Tuesday, April 26, 2022

How to increase clinical efficiency with smaller staff

Two years of facing the challenges of the COVID-19 pandemic and we’re still adjusting our operations and learning ways for our providers and staff to increase efficiency. Born out of necessity, these strategies are helping our independent hand and orthopedic clinic streamline to meet a new challenge – returning to pre-pandemic patient numbers with a smaller staff.

For example, we now have a clearer picture of how to use technology to reduce time-consuming tasks that we put up with before the pandemic. This insight helped us figure out practices that allow us, and hopefully other orthopedic practices, to better utilize the valuable time of our physicians, staff, and patients.

We eliminated paperwork. By switching our electronic medical record to a cloud-based, specialty-specific EHR system during the pandemic, we dramatically reduced the time we spend on faxing and scanning paperwork.

Unfortunately, a round of layoffs in the early stages of the pandemic was part of the impetus we used to start looking for ways to do more with fewer employees. In reality, we simply no longer had enough people for a paper-heavy documentation system.

We’re not the only orthopedic practice that experienced the effects of COVID-19. A survey of US hand surgeons reported multiple furloughs, layoffs -- and even COVID-19 infections among nursing and support staff – in a study in the December 2020 journal Cureus.

Even with staff reductions, the researchers noted that most hand surgeons continued to perform urgent and emergency surgeries during the pandemic. So we were not alone there either.

In January 2022, 93% of practices surveyed were experiencing staffing shortages, and these shortages are having an impact on surgical volume, according to a survey of hip and knee surgeons published in the Journal of Arthroplasty.

We also upgraded our front desk technology during the pandemic. For example, we replaced manual check-ins and appointment scheduling with e-check-in options for patients. This also helps us thrive with fewer people.



In addition, we transitioned to a patient engagement platform that emphasizes easy communication with our patients. The goals are twofold -- to make contacting our practice more convenient for patients and to free up our staff from answering telephones. As a result, staff can spend more time on in-office, patient-related tasks.

We also rolled out a patient portal during the pandemic to change how patients communicate with us, and us with them. This feature also gives patients easier access to their medical records where and when they need them, without the need to scan or fax it to them.

All these actions were fueled by our new digital-first approach with patient convenience and practice efficiency in mind.

We also wanted to make the workday easier for our staff. Ditching our paper-heavy record system meant no one had to spend hours on manual data entry duties. In turn, we found success in spreading out our EHR documentation responsibilities, making everyone’s workday more efficient.

We moved billing staff to remote work. The pandemic necessitated transitioning our billing department to full-time remote work. In so doing, we eliminated the cost of maintaining a building for our billing staff members.

The American Association of Orthopaedic Surgeons (AAOS) is well aware of the business pressures the pandemic is putting on its 39,000 members. “The COVID-19 pandemic exacerbated the preexisting labor shortage in healthcare,” notes Ajay Srivastava, MD, in a January 24, 2022 blog post for the AAOS. Srivastava explains, for example, that the pandemic prompted many healthcare workers nearing retirement age to quit the workforce early.

There is a limit to how many people an orthopedic practice can lose and stay in business, however. “Orthopaedic surgery, like other medical practices, is heavily dependent on trained people. Staff and medical assistants are required at all times to run a practice.”

Still, Srivastava continues, “private practices have been attempting to meet the demand and continue to provide care in a variety of ways” as a result of the pandemic-related staff shortages. In our case at Michigan Surgery Specialists, that meant taking a ‘technology-heavy’ approach.


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Friday, April 22, 2022

4 Design strategies for optimal patient experience

Design matters in every environment and healthcare facilities of all shapes, sizes, and specialties are no exception. Throughout the space, all the way from welcome areas to patient rooms, there are unique needs and some universal solutions that create a patient-centered approach to care. Whether it's a new build or a needed refresh, the most important enhancements depend on making a modern decision versus going with the status quo.

Naturally there's going to be idiosyncrasies between environments. Hospitals and clinics have different requirements and there's a very strict divide between medical equipment and interior design. Working around and with these fixtures can be a challenge but not necessarily one that can't be conquered.


It's the little things


They say that the devil is in the details, but the thoughtful touches in a space are actually heavenly for patients. Think about the way that people feel while they're in a doctor's office and make sure that there's soothing considerations for each. People will universally feel better with seating that includes memory foam or enhanced padding, especially in overnight patient rooms with seating that's adapted for mobility concerns. Reception spaces benefit from enhanced accommodations as well.

Many patients experience anxiety, annoyance, fear, and a whole host of less-than-pleasant feelings before, during, and following an appointment. Stark white walls, bland furniture, and dated artwork does nothing to make anybody more comfortable. Pick out a color palette that's cohesive and unantagonizing, taking into consideration that green can make people feel more ill. Subdued blues, happy yellows, and slightly tinted grays are a perfect choice, especially when paired with coordinating textiles.



The more comfortable the patient, the more they'll embrace the more exciting details, such as intriguing paintings that highlight the room's palette or photography that's uplifting and tasteful. In reception spaces, pick out some plants that are well-suited to your lighting situation (even if that makes a fake fern a better idea) yet easy to maintain by staff. Informative diagrams are a hallmark of doctors' offices, some of which are quite dated or unattractive. Even if the specialists think these are the best, a tasteful frame can make the room look more modern and considerate for everyone included.


Quality, durability, and cleanability


When you're looking for textiles and selecting pieces, plan every space to ensure that you won't need to replace furniture on a regular basis. Reinforced metals aren't just important in bariatric chairs; you'll want to seek out frames that are made from high-quality materials that will stand up to time just as well as clinical fixtures. Especially with motorized recliners, it's worth the splurge to choose timeless and time-tested furniture.

