I absolutely believe the statement above. It is my mantra! You see setting expectations with positive reinforcements helps practices and companies to reach their goals fast and effectively. Not setting positive expectations will leave your team hanging and wondering if they achieve the goals set out for them or not.
Healthcare leaders spend countless hours every year setting strategic goals and projections to achieve over the next year to three years. However, very little time is spent on the expectations of how to achieve those goals and objectives. When the strategic objectives are put out there for our teams we “expect” our directors or managers to achieve the goals without direction. However, not everyone understands how to set expectations for their teams. When no expectations are not put in place to reach the strategic objective then ultimately it will result in reduced outcomes. Therefore, some healthcare practices and systems don’t meet the strategic goals and then wonder why.
I am not going to talk about how to set strategic goals/objectives for your practice or system because you can read hundreds of books on that subject. However, I am going to talk about the importance of establishing expectations and making sure you set those expectations with positive outcomes.
When setting expectations, the expectations MUST be realistic. I cannot tell you how many times I have heard leaders say they need to reach a particular target and set unrealistic expectations. Then when the targets are not achieved, they blame their team! If the expectations are not realistic, then you can forget anyone getting on board to meet the expectations. I have come into practices where they are struggling either with clinic operation or revenue cycle operations, and the first items that is talked about is how fast you can reach the unrealistic expectations. I understand the anxiety entirely to get the ship back on track, and they need to turn it around it quickly. However, remember it is usually not a one-month problem that got the practice or system in the critical state. Typically, it takes months and/or years of for the problem to come to light. Once the problem is noticed by the leaders, they are surprised and need it fixed yesterday, which leads to the unrealistic expectations.
Once you talk the leaders off the edge, it time to talk about realistic expectations and how to meet those expectations to move the practice or system forward. Nothing happens overnight, and one of the reasons it doesn’t happen overnight is that healthcare is about people, not widgets. Healthcare is not a factory, and you can’t just fix a problem with the robot or a computer system or some automated service. Healthcare is dealing with the behaviors and attitudes toward changes to meet the expectations. As operator and revenue cycle leaders, it is important to understand part of setting expectations is recognizing your team’s ability to reach those expectations. This could mean retrain, add or replace individuals to make sure you are setting your teams up for success. Once you have the right people in place, then it is time to look at the systems to ensure that the EMR and PM system is working for the clinic, not the other way around. After that is completed, now it is time to set the expectations and lay out the plan to achieve those strategic goals. Example of expectations could be reaching particular targets every month and a quarter like DAR, RVUs, call center abandon rates, provider productivity, clinical team productivity, etc.
Once the expectations are set, and the processes are in place to move toward than it is imperative that you can track and measure your progress. I can not tell you how many times individuals get to this part and then don’t follow their progress. If you cannot measure the progress, then your expectation is useless. The only expectation that is hard to measure is the subjective expectation. The only time you should have a subjective expectation is when you are dealing with behavior/attitude/culture change in the practice. The only way to measure a subjective expectation is through survey and employee/patient satisfaction. It is time to track the progress through reporting either weekly, bi-monthly, monthly, quarterly and yearly. The reports must be actionable. If your reports are not actionable, then they are useless! I know people love reports (I love reports) and love to pull reports however if your spending days pulling reports and never making actionable progress on those reports then the reports are meaningless. That’s right meaningless. Reports should show trends either positive or negative, and the question you should be asking yourself is what do we need to do to improve when the pattern is not going the way you would anticipate. The reason why most practices and systems have issues is that the leaders forget to act on the information given to them because they are too busy with other items. Reports should drill down from top to bottom and back up, in other words, reports should be able to go right down to the provider level and roll up to the practice, market, corporate level. If a report cannot roll up or down, then it is no use to you. Because if the report is trending negativity, how are you going to pinpoint the problem? You’re not, so make sure your reports are drillable.
The last part of setting expectations (which I believe is the most important) is remembering to celebrate with the teams as you move toward reaching the expectations. You may say, why! The reason is that people need to see that they are indeed making progress and those team members are a direct reason for the success of meeting those expectations. I understand there are leaders out there that believe why should we have to celebrate when it is the individual's job to meet these expectations. Again, I will say PEOPLE are NOT ROBOTS, and HEALTHCARE IS ABOUT PEOPLE, they need to be recognized when they achieve the expectations and maintain those expectations. Healthcare is hard enough with so much negativity that it is terrific to reach out to those you work with and say thank you for reaching those expectations. People work harder when they feel appreciated and recognized for the work they have done to contribute to the success of the practice or system.
Now we covered expectations and reporting to reach those expectations you may be asking what expectations should we have to be best practice? This is a good question; I am a firm believer in the industry leaders and organizations that have done survey and studies on what is best practices. MGMA (Medical Group Management Association) ACHE (American College of Healthcare Executives) and the AHA (American Hospital Association) AMA(American Medical Association) CMS (Centers of Medicare and Medicaid) are the best resources for best practice benchmarks to help you set your expectations. When you are setting your expectations, make sure those benchmarks match your area of healthcare, in other words setting parameters that are geared around primary care practice, and you’re a specialist practice you will be setting unrealistic expectations. When setting quality expectations make sure you are following the Medicare and Medicaid as well as JACHO quality standards to ensure that you meet the best practice.
In conclusion, setting expectations, tracking reports, and celebrating the positive outcomes of those expectations will propel your practice or system forward in a positive aspect. Once your practice or organization is moving forward positively toward those strategic goals, then you will start to see positive healthcare impact in your practice, hospitals, and community.
When your ready to put in place expectations for your practice or organization please feel free to reach out I will be happy to help.
Cissy Mangrum, MBA, CMPE, CPC
Revitalize Healthcare Solutions
Email: Cissy.Mangrum@cmhealthconsulting.net
Website: www.revitalizehealthcaresolutions.com
Cell: 615-397-5042
Disclaimer - My thoughts are my own they do not reflex any practice or organization.
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