance of a chronic multiorgan rare disease home. A nurse practitioner can ensure that barriers to evaluation are removed and communication is prioritized in order to provide accessible and affordable care to a patient with rare disease without jeopardizing quality of care.

The word "audit" generates fear in any situation. Many practices do not audit-sometimes because they are so overwhelmed with just day-to-day management, but sometimes because they would rather not know of issues that they do not wish to confront. Even practices that currently audit may have the wrong focus. Common errors in auditing include performing internal audits only, choosing the wrong auditor, auditing based on the wrong parameters, not repaying or resubmitting after an audit, not performing follow-up education, and thinking that attorney-client privilege provides unlimited protection. Although practices should perform some internal auditing, if this is the only auditing done, there is the risk of the "fox watching the henhouse" effect.

Patient compliance is no laughing matter, but when administrators and doctors are asked if employees follow their directions, the question often is met with nervous laughter. In order to provide high levels of patient care and safety, leaders in the healthcare industry must be able to motivate employee compliance, adherence to policies and preference, and, at a minimum, the following of directions. Each can be achieved, resulting in far higher levels of performance in a hospital or even,small practice, but that requires leadership in each of the following five areas: giving explicit directions; imposing reasonable consequences; monitoring progress; employing empathy; and following through consistently. Without these leadership actions, a lack of employee compliance will have a far more damaging impact than any struggle with patients about following treatment directions.

Patient portals can bring many benefits to both practices and patients, but achieving those benefits requires a thoughtful and well-designed launch plan. This article provides four critical steps to a successful patient portal launch along with some tips from one practice manager who has implemented a portal successfully. Learn how to train your staff, communicate about your new portal effectively to patients, use your portal to improve revenue, and increase patient satisfaction.

Primary care is evolving in response to payment reform, changes in the primary care workforce, and development of new models of work emphasizing team care. The role of registered nurses in these new models is being reexamined and reimagined, with increased registered nurse engagement in chart review prior to visits, histories and physicals, preliminary patient assessment, patient education and coaching in ordered care, delivery of care under standardized orders and protocols, transition planning, and care coordination. The business case for employing registered nurses in these new roles has not been fully addressed. This article examines the business case and financial issues in this expansion of practice. Under both fee-for-service and value-based, capitated, or shared saving models of reimbursement, there are strategies for increasing the number of registered nurses in primary care practices, and expanding the engagement of registered nurses that can increase net revenues for primary care practices, even when the costs of the additional staffing are taken into account.

Many practices find themselves struggling with their patient schedules. Physicians need to see a certain number of patients per week from a financial perspective, yet want to have enough time to spend with each patient. No-shows often have a significant impact on the daily patient flow, from both a scheduling and a financial perspective. Monitoring schedules and creating a work flow that works for your practice can help decrease no-shows.

In the course of your career in medical practice management, you will almost certainly encounter at least one employee who dislikes you. In some instances, an employee's dislike may be justified. But in many, you will have done nothing wrong. This article suggests what you can do to clarify how an employee actually feels about you, to be sure that what you're observing and sensing is dislike. It then suggests 20 strategies to help you manage, change, or cope with an employee who dislikes you. This article also suggests 14 signs that your employees hate you in secret. It offers 10 reasons that employees commonly hate their managers, five reasons that employees dislike managers who micromanage them, and seven reasons employees may dislike you that you can't prevent. Finally, this article suggests an effective first-aid strategy for bad employee-manager relationships and explores the potential upside of being disliked.