1. Hold grand rounds for the medical staff. The physicians at Arthritis & Sports Orthopaedics & Physical Therapy began holding grand round meetings each week to strengthen the lines of communication and trust between the physicians and other medical professionals, says Rebecca Seay, Director of Marketing at Arthritis & Sports Orthopaedics & Physical Therapy in Sterling, Va. The practice has four physicians, four physician assistants and one nurse practitioner. Each week they gather together and discuss the cases they saw over the past five days. Additionally, they analyze a “mystery case” where the physicians give symptoms and ask the other physicians and PAs to diagnose and prescribe treatment.
Often the physical therapists from the practice join the grand round meetings as well. Nobody is allowed to miss these meetings when they are scheduled to attend, which makes the time sacred between the medical professionals. “The grand rounds help keep our service model consistent between all medical staff,” says Ms. Seay. “The medical professionals have protected time each week to communicate with one another.”
2. Train leaders appropriately. John Merski Jr., Managing Partner and Executive Director of Human Resources for MedHQ, says the most common management problem he sees at surgery centers is a general lack of management training. He says surgery center administrators are frequently hired for their operational, financial or clinical skills with little emphasis placed on their “people skills” or management abilities. In many cases, an OR nurse may be promoted to the position of administrator without undergoing management training.
“Managers are not born, and most surgery center managers today do not go to school for management,” he says. “They’re usually someone who is a strong technician and is picked by upper management to advance, and when they get to the next level, they are armed with very little management skill.” He says most managers fall into one of three categories: overly nice, overly harsh or effective. Unfortunately, Mr. Merski sees more “overly nice” and “overly harsh” managers than effective ones simply because they have not undergone the proper training. He says if a surgery center administrator is hired without management experience, they should undergo training in order to learn how to direct people.
3. Evaluate each employee individually and often. It’s important for managers to evaluate their employees regularly so employees don’t have to guess about how they are performing at their job. Every employee should be evaluated individually based on their job description, performance metrics and goals. Even between formal evaluations, giving employees praise or brief instruction can help them progress professionally.
“Give employees kudos for what they did or let them know how things should have been done so they can change their behavior,” says Karen Codere, senior human resource specialist with Insperity, a provider of human resources and workplace management services. “Celebrate achievements for individuals and the office as a whole. This gives employees a sense of fulfillment, which can make the office run smoothly, helps you retain the best people and helps you provide excellent care to your patients.”
Provide employees with a job description and devise a performance appraisal process so their efforts are quantifiable and you can measure achievement and growth. Companies such as Insperity can provide the infrastructure for these types of human resources endeavors.
4. Respect the wisdom of your employees. It’s important to keep good staff members who know how to treat patients consistent with your group’s patient-centered culture and can quickly answer any questions patients might have about their care. Training new staff members takes a great deal of time and money, and if they leave the practice quickly they are a drain on resources.
“If you want to retain experienced and good people, it makes sense to put resources into keeping them happy,” says John Wipfler, CEO of OA-Centers for Orthopaedics in Portland, Maine. “Pay is only the beginning and it doesn’t need to be at the top of the scale. Respecting their wisdom, giving them a voice in the practice, having working committees with staff and creating many channels for hearing about what they are thinking and feeling. We want to keep morale up and be very transparent about what is happening in the practice. Enlist them in helping you solve your problems.”
5. Develop a “teamwork team.” Anne Hargrave-Thomas has spent as CEO of West Bloomfield (Mich.) Surgery Center, says her center has benefited from installing a teamwork team that involves one staff member from every area of the ASC. The team meets once a month to discuss any problems with the ASC, as well as how to fix them. “That has been very successful because they feel part of the process,” she says. “We have someone from every area — front desk, pre-op, post-op, OR and central sterile department.” The team is led by a non-clinical manager — not Ms. Hargrave-Thomas — to give employees the opportunity to speak frankly about topics that could be improved.
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