Cleanability goes hand in hand with durability. Vinyl upholsteries aren't all made the same-- some of them are rated for different solvents that are significantly stronger than those used in other industries. This is incredibly important in patient rooms, ensuring that all specialties are prepared for the worst when it comes to client reactions and conditions.


The importance of lighting


Natural light is a luxury afforded to few clinical spaces and hopefully included in areas that need it the most. Thankfully there's artificial options that mimic sunshine, featuring warmer hues that are inherently more calming. LEDs are longer lasting and available in sizes that can be swapped out for florescent and incandescent bulbs in any area. Private and semi-private rooms should feature a dimmer that can ensure that lighting is tailored to both patient and provider liking.

Providers also need to be considered when creating a lighting scheme. Add task lighting to offices and areas that require utmost focus and concentration, including reception areas and their desktop needs. Some of these lamps can be adjusted to fit the user's preferred lighting with some opting for a brighter, colder lighting temperature.


Feedback and research is key


If you're reading this article, you're going in the right direction. Informed opinions from experts are a great place to start, especially those that go beyond universal tips and tricks and begin to explain the specific needs of specific spaces. It's important to work with professionals during your build, especially furniture-informed space planners that go beyond aesthetics, alongside architects and contractors that are modifying the space.

Particularly with a space refresh or redesign, it's helpful to seek direct feedback from those who have gone through the care experience. Digital surveys, simple questions, and market research provide valuable insight that goes beyond data or uninformed decisions from stakeholders. This also includes providers who have even more experience with the areas they interact with the most. Some of the results may surprise you, others may reflect your initial thought process, but every response is meaningful for the greater success of your facility.



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Tuesday, April 19, 2022

Why healthcare must navigate the muddy waters of ESG requirements

The need for more corporate responsibility has evolved for today’s corporations and the next generation of business leaders in the form of environmental, social and governance (ESG). Investors, activists, and regulators are now requiring proactive, community-structured commitment and accountability that is designed to step above shareholder returns.

Today’s global capital markets aren’t interested in more marketing from companies in every industry. Instead, they are demanding sustainability and eco-friendly business practices as well as a reasonable return. Global healthcare companies and their executives are now hearing this call, and the industry is being more proactive in this movement.

Why are ESG standards needed?


Although ESG metrics are still trying to find their proper place in today’s standardized financial reporting, that hasn’t stopped healthcare companies and other industry institutions from making promises and illustrating the proactive nature of their ESG standards.

What’s needed at this critical step is the ability for companies across all industries to truly quantify their company’s present position relative to investor objectives of integration, values, and impact in the areas of governance over environmental and social contexts. American stakeholders AND shareholders aren’t interested in window dressing and empty promises only for the benefit of a feel-good investor report. They want to know that companies are holding themselves accountable to the promises and commitments they’re making in these key areas.

Proxy advisors making unfair pressures


Many healthcare companies, specifically, have felt their fair share of pressure into adopting more ESG-forward practices. Whether through a reduction of plastic carrier bag usage or gender pay gap reporting, shareholders have certainly brought pressure on a large number of healthcare companies over their supply chain strategies, environmental and sustainability impacts, and certainly gender-diverse practices. This focus has led to a significant overhaul of many business processes alongside the appointment of a new addition to the C-Suite – the Chief Sustainability Officer (CSO). Other companies inside and out of healthcare continuously look at leaders in this movement and have started to replicate their operational changes.

However, making promises about ESG commitments and holding true to them are apparently two different stories for some. Many companies are being pushed into making ESG improvements and commitments, especially through institutional investors and oversight organizations such as Institutional Shareholder Services (ISS).



This has led some to wonder if these proxy advisors have become too focused on ESG issues, have conflicted, and have broadly too much power over the operation of America’s largest healthcare companies.

ISS hypocrisy over ESG requirements


As an example, ISS talks a big game on the issue of Diversity and Inclusion. ISS demanded publicly traded companies disclose the ethnicity of each and every member of their board of directors. More recently, ISS has been accused of refusing to recommend voting for board slates that they allege do not contain enough ‘diverse’ representation.

However, it appears that ISS lacks representation from even a single person of color. Moreover, it does not appear that ISS's two corporate owners---Genstar Capital and Deutsche Boerse---have even a single person of color on their executive teams. This is troubling given the fact that they have claimed Diversity, Equity, and Inclusion is a priority and have asked publicly traded companies and healthcare companies to make commitments towards those ends. Standards are not only needed, they must be adhered to at all levels.

Healthcare companies have a chance to serve as models


Despite the hypocrisy demonstrated by organizations such as ISS, healthcare companies have the opportunity to truly bring about change – not just in their marketing but in the way they go about doing business. In fact, as business models have had to adapt to this new landscape and changed customer behaviors, there has been evidence of the incorporation of ESG elements across the healthcare industry.

These moves recognize it is not solely about making money and preserving the bottom line, but that healthcare companies have been working toward having a positive societal impact. There is no doubt that these newly implemented strategies have the potential to drive increased valuations, which pushes up the appetite of investors, but that they also attract more qualified people into healthcare companies who are extremely committed to the corporate cause.

As more healthcare companies focus on staying committed to their ESG promises, everyone will win in the end, including customers, stakeholders, investors, the environment, and certainly employees. These companies will truly serve as models of operation in the future. But we must move beyond just promises and commitments, a new set of ESG standards must be developed to level the playing field of reporting.


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