Rheumatology Practice Management
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Evidence-Based Leadership Model: Achieving Desired Results and Keeping Them

At the 11th Annual National Organization of Rheumatology Managers Conference, held September 15-17, 2016, in Mobile, AL, practice managers, physician managers, and other healthcare administrators gathered to network with their peers and attend educational sessions on the future of rheumatology management in the age of value-driven healthcare.

In a general session, Pam Beitlich, DNP, ARNP, RN, NEA-BC, National Speaker for the Studer Group, Pensacola, FL, shared proven strategies that rheumatology practice managers can use to help their staff make necessary improvements in behavior. She emphasized the importance of using an evidence-based leadership model to achieve and sustain positive changes.

Evidence-Based Leadership Model

The 3 key components of an evidence-based leadership model are: (1) aligned goals, (2) aligned behavior, and (3) aligned processes. “Alignment of goals in your practice or department is key to getting the results you want to achieve,” Ms Beitlich said. Successful goal alignment requires the use of an objective evaluation system so that everyone is aware of the shared goals and the steps required to reach them. Effective leaders are essential to the achievement of aligned goals. “Leadership doesn’t just happen. You have to really have some development. What I do know is that you’ll never get good results without great leaders,” she stated.

Aligned behavior promotes consistency in the way that patients are treated, from the time they sign in at the registration desk through their prescribed treatment. However, it can be challenging to align the behaviors of several individuals in any given practice. Ms Beitlich encouraged managers to make an effort to build relationships with each member of the staff. She referred to this as “rounding.”

“It is important to know what is happening in your practice every day,” she stated. There also must be a culture of recognition. “If you want to change what’s happening in your practice, you have to recognize the behaviors that you want to change,” she noted.

Ms Beitlich cited peer interviewing as another useful tool for aligning behavior because it increases the likelihood of choosing a new employee that will fit into the existing culture of the office. In addition, staff members who interview potential employees will be more motivated to help them succeed if they are hired.

She went on to discuss the importance of implementing a consistent conversation framework to help staff members mitigate patients’ anxiety and better anticipate their needs. She introduced AIDET® (Acknowledgment, Introduction, Duration, Explanation, Thank You), a foundational tactic created by Studer that can be used by nurses, physicians, technicians, administrators, and any staff members who are involved in patient and family encounters.

When practicing “acknowledgment,” staff members should make an effort to smile, make eye contact, acknowledge the patient by name, and stop whatever they are doing so that the patient knows that he or she is the most important person at that moment.

“Introduction” refers to the way that patients are greeted. They should always be warmly welcomed into the office. In addition, staff members should introduce themselves by name and department, and explain their role in the patient’s care.

“Duration” refers to the practice of keeping patients and families informed of what is happening. Staff members need to explain how long it will be before the procedure starts, how long it will take, and what will happen afterwards.

“Explanation” to patients and families should include the following: what the procedure entails, who will be involved in providing care, whether the procedure will cause pain or discomfort, and if any follow-up instructions are necessary. Staff members should answer any questions or resolve any complaints that patients may have.

“Thank you” reminds staff members to express their appreciation for the privilege of caring for patients and to ask if there is anything else they can do for them.

The final component of an evidence-based leadership model is aligned process, which, in some ways, can be compared with a flywheel. “Once you get it started, it’s really hard to stop it when you’re getting results,” Ms Beitlich said. At the center of the flywheel is purpose and worthwhile work. However, even when staff members are passionate about helping others, they need principles and prescriptive “to dos” to achieve lasting results. It is these bottom line or “pillar” results that can be built upon to keep processes moving along.

10 Questions to Ask If You Are Not Getting the Desired Results

Ms Beitlich concluded her presentation by posing 10 questions that managers need to ask if they are not getting the desired results in their practices.

  1. Have we set clear and high targets?
  2. Was education provided to all involved as to what the expected behavior is and have we overcommunicated the why?
  3. Has leadership made it clear that the behavior is mandatory, not optional?
  4. Is the behavior being modeled by leadership?
  5. Has the new behavior been practiced using role-play? Have we checked competency?
  6. Are we measuring for success? Are we auditing the results?
  7. Are results of the verification being reported transparently? Are they out where everyone can see them?
  8. Are leaders giving positive feedback when they see the behavior being done correctly?
  9. Are we correcting poor performance quickly and on the spot if necessary?
  10. Are there consequences for noncompliance, up to and including termination?

“If you have behaviors that just aren’t optimal, you’ll find that you’ll start really losing results. And it comes back to us as the leaders,” Ms Beitlich concluded. “Become a better leader and commit to being even more accountable. Your patients deserve it.”

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