Solution-Based Thinking and the Savvy CA
Kathy Mills Chang
What is solution-based thinking? A brief review of job listings at Monster.com reveals that nearly every managerial-level job description requires that candidates possess this skill. In fact, I'd submit that every chiropractic team member should possess this skill. In today's data-rich healthcare environment, we should all be stepping up to solve problems and make decisions, either individually or as parts of teams. The solutions determined should then be communicated to the doctor, office manager, fellow workers, and, where appropriate, patients.
When faced with a problem, most of us do a lot of worrying before teasing apart individual issues, examining the facts, and reaching a decision. All that worrying can become directed thinking by channeling it into the following procedure. To make the best decisions and to become valuable solution-based team members, follow this simple five-step plan.
1. Identify and clarify the problem. Your first task is recognizing that a problem exists. Some problems are big and unmistakable, such as an angry patient who disagrees with their bill. Other problems may seem more like continuing annoyances, such as the doctor regularly running 20-30 minutes behind schedule. Both are serious issues that can affect your practice in a profound way. The first step in reaching a solution is pinpointing the problem area.
2. Gather information. Learn more about the problem situation. Look for possible causes and solutions. For the angry patient, this step might mean checking files, auditing accounts, and reviewing the computer itemization. For the doctor's schedule, this step may involve more critical thinking and teamwork. For example, you could keep a time stamp on each and every patient clocking in the time they arrived and the time they left. At the end of each day, review it as a team to identify where problems occurred. We all know there are patients who require more time. Are we scheduling them in the middle of drive time?
3. Evaluate the evidence. Where did the information come from? Does it represent various points of view? What biases could be expected from each source? How accurate is the information gathered? Is it fact or opinion? For example, we might find that when we
“in today's data-rich healthcare enviro, we
should all be stepping up to solve problems and make decisions, either individually or as parts of teams. ”
estimated the patient's financial responsibility, we were under the impression the patient's deductible had been met when in fact the deductible was applied to another bill, thus causing the patient to owe a little more to us and a little less to another provider. What about that scheduling concern? Was the doctor chit-chatting about the Yankees score last night, were patients running consistently late for appointments, or did we find that we were not carefully placing special appointments like report of findings and new patient visits?
4.Consider alternatives and implications. Either as a team or individually, come up with conclusions from the gathered evidence and propose solutions. Then, weigh the advantages and disadvantages of each alternative. What are the costs, benefits, and conse-
quences? What are the obstacles, and how can they be handled? Most important, what solution best serves your goals, your patients, and your practice? Here's where your creativity is especially important. For instance, how can we keep better track of additional balances that come duefora patient, otherthan what they believed to be so? When we see services that are immediately applied to the deductible, we should apply that in our computer system as a line item entry, transferring the balance to the patient. Then an explanatory note should be sent with the bill to the patient, with a copy of the explanation of benefits. This could alleviate a lot of confusion! If the schedule continues to be clogged during busy times, consider what setting aside certain hours for new patients, report of findings, and other special appointments could do for the flow.
5. Choose and implement the best alternative. Select an alternative and put it into action. Then, follow through on your decision by monitoring the results of implementing your plan. Perhaps one piece of evidence you discovered was that when wellness patients came in once every month, they tended to stay in the room longer. Why not set aside certain mornings for wellness visits only? That would free up the doctor to spend a little more time for patient education without the clock ticking. Schedule as many of the wellness patients into Tuesday from 9-11 and see if that makes a difference. Track this and monitor it over several months. On the job you would want to continue observing and adjusting the solution to ensure its effectiveness over time.
Obviously, not every team member has the authority to make decisions and change policy. But most employers appreciate team members who present not just the problems, but some ideas for solutions as well. This makes the doctor's or office manager's job easier and creates more synergy within the team. Each team member should take ownership over their little corner of the world, and take responsibility for its outcomes.
One of the biggest complaints I hearfrom clients is that their team meetings don't work. They believe everyone is just there to complain. With solution-based thinking as a requirement of each job description in the practice, watch how your team meeting will transform from gripe sessions to solution machines. Not only will each team member be empowered to contribute, but the mastermind quality of your team will shine forth. All of us is always better than one of us!
Kathy Mills Chang is a Certified Medical Compliance Specialist ßdCS-P) and Certified Chiropractic Professional Coder (CCPC). Since 1983, she’s been '^B providing chiropractors with reimbursement and " compliance training, analysis, and tools to help practices increase revenue and decrease risk. Kathy leads a team of 14 at KMC University, and is known as one of our profession ’s foremost experts on Medicare. She or any of her team members can be reached at (855) 832-6562, at http://kmcuniversity.com, or by emailing [email protected].
