We are on the same team, RIGHT?

1. We are on the same team, RIGHT? Mary Sue Jacka, COE Sunday, april 22, 2012

2. Are we on the same team? Never Occasionally Some of the time Most of the time Always

3. Are we on the same team? Never Occasionally Some of the time Most of the time Always

4. Overview Practice located in northeast corner of Louisiana and we serve a 7 parish area In 30 years, we have grown from 2 doctors and 5 employees to over 9 providers, 3 opticals, surgery center, 3 locations and 80 employees With 80 employees on board, departments have become little entities of their own and the ability for staff to work cohesively has decreased

5. Challenge Run office effectively, efficiently with high patient satisfaction Train staff Create experts and super techs Adhere and comply with new regulations and rules Discover and implement innovative ideas to decrease cost and increase revenue in a revenue declining era of healthcare Maintain high morale and peace

6. Through the years Amazing growth Technicians with little training, to now a requirement for COA and COT Departments were formed with department managers Technician teams formed with team leaders and an overall technician manager Growth, growth and more growth

7. Did we go too far… For many years we put so much emphasis on certification and training Maybe we created too many “specialists” and now we need everyone to pitch in and help With some of the doctors getting older they usually begin to keep shorter hours but staff needs 40 hours of paid time In recessionary times, we hire less and expect more work from the same group of employees

8. Our idea of staff interaction was to… Mix it up, let the groups work on projects together When MDs are on vacation shift the duties around Encourage work some in another area

9. In our office … • The various departments work to provide total eye care to one patient after another; day in and day out • Front desk/Telephone reception • Technicians • Billing/back office • Optical • Surgery Center • But these groups need improvement to be perceived as one seamless customer service icon • Too many hiccups and turf wars

10. Disharmony between departments Loss of respect I am “better than thou” concept

11. Monthly staff meeting Inadequate to fix the problem in and of itself

12. Time to think out of the box Involve them in the old and new projects Post openings internally Require excess staff to become an alternate worker fully trained and engaged in a different department In other words have a meaningful job for them to do that is challenging when they are not doing the primary job

13. No more busy work Engage them in alternative parts of the practice that are not time sensitive If work is time sensitive scheduling is challenging But never-the-less these tasks are mandatory and vital to the team Staff indicates that observation of other work is meaningless To understand the work, they need to do the work

14. Have you ever heard the term:Parallel Play • In early childhood the child plays with toys in the same room as another child but they play separately, they may observe the other child but they do not interact with the toys nor play together • We have parallel play in our office • The staff acknowledges other departments but does not become involved with them

15. The Solution As the LEADER (YOU) need to carry all groups together to the next level

16. Two challenges to you the leader Assure that each group or department works effectively and efficiently Meld all of the departments or teams together to reach common goals together

17. Obstacles We discovered that each group is more loyal to the group than loyal to the whole Participants of other groups will have little experience and therefore little empathy related to the other departments The learning desire of each individual is centered on what they do, not on what the group does Participant not eager to learn if project does not directly involve them

18. Habits Habits do not change with hopes, desires, thoughts or logic Habits change as a result of courage, a good game plan, a first few steps and consistent action Break old habits Making a change is no small task For learning to occur, adults have to do things

19. The process of staff unity gave us the chance to work on three new projects within the office Group effort to verify insurance Group effort to promote optical Modified team approach with technicians

20. Project #1 Verification of Insurance inadequate for billing department to produce clean claims Denial rate climbing Billing department ready to “pull their hair out” Bickering and name calling between departments We are not on the same page! Basically staff had become complacent with work load and did not get insurance verified correctly

21. Challenge Make sure all insurance is verified correctly and timely

22. Discovered vision insurance available to Medicare Managed Care patients Discovered patients come in everyday who have an expired spectacle prescription Decided to engage the staff in a new program that would present to the patient upon arrival their insurance benefits in a nice package along with vision coverage Basically we change the terms and introduce a new program of how to verify insurance as well as produce increased sales for the optical

23. Front presents form to patient outlining benefits Tech encourages purchase Billing now is happy as benefits are correct Optical makes it happen TEAM working in harmony

24. Result Team work Excellent insurance verification Increased optical sales $162.00 (first 2 days) Expired

25. Result Team work Excellent insurance verification Increased optical sales $162.00 (first 2 days) Expired

26. Loyal to the group not loyal to the whole • Mix it up • Allow/require staff to fill in different departments • Match skills to new activities • When • MD on vacation • MD in satellite office • For us we started with rotating staff to man the new optical glasses pick up station

27. Have you ever been told you weregood but not great? We are a good office We are a work in progress to become great The Journey to the modified team approach

28. Modified Team for Technicians • How we got in this mess to start with • No place to hide • Groups became too strong to work together so we had a consultant come to the practice • Patients waiting too long • Practice patterns adopted and defined • Not finished but a great start to enhanced and rewarding jobs for the entire office

29. Retina clinic runs 7am to 7pm How to staff such long hours Injections should be planned ASC is open on Sunday

30. Summary Three big projects worked out because we have invested in teamwork Thank you for your kind attention