By Kameron Gifford, CPC / 7.13.2013 / kgifford@ermconsultinginc.com
You can’t manage healthcare today, with yesterday’s models,
and be in business tomorrow...
In the context of education, is it culture or strategy that
drives our desire for something better? In terms of change, is it more power or
responsibility that one is seeking? And what has enabled some leaders to drive
mass change across large organizations while others fail? Perhaps the single
greatest predictor is the power of influence, the human factor that encourages and
sustains the necessary energy to get to that point of “something better.”
The process of identifying and eliminating waste and
ultimately defects was made famous by Toyota and has since infiltrated every
other industry on some level. But can process improvements alone be enough to
tackle the bureaucracy of America’s healthcare system? Can regulatory reform
inspire those farthest from Congressional hill, those who return to the front
lines day after day to care for our aging population of seniors or will it take
something more?
The path of progress must not be paved in external
motivation alone but incite the flames of internal desires to be effective. If
the agent of change is not truly embodied in the cause themselves, then can the
message accurately be broadcast from payer to provider to consumer or is it
lost in translation?
As a consultant, an educator, or a trainer, it is that
single moment of transition from external to internal, that aha moment, if you
will, that keeps us coming back again and again. Empirical Risk Management was
founded on the belief that change, must be initiated at the initial point of
contact to be effective, and in managed care that means the process must begin
when the patient walks in the door.
Over the last week, my husband and I were once again taken
aback at the power of an individual to influence and inspire those around them.
In Buffalo, New York just a few shorts steps from the Mission of Mercy
Hospital, we witnessed progress first hand. Discreetly set against a row of
similar houses turned businesses that line just another typical lazy road in
upstate New York. But this is not your typical practice, inside you will find a
leader, whose charge for change begins with strength and whose passion
resonates within all four walls. The epitome of a healer, a champion of champions.
Our call to action was prompted by a desire to improve the “team”
and to create a shared vision for the future. Our mission was not defined by
reaction, but instead action, originating from that desire for something
better. We were not there to “fix” a specific problem, but instead to observe,
assess, and to improve if at all possible. These projects, coined RPI or rapid
practice innovation, are not for the faint of heart, and in fact the obscurity
of the task often leads most to shy away. However, it is that exact uncertainity
that elicits my passion. For isn’t it the shared success of the sum that is greater
than the individual triumphs?
The value that is derived from a receptionist who
understands the clinical significance of a 1% improvement in a Hgb A1c will far
exceed the value of your investment. A nurse who understands the 10 guiding
principles that influenced the creation of the CMS-HCC model will inherently
improve the experience for both the provider and the health plan. A coder who
understands the potential financial impact of rejected encounters on the
Medicare Advantage plan will provide incredible value to your revenue cycle. It
is this proactive team approach at the initial point of contact that ultimately
improves outcomes and minimizes opportunities for errors.
And at the end of the day, it is this shared vision, that
unites once starkly contrasting goals into one uniformed march towards
innovation.
