Operational Improvements for Your Oncology Practice presented by Christian Baldwin, FACMPE

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Operational Improvements for Your Oncology
Practicepresented byChristian Baldwin, FACMPE

This presentation is designed to provide accurate
and authoritative information on a general basis.
It is distributed with the understanding that
the editors are not engaged in rendering legal,
accounting, or other professional service. If
legal advice or other expert assistance is
required, the services of a competent
professional should be sought.
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Bio for Christian Baldwin

• Assists oncology practices with operational
  challenges
• Graduated from the University of Virginia
  (Systems Engineering)
• Graduating from The Ohio State University June
  10th, (Executive MBA)
• Fellow in the American College of Medical
  Practice Executives
• Author of articles in MGMAs Connexion Magazine
  and Hematology Oncology News and Issues (HONI)
  Journal
• Six Sigma Black Belt

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Presentation Agenda

• Strategy
• Marketing
• Developing an operational plan
• Process improvement and project management
• Implementation
• Culture
• Scheduling

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Strategy
A long term plan designed to achieve a
particular goal.

• Research and analyze
• Markets
• Technology
• Regulation
• Competition
• Establish strategy
• Create a differentiator
• (Valuable, Rare, Difficult to Imitate, and easy
  to Organize)
• Organize staff to align with strategy
• Establish incentives

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Marketing

• Know your customers
• Know your competition
• Seven Habits of Highly Effective Practice
  Marketing
• Website
• Referring Physician Direct Mail
• Community Outreach
• Satisfaction Surveys
• Practice Brochure
• Branding
• Referring Physician Outreach
• Les Mann, VP Marketing, US Oncology, March 21,
  2007

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Marketing and Operations
Marketing
Operations
What is our demand? What systems are required to
safely treat our patients? What staffing levels
are required? How will our schedules accommodate?
What does our market look like? What is our
differentiator? What is our competition
doing? Who are we serving? What is our message?
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An Example

• Marketing Refer your patients to our practice
  and we guarantee wait times less than 10 minutes,
  the most up-to-date clinical trial information,
  and a peaceful atmosphere for treatment.
• Operations Plan
• Scheduling system designed for 10 minute maximum
  wait times
• Clinical trial database and support staff
• Aesthetically pleasing treatment room

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Developing an Operational Plan
The strategic role of operations is to support
the needs of the market.

• Understand the marketing requirements
• Separate market winners and qualifiers
• Define the expected volume by patient type
• Define current capacity
• Establish appropriate processes
• Provide correct infrastructure for support

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Capacity and Efficiency

• Capacity is the number of patients you can treat
  per given unit of time
• Our office can see a maximum of 25 patients per
  day
• Our treatment room can treat 5 patients at once
• Practice efficiency is vital because
• Increasing capacity increases your ability to
  increase revenue
• No expense of facility expansion or capital
  outlay

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Operations and Financial Concerns

• Under efficient systems, additional revenue
  streams can be supplied by the existing workforce
• Fixed costs stay constant
• All practices are seeing higher costs and most
  are seeing lower reimbursements

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Process Improvement Lifecycle
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Example Efficiency Project - Definition

• What
• Patient arrival patterns
• Patient wait times
• Waiting room
• Exam room
• Why
• Identify disruption to patient flow
• Understand and improve capacity
• Schedule efficiently
• Reduce wait times
• Increase staff and provider productivity
• Increase profitability

• How
• Compare arrival times to appointment times
• Demonstrate how early or late patients arrive
• Compare check in time versus time patient called
  from waiting room
• Compare time patient entered versus time provider
  entered
• Who, When, Where
• Patients
• Providers and staff
• Now
• Your office locations

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Measure for Baseline

• Process mapping
• Patient flow
• Workflow
• Data needs
• Appointment time
• Arrival time
• Time patient called back
• Time patient entered exam room
• Time provider entered exam room

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Gather Your Data!
Diagnosis Type
Appointment Type Time Info
Reason for Physician Delay
Report Average, Minimum, and Maximum Appointment
Times Required by Diagnosis by Physician Schedule
Accordingly and Cut Your Wait Times!
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Measurement Tools Available

• Time studies
• Six Sigma techniques
• Simulation
• Capacity graphs for treatment department

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Analyzing Data Arrival Patterns
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Improve Efficiency

• Now with a baseline understanding, work to
  improve efficiency
• Brainstorm
• Construct or adhere to policies
• Work for small wins not insurmountable gains
• Select two or three options to test

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Implementing Success

• Forces for change
• Nature of the workforce
• Technology
• Economics
• Competition
• Social trends
• Politics

It is not necessary to change. Survival is not
mandatory. - W. Edwards Deming
Robbins, Stephen. Essentials of Organizational
Behavior, 8th Edition, Prentice Hall, Upper
Saddle River, NJ, 2005 p 265.
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Resistance to Change

• Individual resistance
• Habit
• Security
• Economic factors
• Fear of the unknown
• Selective perceptions

• Organizational resistance
• Structural inertia
• Limited focus of change
• Group inertia
• Threat to
• Expertise
• Power
• Resource allocations

Robbins, Stephen. Essentials of Organizational
Behavior, 8th Edition, Prentice Hall, Upper
Saddle River, NJ, 2005 p 269 - 71.
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Overcoming Resistance to Change

• Reward acceptance of change
• Create a learning organization
• Communicate
• Participate
• Provide support

Robbins, Stephen. Essentials of Organizational
Behavior, 8th Edition, Prentice Hall, Upper
Saddle River, NJ, 2005 p 271 - 72.
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Control Processes for Continued Success

• Review processes regularly
• Constantly improve
• Always work to increase efficiencies even if it
  is a little bit at a time
• Make it fun
• Small project success will help you implement
  larger change such as EMR installations or new
  building design

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A Brief Word on Scheduling
You can use these techniques to improve
scheduling. Refer to the data sheet on slide 14!

• What resources are needed?
• How long is each resource needed?
• Which resource is the primary concern?
• Do any other legitimate concerns exist?
• What order should the resources be scheduled?

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Summary

• Operational plans support marketing requirements
• Marketing requirements are driven by strategy
• Operational techniques can be applied to increase
  productivity and efficiency without added costs
• Use these techniques to schedule correctly
• Gather data, monitor, and always improve!