1. Appoint a safety officer. This person – who may be the office manager, a nurse or back office assistant, or other staff member interested in taking on the role – should be in charge of keeping your safety manual up to date, organizing training for staff (see next two items), and generally being responsible for office safety.

2. Write, or purchase and then customize, a safety manual for the office, or review and update the one you already have. Make sure that policies in your manual are consistent with OSHA, ADA, CLIA, and HIPAA requirements. Have each new employee read the manual upon hire and ask existing staff members review it at least annually.

3. Send staff to safety training sessions. Check with your local medical society, specialty organization, or hospital for resources. Topics may include universal precautions, CPR, first aid, emergency preparedness, and personal safety.

4. Encourage employees to bring up safety issues. Add “Safety Check” as a standing discussion item on your staff meeting agenda as a way to remind employees to bring up potential problems. In addition, your safety officer should be prepared to address staff concerns at any time.

5. Bookmark the CDC website (< color=”#0000ff”>www.cdc.gov). The Centers for Disease Control and Prevention site includes a wealth of information on workplace safety, environmental health, and emergency preparedness for healthcare workers.

6. Make friends with the local police and fire departments. In many communities, police and fire officers are available to make on-site visits and offer recommendations on how to improve building and personal safety.

7. Comply with regulations. Even though it’s a lot to keep abreast of and takes time, complying with OSHA, CLIA, fire codes, and other safety-related regulations will force you to keep safety top of mind.

8. Use common sense. Many of the same things that make your home safe also make your office safe. Everyday safety hazards include such things as rugs that slip or trip, loose electrical cords, heavy items on high shelves that might tumble onto someone’s head, and icy sidewalks in the wintertime. If you have children in your practice, even as visitors, be sure to kid-proof the environment.

(1) Use a recall system. If you have an electronic medical record system, chances are that it has a built-in recall feature to follow up with patients who need, for example, quarterly or annual office visits. If you’ve not yet converted to an EMR, the old-fashioned but very effective postcard system works well. 

(2) Make appointment reminder calls. It takes time to have a staff member call every patient on tomorrow’s schedule to remind them of their appointments, but if the effort results in 1-2 fewer no-shows, then it’s time well spent.

(3) Keep a cancellation list. Again, your EMR system may have a feature for tracking patients who want to be moved up in the appointment schedule or need to be “squeezed in,” but if not, a notebook with names and phone numbers at the front desk can be very effective. If a patient cancels on short notice or you hear, “Oh, I totally forgot, can I reschedule?” when you make appointment reminder phone calls, you’ll be able to quickly fill that gap in the schedule with someone from the cancellation list who will be grateful for your efficiency.

(4) Stay on time. People are busy. You’ve no doubt had the experience of having a patient leave the office without being seen simply because they’d been kept waiting too long. Perhaps they had to get to work or to another appointment, or maybe they were just mad enough to walk out the door. Keep your office running on time to make sure that every patient who comes into the office is seen by a provider before they leave.

(5) Promote your practice. You’ll be more likely to keep a full schedule if potential new patients know of your availability and understand the services you offer. If you don’t have a comprehensive practice marketing plan in place, make 2010 the year you write and implement one. Practice promotion does not have to be expensive. Watch for a future post on cost-effective marketing activities.

Set an expectation. Create a written financial policy for your office, one that’s easy to understand and not too long. Consider an FAQ format for simplicity. Post the policy on your website and give a copy to each new patient who visits your office. Having a written policy sets the expectation in the minds of patients that you intend to be paid for the services you provide. It also gives staff a document to rely on when patients have questions about payment issues.

Collect at the time of service. This sounds obvious, but far too many offices allow patients to waltz in for care and out again with “bill me” as their parting words. Make it clear when you schedule appointments that co-pays and other balances due are payable at the time of service. Patients who “leave their checkbook at home” should leave the office with a return envelope and a request that they mail a check the following day. Follow up by phone if no check is received within five days. Yes, this is time consuming, but less costly in the long run than sending a statement (or multiple statements) or waiting weeks or months for payment, which sends a message that late payments are acceptable in your practice.

