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My Presentation from the 2009 Decision Health Coding Summit
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Look , Think, Do: A Dynamic approach to Management for Home Health Administrators
Presented by:Kermit Springstead, RN MBA
Administrator, Memorial Home Health Services
Hollywood, FL
www.decisionhealth.com
In the beginning……
I inherited an agency that was $1.2M in the Red and in ten months I increased Net Revenue by $900K, reduced Deductions by $200K offset by an increase in Expenses of $500K for a net improvement to the bottom line of $400K and turned a profit of $49K for the month ending April 30, 2009
www.decisionhealth.com
Some more information
• Strengths: 5 hospital system &1600 member medical staff, MHS with a healthy bottom line, longevity of HH staff, consistently strong pt outcomes, agency provides a wide spectrum of services
• Weaknesses: paper based system, “software” is 35 yrs old, limited HH SMEs, serve all patients regardless of ability to pay (20% free care)
www.decisionhealth.com
Some more information
• Opportunities: census on July 7, 2008= 310; less than 60% Medicare business captured from system, 1000 medical staff not referring to HH
• Threats: 6 competitors with strong ties to high volume referring docs, HH not on managed care panels, 250 other Medicare certified HH agencies in Broward County, FL
www.decisionhealth.com
Putting Look, Think, DO into practice…..
www.decisionhealth.com
LOOK:
Rounding on staff: • walk around and observe people at their
workstations• spend time with your productive and
valued staff to learn how they do it• spend time with marketers/educators
www.decisionhealth.com
Look at staff as HML Performers: High, Medium, or Low
• Always be looking for ways to get rid of your low performers
• Move your M to H otherwise over time they become an L
• Learn to re-recruit and retain your High Performers or they will leave you
www.decisionhealth.com
• EX1: a staff person has been employed by the agency for over 10 years. A recent change to speed up the paper flow involves her getting out of her chair and checking through the discharge OASIS bin to verify which d/c OASIS and d/c summaries have been turned in. She wrote me an email saying how this unfairly singles her out for change. Not a bad person, doesn’t steal, BUT I decided in that encounter that I have no room for her on my team.
www.decisionhealth.com
• Ex 2: Leanna, the 8 year old daughter of my cousin Grace who lives in New Jersey was telling me about the power point slide show she put together for a fourth grade class project on nutrition. It had movement, sound, and video inserted. It took her 45 minutes to figure out how to use the program. I look for Leanna’s attitude in all my staff.
www.decisionhealth.com
Look at Your Customer Satisfaction Surveys• -Most candid feedback you can get from your
customers• -HH CAHPS are coming. What will they say about
your agency?• Go to: www.cahps.ahrq.gov • Will they be P4P indicators?
www.decisionhealth.com
POP Quiz:• What is your definition of a High, Medium, Low
Performer?• Can you list your employees by HML? • When is the last time you have removed a low
performer from your team? • How effectively do you use your annual
performance evaluation process to move an M performer to an H level?
www.decisionhealth.com
Think (Dashboard):
Data Analysis:• Management reports• Budget versus actual at month end• Trending admissions and expenses • Planning versus reacting
www.decisionhealth.com
POP Quiz 2:
• How much time per week do you commit to data analysis?
• Who is in your inner circle? • Who is in your network?
www.decisionhealth.com
“ You’ll never find time. It isn’t lost. You’re living it. You have to consciously decide to live it in certain ways and not others.You have to make time by taking it away from one activity and giving it to another.”
From: Time Management by Marshall Cook 1999 Edition
www.decisionhealth.com
From Stephen R. Covey: ‘The Seven Habits of Highly Successful People’ Simon and Schuster. 1992
Urgent NotUrgent
Important Quadrant 1:Urgent andImportant
Quadrant 2:Important but not Urgent
NotImportant
Quadrant 3:Urgent but not Important
Quadrant 4:Neither Urgent or Important
www.decisionhealth.com
Five Year Vision Statement:
• Memorial Home Health Services will be recognized as a clinical center of excellence
www.decisionhealth.com
Three Year Vision Statement:
• Memorial Home Health Services will have a fully integrated EMR with the capacity for telehealth and an interactive physician portal
www.decisionhealth.com
One Year Vision Statement:
• Memorial Home Health Services will financially break even at fiscal year end close
www.decisionhealth.com
DO:
• Provide Coaching to your leaders - • Show a genuine interest in staff and what
their jobs are:– build loyalty
• Keep an Open Door Policy:– hear about problems when you can solve them
and prevent bigger problems
www.decisionhealth.com
DO:• Work on your calendar at least 30 days out from the
current day• My monthly meeting calendar:• - Data Entry• - Billing and collections• - Medical Records• - Team Meetings• - General Staff Meetings
www.decisionhealth.com
DO:
Create reasons to celebrate:• Patient safety awards• Compliments from patients• Themed gatherings coupled with an in-
service or chart “catch up”
www.decisionhealth.com
DO:
Create a Standard of Excellence in your office
www.decisionhealth.com
Pop Quiz 3:
• How clean is your agency? • How inviting is your office to receive guests? • What example do you set in how you dress,
act, treat others? • How important is it to you to learn and apply
technology to your agency?
www.decisionhealth.com
The Real Leadership Challenge is Keeping Ahead• If you haven’t seen this video clip from
YouTube, check it out:http://www.youtube.com/watch?v
=jpEnFwiqdx8• Or go to YouTube and search for Shift
Happens 2008 Latest Edition
www.decisionhealth.com
How I Apply Look, Think, DO to my Workweek• I spend a minimum of 2 hrs weekly planning ahead
(30 days out)• I spend a minimum of 1 hr daily reading reports and
comparing to budget• I spend a minimum of 1 hr daily on emails ( avoid the
junk, follow up promptly, trash/delete at end of day)• I avoid initiating phone calls
www.decisionhealth.com
How I Apply Look, Think, DO to my Workweek• I round at least twice per week outside of my office• I round at least three times per week inside to the
teams, data entry, medical records, and billing/collections
• I am in contact with my boss at least once per week (formal or informal)
www.decisionhealth.com
How I Apply Look, Think, DO to my Workweek• I make coffee• I set up for meetings and clean up messes • I rotate the times I eat lunch in the lunchroom• I share my calendar with others
www.decisionhealth.com
Any other questions?