Making It Happen

Bob Vosburgh

As our summer flies by, we’re learning more and more about how to take the model for continuous improvement to an effective level. We just finished up a “full cycle” with a family medicine practice in Idaho. Let me run through a few of the key points, because THIS IS WHAT YOU NEED TO BE DOING!

Many of you are so busy, or perhaps so disorganized and un-prioritized, that you haven’t elected to spend the handful of hours, and I’m talking annually, it takes to be a truly outstanding organization. Do you want a better practice? Do you care about the work environment? How about patient care? Or, to cut to the quick, do you want to survive and thrive in this challenging environment?

First a reminder that the Organizational Evolution model has three phases:

1. Reflect
2. Observe
3. Improve

Whether you are a small business, a chamber of commerce or a medical practice, this model is very effective.

Reflect

If you and your senior leadership team are not committed to real change, it probably isn’t worth taking the time or making the effort to move to the next two levels. Many of the organizations we work with ask us to come in and help with their reinvention/board retreat. We are happy to do so the first year in the hope they’ll pick up on the model and move forward autonomously in the future. A typical first response suggests they’ve spent years reinventing “only from the top.” By this I mean only the CEO/Administrator/Ownership show up for the party. Frankly, this is a barrier to success, so much so that we aren’t at all interested in “rearranging deck chairs on the Titanic.” We won’t facilitate a reinvention unless all the team members, as in the entire organization, are invited to the event. How can the people at the top possibly know all the issues/solutions associated with employees, customers, patients?

Observe

You must have a high rate of survey participation in order to be certain you can rely on the data you obtain. To paraphrase Toyota’s rule #4: “Use science, with the help of a teacher, and push it all the way down to the lowest level of the organization.” For a medical practice, we suggest three surveys need to be run to obtain the best perspective:

1. Patient Satisfaction Questionnaire. You need to ask your customers for input. It needs to be at a level of participation that ensures high-quality statistical results. For a physician we recommend a minimum of two surveys per day. Getting that many should not be a huge task so long as everyone in the organization knows they will be held accountable for obtaining those numbers. If you make the surveys available through your website, at a kiosk, and via email as well as providing a written version, that’s a good start. Consistent quality comes from assigning the responsibility to your receptionist/front office manager with the understanding there will be clearly defined numerical goals for the percentages of patients who complete the surveys, and there will be positive and negative consequences associated with those goals. The results/frequency quotas should be in each job description and included in the annual review, and they should be tied to any bonus opportunities. If employees are unwilling to own this part of the process, perhaps there’s another organization where they’d be a better fit.

2. Employee Satisfaction Questionnaire (ESQ). You can ask your team to take the ESQ voluntarily and hope for the best. A valuable technique is to set up a computer in an office/conference room and have every team member sign in and take the survey. It is still an online, anonymous survey, and this way you’ll be able to track participation. I like to remind team members that if they aren’t willing to share their assessments and suggestions then they’re no longer allowed to complain! I tell them, “That’s part and parcel of being on this team. Right?”

3. Referring Physician Questionnaire (RPQ). We just finished up a consensus building test with your peers, and we’ve completed a generic RPQ. This is being added to your portal as I type this, and you will receive a call from our customer support group informing you when it is available. After all, referring physicians are your customers as well… for some of you they’re a huge source of business.

Improve

From studies we’ve read and also from personal experience, we know that those organizations who take the half-day per year needed to complete an annual reinvention are consistently the highest performers. As part of your portal solution, you can download an overview of the process (support videos) as well as a Power Point template for our well-tested half-day model (support documents). Commit the time, plan the event, and do it!

As I mentioned at the start of this article, we just completed a session with a family medicine practice in Idaho. They committed to the process (Reflect), they ran over 1,000 patient surveys and employee surveys in four weeks (Observe), and they committed to a half-day session, with all staff invited, for an annual reinvention (Improve). Below you can hear the practice’s CEO tell you more about how it went.