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With quality a monthly topic, improvements are never ending

A surgery practice in Grand Rapids, MI, stays in constant improvement mode with ongoing quality discussions.

Quality is part of the agenda of the monthly business meetings, which include both staff and physicians, says practice manager Jennifer Jamula of Pediatric Surgeons of West Michigan.

“Anything somebody thinks needs improvement” is open to discussion – patient care, scheduling, efficiency, whatever, Jamula says.

Suggestions come from everybody. Sometimes a staffer sends Jamula an e-mail noting, “Next time we should talk about X.” Sometimes a physician makes a recommendation. Sometimes Jamula brings up an issue. Or a staffer or doctor might say, “I read a good article on X” or “I heard about a good idea this other office uses.”

Whatever it is, the entire group talks about it “and irons it out,” Jamula says. And the discussion may or may not result in a change.

The outcome of the process, however, is never-ending improvements.

For example, some patients have a five- or six-hour drive to the office, Jamula says. To help them out, the doctors decided to set out qualifiers for several minor surgeries that make it possible to do a post-op progress call instead of having the parents drive the child back for a visit.

The office also developed a new procedure for getting test results to parents faster. The change not only accommodated the parents “but was a safety improvement,” she says.

In office operations, there was a change in the way lab results are given to the physicians. “Staff were pulling the chart for every test,” Jamula says. So the group decided which tests the doctors could review without seeing the charts, and now staff pull and refile only the ones that are necessary for review.

Yet another improvement was to give parents a pre-surgery printout of the out-of-pocket expenses. Besides improving collections, getting the financial issues settled ahead of time eliminates part of the stress any parent faces when a child has surgery.

To make sure everybody stays aware of what’s been decided, Jamula reviews each item at the following meeting. Then everybody discusses whether the new process is working or needs changing.

With the ongoing quality discussions, she says, everybody “has a voice” and can say, “this is not going well” or “this is frustrating.”

Equally important, everybody hears about what needs to be changed and why and has a say-so in how the change is made. That means front office and back office understand each others’ needs, and doctors and staff are all on the same page.

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