THE CRITICAL NEED FOR TEAMWORK

Teamwork has been a buzzword around the business culture for some time.  Leading businesses know that well performing teams are the key to profits in a business.  However, teamwork takes on a whole new level of importance in life or death situations such as military combat, airline travel, and healthcare. In 1999, the Institute of Medicine (IOM) published To Err Is Human: Building a Safer Health System, which was a revealing review of the U.S. medical care system and the inadequacy of safety practices used in the treatment of patients. The IOM report estimated that medical errors result in 44,000 to 98,000 deaths annually—more than automobile accidents (43,458), breast cancer (42,297), or AIDS (16,516). Since then, there have been a number of initiatives and task forces to address this problem, including the development and research of team based training to improve patient safety.

While the focus on teamwork in healthcare has brought improvement, there is still work to be done. The study, “Medical Errors Involving Trainees: A Study of Closed Malpractice Claims from 5 Insurers,” appeared in the October 22, 2007, issue of the Archives of Internal Medicine. The lead author, Hardeep Singh, M.D., M.P.H., noted, “Our study confirms the relationship of poor teamwork to preventable errors and quality of care.”  The Agency for Health Research and Quality (AHRQ) Director Carolyn M. Clancy, M.D. stated about this study, “This study reminds us that we have a lot to do to ensure that hospitals are providing appropriate supervision to trainees and implementing team-training programs, both in the inpatient and outpatient setting.”

In addition to the obvious importance of teamwork for patient safety, there is also a critical need for effective teamwork to create the efficiencies needed to deal with increased patient volumes and decreasing reimbursements. Physicians today need to make sure they have expert teams, not just teams of experts.  Expert teams aren’t created overnight.  It’s a process and takes purposefulness and commitment.  Teams typically begin in the formation stage where people are learning, leaders are directing, and people are getting to know one another. Unfortunately, this is usually followed by the storming stage where clicks can development, a great deal of supervision is required, and disagreements can ensue.  While many teams get permanently bogged down in the storming stage, better performing teams will enter a norming stage.  In this stage, the team starts to actually work together as a team, goals and directions become clear, and the overall performance improves. Truly high performing teams will enter a performing stage where team members all exhibit leadership, self-motivation is high, and the team members all have strong skills and knowledge.  The reality is that most teams will move up and down this spectrum as they progress and decline in their teamwork.

For some, discussions about teamwork and team building conjures up images of warm and fuzzy games and retreats.  Working on teamwork can be seen as a waste of time and money and not “real work.”  The reality is quite different.  From 1955-2008 there were over 300 empirical articles on teamwork studying over 10,000 teams. For example, a study by Eduardo Salas, Diana R. Nichols and James E. Driskell Small Group Research 2007; 38; 471 entitled “Testing Three Team Training Strategies in Intact Teams: A Meta-Analysis” found unequivocally that team training improved performance.

There are a number of training methods that can be used to deliver results including: cross-training, event-based approach to training, scenario-based training, self-correction training, stress exposure training, team adaptation training, and team leader training.   The reality is that physician team settings vary dramatically from emergency room, to general surgery, to primary care physicians.  The key is adapting your training to your specific environment. For those considering team training, it can be a waste of time and money unless the design and delivery of the training is based on scientific principles, the physicians take ownership, teamwork is rewarded and encouraged, and there is feedback loop to debrief and measure success.  True team development should focus on building the knowledge, skills, and attitudes of your team members and should be an ongoing process.

The handwriting is on the wall.  There is no doubt that quality of care will continue to be scrutinized with greater intensity, particularly with the shift to electronic medical records.  The link between pay and quality of care is only going to get stronger.  Physicians will have to continue to do more with less.  There will be increase pressure to see more patients and be highly efficient. At EMHC, we are continuously striving to stay up-to-date on the quality of our patient care. While more studies need to be done, we have enough data from the commercial airline industry and the military to show us that we need to strive for better teamwork in healthcare to improve safety.  Since many physicians are also entrepreneurs, they must keep an eye on the bottom line and the work of business has shown us undoubtedly that it’s hard to be profitable with a poorly performing team. In the near future developing your healthcare team won’t be a luxury, but a necessity.

 

HEALTHCARE OPPORTUNITIES FOR ENTREPRENEURS

 

We live in a high velocity, flat world economy.  New business models, products, and markets are appearing at a fast and furious pace.  Whole new careers are available that weren’t around even ten years ago.  Job opportunities for being a search engine optimizer or webmaster weren’t on the career menu when I graduated Millsaps in 1990.  I can’t even imagine how it will change by the time my daughter Ally graduates college in 2022.

For entrepreneurs who observe, study, and understand these trends, opportunity abounds. There are probably no greater opportunities right now than in the healthcare industry.  This article will review five emerging trends in healthcare technology.

Bio-Connectivity

Bio-Connectivity has been described as “the marriage of the computer chip and connectivity technology to medical devices, and ultimately, to people.” Two high growth areas within Bio-Connectivity are wellness monitoring services and e-health services. Wellness monitoring allows doctors to remotely monitor a patient’s condition. E-health services provide pro-active medical care. For example, a patient could have a sub-dermal patch which provides for automatic delivery of the pharmaceutical but also allows the treating physician to monitor its effect. Digital Connect Magazine, which monitors development with home and business connectivity devices, suggests that U.S. revenue from digital home health services will quadruple to exceed $2.1 billion by 2010.

Bio-Informatics

Bio-Informatics, which is predicted to be a $3 billion dollar market by 2010, is the field of science in which biology, computer science, and information technology merge to form a single discipline. Advances in the field of molecular biology together with advances in genomic technologies have led to an explosive level of growth in biological information generated by the scientific community. This massive amount of information has led to a great need for computerized databases to store, organize and index data and sophisticated tools to view and analyze this data. For example, when faced with the overwhelming task of identifying each of the individual victims of 9/11, the New York City Office of the Chief Medical Examiner turned to a small software company called Gene Codes and its software based on the principal of Bio-Informatics to address the issue.

