Business Planning: Optimising Time & Resources

1. Business Planning:Optimising Time & Resources Mary Toomey Strand Hotel, Limerick 23rd July 2011

2. Where We Are • Economic crisis : greater social needs but much reduced resources • Recent political turmoil : new expectations • Increased legislative demands • Increased patient expectations • Out of date public contracts : unsuitable, abused, and dying painfully • Several new (but largely uncoordinated) models of Primary Care emerging • Insufficient planning, poor communication and sometimes disrespectful / undermining attitudes between government, HSE, and Primary Care Providers

3. Where You Want to Be • What are your strengths? • What would you love to see your Practice achieve in the future? • What are your personal ambitions for the Practice? • What do your patients/ community need from you?

4. Where You Want to Be • What steps do you need to achieve these goals? • What resources do you need? • What obstacles will you need to overcome?

5. Problems Most common problems: • Financial crisis, cash flow problems • Stress of staying on top of daily workload • Paralysis because of uncertainty / fear of risk, frustration or fatigue at challenges of change • Spend less and/or earn more • Take control of your workload • Change... one step at a time

6. Spending Less • Start by looking at bigger spends and areas which won’t affect patient care quality • What are you using in a wasteful manner? • What can you manage without? • Get cost comparisons and samples. • Look at ‘sneaky’ charges, e.g. carriage/delivery • Look at your bank charges

7. Spending Less • Drawings... Monthly and Profit Share • Assistants and Locums – how profitable and why? Have you the right balance between Partners and other doctors? • Nurses, Phlebotomists, and other HCPs • Administrative / Support Staff Wages • Pay cuts or freeze; unpaid leave or shortened working hours; restructuring or redeployment • Redundancy

8. How to Earn More : Develop a Marketing Strategy • Any marketing strategy should be based on your patients. • A marketing plan is an action plan for a given period, usually one year or more, to offer and promote a range of products and services to your market. • This action plan must fit in the broader and longer issues of your Practice.

9. The Hands That Feed Us How well do you know your patients? • Demographics • Social / medical histories • Their needs (physical, emotional) • Their desires and preferences ...their needs / desires are your opportunities

10. The Hands That Feed Us • How well do your patients know you? • Your opening hours and location • Your services • Your staff • Your best features How do your patients feel about you?

11. Looking at Your Existing Services • Who availed of what service? • How did they hear of it? • What did they think of it? • Did they think it was good value? Why? • Will they come back for more? • Would they recommend to a friend? • Is there any other service this patient needs? • Who didn’t avail and why not? • Who else might need or want this service?

12. Creating New Spaces...Marketing • Who are your target group of patients? • What product or service do they want / need? • How can you provide those services? • Can you revitalise an old service? • Can you find synergy with partners? • How can you make those services profitable? • How can you let people know you offer them?

13. “Well Woman” Transformation • Well Woman : cost €290 – patients not availing of the service • Most patients didn’t know what it was about • Some patients felt it was too expensive • Many patients were taking extended periods of time in ordinary consultations with various medical-style issues, but not enough to justify referral to Well Woman

14. “Well Woman” Transformation • Well Woman broken down into different parts gave us a range of shorter, more targeted and much cheaper check ups: • Women’s Cardiovascular Check-Up (€108) • Women’s Personal Health Check (€108) • Well Woman Comprehensive (€261) • Women’s Mini-Medical (€108) • Women’s Sexual Health Medical (€72) • Sports Medical (€108)

15. “Well Woman” Transformation • We also identified patients had need for diet and lifestyle advice so we linked in with the GP Exercise Referral Programme and HSE dietician-led PHEW and Expert Group services • Women’s Health Evenings to be run in Autumn 2011 to encourage a healthier lifestyle and further our commitment to patient education; also promoting new Women’s Health services

17. Your 12 Month Marketing Plan • Start with season-specific services e.g. flu vaccines • Plan to fill up times when you may be fallow • Consider pilot projects during quiet times • Avoid taking on too much at busy or holiday times • Manageable amounts with breaks as needed

18. Extract from Carlton Clinic’s 2011 Marketing Plan

19. Ways to Let People Know • Word of mouth • Practice Brochure • Notice in waiting room • Mail • Flyer drop • Newsletter • Website • Directories / web listings • Social network sites etc • Newspaper / Radio / TV

20. It’s not how I see myself...

21. ...it’s how other people see me that counts

22. How on earth did you get that impression???

23. Creating an Impression • Success comes from doing ordinary things extraordinarily well • Good management (of people and processes) is essential to create the right impressions over & over

24. Manage Your Workload • Micro level : Me • Accept that stress is my reaction to things and people around me, and can be controlled or eliminated • Accept that I have limitations • Prioritise the big picture: things that have serious short term or chronic long term consequences • Focus on managing others well • Say no assertively

25. Time Management Tips • Understand the business position and aims • Have a long term plan which is broken into several clear objectives • Take a few moments to prioritise at the start of every day, ensure you have one long term “mission” for the day – and get it done! • Expect the unexpected and accept the things you can’t change – but prevent repeating patterns where possible

26. Manage Your Workload • Macro Level : The Whole Practice • Look at the roles required and what each team member should be doing • Focus on the people, not the processes • Engage them in their own transformation process • Believe in their ability • Reward them for changing for the better

27. Your Team Needs • What you are doing really well? • What needs to be improved? • What needs to stop? How we do things? How we behave? How we speak?

28. Self Fulfilling Prophecies • Be aware that people will most often achieve what you expect from them... Whether that is good or bad... • Be very aware of your prides and prejudices • Bad performance is (almost) always the product of bad management! • Your people have enormous potential... Do you believe they can achieve it? Do they?

29. Repeating Patterns • Recognise them – record them (e.g. trends in sick leave, lateness, poor performance) • Discuss them (informally; return-to-work interview; performance appraisal, disciplinary process investigation) • Explain the effects of the behaviour on the team and the business – why this trend is a problem • Ask for improvement as appropriate & follow up • Have the right procedures and stick to them • Stay within the law!

30. Giving Feedback • Have your facts to hand (in the background) • Explain why you are giving feedback – so as to help improve, and achieve better together • Approach it constructively • Tell the truth • Agree a way forward and advise the staff member of a future date when you’ll follow up on progress • Make a record of the meeting

31. Summary • Spend less and/or earn more • ...Make a marketing plan • Take control of your workload • ...For yourself and your practice • Change, one small step at a time