Autocracy or teamwork

I recently came across this on a member’s MGMA Knowledge Center Forum: “I recently came across an implementation where the practice manager threatened to charge each staff member $ 1.00 for each registration error they found on the system. She was serious about this and the Staff were terrified of making a mistake. It was also a mistake in interpreting how the required fields should be entered. This is similar to a jar of oaths. How enforceable is this and How legal is it? Just curious about the HR repercussions with this concept. “

Retha Reeves, a consulting administrator in Houston, Texas and a frequent contributor to MGMA forums, responded, “I will leave the legal question to an attorney. As for HR, didn’t we all know a long time ago that managing Are fear and intimidation a disaster at best? The only successful management style is to work every day to create and maintain a team. On achievements. I have always advised that an important part of management is helping your people succeed in their roles. With a manager like the one you described, he totally misunderstands that critical piece and it will only lead to poor morale, paranoia, and minimal production. “

I fully support Retha’s point of view. I have been a member of teams with autocratic leaders and those who listen to and support team members. My own experience is that equipment that meets Ms. Reeve’s criteria works best and achieves the best results for patients and clients. I am currently a member of a team that is building a program to prevent falls in the elderly in the community. This team is part of Calvin College Rehabilitation Services in Grand Rapids, MI. The team recently met to complete a work plan template that included the key activities and how to measure them. Each team member freely contributed ideas to the plan and asked questions to clarify an idea if necessary. A great deal of planning was accomplished and I left feeling that my contributions were valuable and welcome.

The American Medical Association also views teamwork as beneficial practices by increasing productivity and patient satisfaction, as well as employee satisfaction. The success or failure of a practice depends on the culture of the practice. WADA believes that practices should focus on continually improving team culture. They have implemented a free online module on their website as part of their STEPS Forward collection that can help internships build a positive team culture. You can find it at by clicking this link.

In the module, the AMA lists ten steps to building a strong team culture:

1. Diagnose the current state of your team’s culture.

2. Discuss the results and brainstorm possible improvements.

3. Create a staff pact as a group

4. Create opportunities for team communication throughout the day.

5. Meet regularly

6. Strengthen the team by focusing on individual development

7. Get to know your team members

8. Teach leaders to be mentors, not managers.

9. Create an environment that supports continuous learning.

10. Involve patients

The module begins by asking practice managers to assess the culture of their practice by having each team member complete an anonymous survey that is provided online. Some of the questions are (1) Team members say what they really think and (2) All team members participate in making decisions about the team’s work. The module begins with this assessment because it is understood that “you cannot move forward unless you know where you have been,” a common wisdom.

After the survey is conducted by staff and the results are analyzed by a trusted staff member or external quality expert, practice leaders should have team meetings to discuss how to move forward. The first task of the team meeting should be to write a goal stating the purpose of the meeting and future meetings. You should focus on building a culture that values ​​teamwork.

The ‘culture team’ in the first meeting can brainstorm how to improve the practice culture in concrete ways that leaders and other staff can implement. I think it would be a good idea to use the survey again in the future to see what growth has occurred and to make adjustments that will lead to even better teamwork.

One of the benefits of improving teamwork is that the team can work together more effectively to improve practice processes. Team members can come together to focus on processes that affect patient outcomes, such as processes that improve patient satisfaction and engagement. Having practice staff involved in improving processes like these will lead to noticeably better results than if just one or two people are involved. Team members can brainstorm, for example, to improve patient engagement, and then appoint a team member to own the process of implementing their ideas. The results should be measured and reported to the team.

The development of teamwork among physicians is taking place in universities in the United States. Universities have created courses that support interprofessional practices. This is the IPE movement. In September 2017, Grand Valley State University in Michigan will host a two-day conference dedicated to interprofessional practice, education, and research. One of the focuses of this year’s conference will be telehealth. John Scott, medical director and deputy director of telehealth at the University of Washington’s Harborview Medial Center, will be the keynote speaker. One of the thematic sessions of the conference will focus on the collaboration of graduate students in healthcare with Answer Health on Demand, a local telehealth provider in Grand Rapids.

As you can see, there are many supporters of teamwork development in the health field. The benefits of developing a strong team culture are many, including achieving the triple goal of better healthcare at lower cost with greater patient satisfaction. Focusing on teamwork in a practice setting will help transition to values-based care.

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