NanoMedicine

NanoMedicine is the medial application of the ability to manipulate and modify material properties at the molecular or nanoscale level. It is predicted that the United States’ demand for nanotechnology health care products will grow to $50 billion in 2011. This technology is being utilized in pharmaceuticals, diagnostic products, medical supplies and devices.  For example, scientists in Illinois are using corn protein to create new skin and deliver medicine through nanotubes.

Health 2.0

Health 2.0 is the emerging concept of the Web 2.0 phenomenon as applied to healthcare.  As a starter, you can think about the world of Facebook and MySpace and the power of social collaboration in the healthcare arena.  Websites such as www.patientslikeme.com connect patients together to share and support one another. Health 2.0 is more than just social collaboration, as evidenced in one definition of Health 2.0 companies as “those next generation health companies that leverage the principles of openness, standards, and transparency; utilize the technology tools of collaboration, information exchange, and knowledge transfer; and focus on delivering value added services that empower health participants (patients, physicians, providers, and payers) with freedom, choice, and accountability for health outcomes.”

These are exciting times.  Business markets and opportunities have literally expanded from the city square to around the globe. I am optimistic that our state and its talented and visionary entrepreneurs will be a part of leveraging these and other trends in healthcare technology.

 

Originally published in Pointe Innovation Magazine

ARE YOU A MEDICAL ENTREPRENEUR?

Successful Medical Practices

All doctors are medical entrepreneurs to some degree. Since the pioneer days in America when they hung a shingle outside their practice door, doctors have been the original medical entrepreneurs.

A simple definition of an entrepreneur is “a person who has possession of a enterprise, venture or idea and assumes significant accountability for the inherent risks and the outcome.”

Sound familiar? Physicians, like other professionals, often practice in solo or group settings where they are the boss and certainly experience the intrinsic risks and rewards of their medical practice. You may not necessarily feel like an entrepreneur and that’s certainly understandable. A physician’s first and foremost responsibility is obviously patient care. In fact, almost all of medical training prepares physicians just for that task. However, most professionals, including physicians, rarely are trained on how to run their own practices.

I have spent more than 25 years operating and working with entrepreneurial business ventures, and I am now the CEO of an emergency health care company in Memphis, TN, Emergency Mobile Health Care. I have had the good fortune to study with and learn from some great mentors in this arena, and I’m passionate about seeing people fulfill their entrepreneurial potential. I’m excited to share with you in this column some of the key principles I’ve learned about entrepreneurial success, and specifically, how those can be implemented in a physician practice setting. In addition, I’ll highlight some notable medical entrepreneurs and offer tips on how to evaluate business opportunities outside of your core medical practice.

I begin with the simple premise that your medical practice is an entrepreneurial business, and that your practice shares many common features of any entrepreneurial organization. Common characteristics include people management, implementing systems and processes, taking care of your customers, and financial risks and rewards.

People Management (or Cat Herding)

Rarely do I find an entrepreneur or a physician who operates as a solo act. To run your practice, it takes nurses and staff to operate effectively. Therefore, your success becomes interwoven with your ability to get the most out of the people you work with. Anyone who has every managed an employee knows that hiring and developing talent is no easy task. Therefore, the questions become: what kind of leader are you? Are you getting 100 percent from your team or are they giving you the bare minimum to get by? Building a great team around you is a key step in your path to success.

Systems Management

Every medical office, like every business, also has systems for doing things. The question is whether you know what those systems are and how are they working.  Are you streamlined and efficient, or are you daily enduring broken systems?  Exemplary practices have written ways to do things that people understand and follow. The way Chic-fil-A can serve up a great chicken sandwich no matter what store you visit in the country is based on one simple thing: a great system!

Customer Management

Your patients and referral partners are your “customers.” Every time one interacts with you, they have a customer experience. Do you know what that customer experience is? Have you thought through your interaction from first contact to final communication? Is there consistency and predictability in what your customers experience with you? Great practices have a well thought out customer experience cycle that is clear and repeatable.

Financial Management

What about the bottom line? While we all hopefully work to pursue a calling and seek personal fulfillment, we also are trading our time and effort for money.  Today’s medical practices are complicated and can be difficult to manage financially. There are lots of expenses, and reimbursements tend to go down and not up. Therefore, keeping a careful eye on the bottom line is critical. Physicians, like many busy entrepreneurs, tend to entrust financial responsibilities to others in the organization. However, I believe it’s also critical for physicians to know and have clear visibility into the key economic drivers of their businesses.

Thinking Strategically

Finally, as entrepreneurs, I encourage physicians to take time to work “on their practice” and not just “in their practice.” Most people are so thankful for a day off that they rarely want to turn around and think more about work. However, most of us stay in the trees and rarely plan and dedicate time thinking about the forest.  The end result is that we often feel like we’re on a treadmill we just can’t seem to get off.

I spoke with Robert Harris, MD, a urogynecologist with Women’s Specialty Center in Jackson, MS, who is a well known entrepreneur physician. He shared:

“I try to purposefully take time away from my day-to-day practice each week and work on improving both my practice and my life.”

For Dr. Harris, this has allowed him to not only strategically improve his medical practice, but also to create the time to pursue medical start-up businesses outside of his bread-and-butter practice.

In sum, we give a great deal of ourselves to our work and professions. By becoming entrepreneurially minded, you help not only gain better control over your practice, but also your life.

(c) Martin E. Willoughby, Jr.

 

Originally published in Medical News

Creative design from the South

Get in touch with us!