Accept credit cards. If you’re not already accepting major credit cards at the time of service and as an option for patients to use when paying bills by mail, now is the time to start. Check with the bank where you have your business accounts to find out how to get up and running with credit card processing, or Google “accept credit cards” to find vendors.

Offer payment plans. No, you’re not a bank or finance company, but offering patients a reasonable payment plan might be a good solution in certain cases. If, for example, someone owes a few hundred dollars and can’t put the balance on a credit card, better to accept $100 a month than write off the balance or send a long-standing patient to collections. There are some rules associated with payment plans, so check with your accountant and create a policy that you follow carefully.

Half day, on site, internally facilitated. The most basic staff retreat would be a half-day session when you close the office and hold the retreat on site. If you go this route, either forward your phones to the answering service or hire a temp to handle incoming calls so that everyone can participate in the retreat. Four hours is about the minimum investment of time if you plan to really dig into practice goals, map out a strategy, and begin assigning specific tasks. For this simple retreat format, you’ll need only a comfortable meeting space, a flip chart, refreshments, and someone who can volunteer to facilitate and keep the group on track in terms of the agenda and schedule.

Full day, off site, with or without a professional facilitator. When you decide on a full-day retreat, it’s probably best to take it off site. You may choose a local hotel or retreat center, or if the budget is tight and your staff is small enough, someone’s home might work if there is a space conducive to a day of brainstorming. If you’re not in a facility with food service, have morning and afternoon refreshments as well as lunch catered so that no one is distracted with playing hostess. If you go with the full-day format, consider hiring a professional facilitator (more on that in the next item).

Two days, off site, with a professional facilitator. If you invest in a longer retreat, it makes sense to also invest in a professional to run the meeting. A skilled facilitator (ideally one with medical practice knowledge) can walk your team through not only how to achieve your critical goals, but can also help you work on longer-term strategic planning, mission/vision/values statements, and assist in resolving any conflicts that might arise during your retreat.

No matter which retreat format you choose, follow-up is essential. Immediately after the retreat, someone should transcribe everything that was written on your brainstorming/planning flip charts into a document that everyone can access and reference. Follow-up should continue throughout the year during regular staff meetings or specially scheduled “mini retreats” to ensure that you are continually moving toward achieving your goals.

National Medical Group Practice Week™ is January 18-22, 2010.  W

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(1) Debrief 2009. What worked? What didn’t? What did you hope to accomplish that’s still on the “to do” list? What (or who) changed in your practice last year that might influence new goals for 2010? Don’t forget to include a thorough financial review. Did you meet your revenue targets? Did you stay within budget? Having a clear picture of the recent past will help you effectively manage the coming year.

(2) Poll office staff and providers. What does each person and the group as a whole consider to be top priorities for this year? You may be thinking that investing in a new phone system is number one on the list but find out that the staff is more than willing to limp along with the current system for another year if only they could please, please, please have a copier that doesn’t jam up every day.

(3) Set a limited number of clear, achievable goals. Resist the temptation to make a long list of goals. Instead, pick just a few very important ones and focus your attention there. What one, two, or three goals – if achieved – would have the most positive long-term impact on the health of your practice? Make sure your goals can be measured. Instead of “Do better with collections” say “Increase collections by 8% over 2009.” That you can measure.

(4) Create an action plan. Once you have your handful of goals written down (yes, put them in writing!) put together a step-by-step action plan that will help you stay accountable to continually working toward the goals. For example, you might review your current collections policies and hold a special staff meeting to discuss upgrading those policies in January as your first step toward that 8% increase.

Work toward getting everyone in the office on board to ensure that you achieve your goals this year. One way to do this is by holding a retreat for your practice. Watch for another post here soon on that topic. Good luck with your 2010 goals