Administrational Management Skills

1
Administrational Management Skills

• Major Kevin R. Whitney M.D.

2
OBJECTIVE

• Develop strategies and techniques to effectively
  manage areas beyond your control

3
OVERVIEW

• -JCAHO
• -TRICARE/HUMANA
• -Evidence based medicine
• -Nursing Staff
• -Clerk Staff
• -PAD
• -Inpatient/ward Rules and Regulations
• -Pharmacy
• -MCBAD/MEPRS

4
JCAHO

• Joint Commission on Accreditation of Healthcare
  Organizations
• Onsite review every 3 years
• Have ongoing Pre/Post inspection teams
• Designate a Nurse Champion
• This process is generally driven from above
• A well run clinic has nothing to fear

5
JCAHO

• CBO (Competency Based Orientation) folders
• Clinic SOP manual
• Documentation of Pain on the Patient encounter
  forms
• Process Improvement Program
• Quality Assurance Program
• Continuing Education Program
• Updated Master Problem lists and Med Lists
• Locked Medicine Cabinets

6
TRICARE/HUMANA

• Know your local Tricare Representative
• Portal to gain access to numerous Tricare
  resources
• http//www.tricare.osd.mil/
• Portal for patients to access appointments
  online
• http//www.tricareonline.com/

7
Evidence Based Medicine

• A key component in decreasing overuse/misuse of
  your clinic by the worried well
• Low Back Pain, Upper Respiratory Colds, Acute
  Gastroenteritis, Urinary Tract Infections
• One of the most difficult processes to start and
  maintain, but has a huge return on improving
  clinic efficiency and effectiveness

8
Evidence Based Medicine

• Journal Club
• Lecture series
• Develop Practice Recommendation
• Develop standard patient encounter forms,
  profiles and educational handouts
• Chart Review feedback
• Group email discussions with specialist included

9
Nursing Staff

• May not work for you (Ward, other clinics,
  resource share, temporary hires)
• May outrank you
• May have an inside track (friends in high places)
• Respond best to SOPs and official memorandums.
  (They like their world well defined and supported
  in writing)
• Treat Nurses as equals, as peers and as the
  valuable resources they are and you will be
  successful

10
Clerk Staff

• May not work for you (Central Appointments)
• Know their boss well and provide him/her with
  clear booking guidelines.
• Police up deficiencies regularly, but only
  through their boss (even your clerk staff)
• Push a uniform Clerk Job Description up to the
  top so it filters down to all

11
PAD

• Medical Records (less of an issue with CHCSII),
  Med Boards, request Med records from other
  facilities, Air-EVAC, tracking of wounded
  soldiers, Inpatient chart room
• Know the OIC and NCOIC of PAD very well
• Know the senior staff in the inpatient and the
  outpatient Medical records room well

12
Inpatient/ward Rules and Regulations

• May be a shared mission with Internal Medicine,
  Pediatrics and other FP clinics
• Without clear rules and regulations becomes a
  significant battleground
• Decreases conflict between admitting staff and ER
  staff

13
Pharmacy

• Ensure one of your staff is a member of the
  Medication Review Committee
• Do not be afraid to utilize your medical degree
  and your numbers (group of doctors) to assist in
  establishing reasonable policies
• Encourage your Pharmacist and/or your Community
  Health clinic to create a self help clinic where
  patients have access to OTC medications (cold
  packs)

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MCBAD/MEPRSThe Number Crunchers

• Know this group of people well
• Review their data and make sure it makes sense
• They brief the command and the command makes
  decisions on manpower and resources based on what
  they brief

Patient Satisfaction Surveys 30,000 patients
year, 500 patients return survey, 50 negative
10 unsatisfied patients
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SUMMARY

• -JACHO
• -TRICARE/HUMANA
• -Evidence based medicine
• -Nursing Staff
• -Clerk Staff
• -PAD
• -Inpatient/ward Rules and Regulations
• -Pharmacy
• -MCBAD/MEPRS

16
QUESTIONS