Healthcare Issues & Trends

Advice & Insights for healthcare's Leaders & HR Professionals


Staffing Ratio: Clinical Support Staff & Provider FTE Outside the 25th-75th Percentile

Posted on August 22, 2014 by Brad Lenertz

What is impacting your clinical staffing ratios? Are those impacts within benchmark range? 

Many physician practices do not take the time nor make the effort to "right-size" their clinical support staff in the face of either external or internal changes in the practice. Recently-trained physicians joining the private practice may feel the need for the level or type of clinical support staff they had in their training program. The costs of that support, however, may not have been justified by the activity level or revenue received per visit. Additionally, senior physicians in practice may not feel comfortable in the office without their regular nurse, despite spending little time in an office setting.

Conversely, the lack of a balanced clinical support staff can lead to poor patient service and inhibit patients from accessing proper care. The key in both cases is to revisit the rationale for the type of clinical support staff to ensure both financial and clinical issues are considered and that any "right-sizing" takes place in a thoughtful manner.

Recently, INTEGRATED performed an Operations Assessment for a client that revealed their overall nursing support staff to be at or above the benchmark media. Their staff, however, felt overwhelmed by the workload and couldn't keep the pace with the increasing demand from patients along with returning phone calls. Their preferred solution was to hire an additional staff member to take care of the additional workload. INTEGRATED was able to identify process changes that led to more efficient use of the nursing staff's time. The practice's physicians and staff supported the changes and the organization was successful in avoiding the added cost of hiring. 

At INTEGRATED Healthcare Strategies, we have a team dedicated to Physician Practice Operations. Their entire focus is on measuring, benchmarking, and improving operational performance. If your practice struggles with optimizing operations with the right staff, invite one of our senior consultants to give you a call--no obligation. They're well-equipped to spend time assessing the situation and give you their initial impression. 

Benchmarking Without Benchmarks?

Posted on July 28, 2014 by Brad Lenertz

“We are unique, so finding a benchmark for us is impossible!” If you’ve heard this once, you probably have heard it a thousand times! Even worse, if you’ve said this once, it was probably one too many times!

In the healthcare industry, the concept of individualized patient care is natural. But that doesn’t mean we don’t do diagnostic tests and compare the results to what is considered “normal” ranges for similar patients? Healthcare providers benchmark patient care all of the time – yet still create an individualized care plan for each patient’s specific needs. Why would we approach the health of the practice any differently?

It isn’t uncommon that we encounter a client program where benchmark data truly doesn’t exist. In these cases we don’t stop trying to help the client improve. After all, we know what “better” looks like without a benchmark. So, driving improvements in the absence of benchmark data, starts with an assessment of the “current state” of the program with common metrics. The next step is to envision what the “future state” will look like, quantified in terms of those metrics and allowing for the gaps to be identified. Then, through rapid cycle improvements targeted at those gaps, we make changes and re-measure to determine impact.

The concept isn’t new. It is the scientific method, the same methodology that drives medical advancements.

We have often seen a practice with performance that benchmarks well ahead of its peers, sustain a false sense of accomplishment, resulting in performance below potential. Conversely, we have seen practices with performance well below benchmark, lose enthusiasm for improvement because they see how far they are behind, how far they have to go. So even when benchmark data is available, measuring impact of change relative to previous performance will never lead you astray in your quest for optimizing your practice’s potential.

Benchmarking with out benchmarks? Sure! You should do it all the time!

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