Difference of opinion in Texas

Public Citizen, a nonprofit organization that advocates for individual rights, says the Texas Medical Board needs to step up its game. The organization asserts that the state medical board has failed to punish many physicians in the state who have received sanctions from healthcare organizations. The Texas Medical Board disagrees, citing Federation of State Medical Boards data that often ranks Texas at the top for disciplining physicians.

According to an article from HealthLeaders Media, Public Citizen analyzed 21 years of NPDB data.The group found that almost 450 Texas physicians who had been sanctioned by a healthcare entity had yet to be disciplined by the Texas Medical Board. Public Citizen sent a letter to Texas Governor Rick Perry urging him to take “immediate action to improve the performance of the Texas Medical Board and thereby protect patients in Texas from physicians who should have been, but were not, disciplined.”

Public Citizen does not blame the medical board; it instead puts the blame on a lack of funding and staffing. In Texas, the money that is collected through physician appointments, reappointments, and fines is placed in the state’s general fund. The medical board than submits a request for funding to perform its functions.

Lee Hopper, spokeswoman for the Texas Medical Board, says the agency is not underfunded or understaffed. “Like anybody, of course we would always like more money. But we haven’t been dealing with a budget crisis so the agency is healthy and it’s effective,” she tells HealthLeaders Media.

In its letter to Perry, Public Citizen recommends letting the medical board keep more—preferably all—of the funds it collects. This raises some interesting questions to think about.

Should the medical board be entitled to all of the money collected through its processes? Should the medical board learn to do more with less, like many other businesses and citizens are currently forced to do?  Would more funding lead to more disciplinary action?

The question that really sticks on my mind is, as a healthcare consumer, how important is it that disruptive physicians be disciplined? I know the short answer is very, but at what cost? Do you want your state’s medical board to use all of the money it collects to fund its needs? Or would you like to see some of this money go into the state’s general fund to be used for other public services?

What’s new with CRC?

Dear readers,

Welcome back to the revamped Credentialing Resource Center blog. I know on first glance everything looks the same. And aesthetically speaking, it is. What changed is the scope of content on the blog. Some of you may be familiar with our sister blog, Medical Staff Leaders. The original intent was to have one blog for physicians to focus on medical staff issues and another for MSPs to focus on credentialing and privileging issues. What we continue to see at HCPro, Inc. is that these two areas are becoming more entwined as the two groups form a strong relationship. For this reason, we want MSPs and medical staff leaders to be exposed to the same news alerts, tips, and best practices to excel in their roles.

The blog will still feature posts from experts in both the medical staff and credentialing fields, now in one central location. I hope that you give all entries a read; even if at first glance you think it is not relevant to your job function, read it and pass it along to one of your colleagues!

Free Form Friday: Quality Dashboard

Congratulations to Dianna Jernigan, RN, MSN, director of quality, risk management, and education at Cobre Valley Regional Medical Center in Globe, Ariz. for winning a free seat at the 15^th Annual Credentialing Resource Center Symposium. Jernigan submitted a quality dashboard form that the organization uses to get a quick snapshot of how practitioners are doing with certain quality measures, such as Hospital Consumer Assessment of Health Providers and Systems survey results and core measures. Jernigan says the dashboard is a quick and concise way to look at the information, and has led to increased accountability among the medical staff.

“It used to be, we had someone in medical records that reported the core measures and turned them in and the report only went to administration; no one else really ever saw it,” she says. “Now we have someone who gets that information, it comes here to this report, than all of the directors are able to see it and be held responsible for their part in those scores.”

Here is a copy of the quality dashboard.

Featured free webcast: ACOs influence on MSPs

By now, you’ve probably heard the acronym ACO a few times at your organization. Although there are still many questions, one thing is for sure: ACOs will create changes throughout the healthcare industry, including the medical staff office. For MSPs, what this most likely means is a change to how practitioners are credentialed.

Bruce D. Armon, Esq., a legal expert in corporate healthcare law, will present a free 30-minute webcast next week about the MSPs role in an ACO formation. Armon is managing partner of Saul Ewing LLP’s Philadelphia office and co-chair of its health law group. He is also a member of our panel of highly-respected experts presenting at the 15th Annual Credentialing Resource Center Symposium, May 10-11, in Orlando. For more information on the symposium, click here.

To sign up for this free webcast, call 781/639-5599 or click here.

Get creative, get 50% off price of CRC Symposium

One thing I’ve learned quickly in this role as credentialing editor is that MSPs love to share their great ideas with other MSPs. They know the stress their MSO faces and if they have a solution to a common medical staff problem, they don’t want to keep it a secret. With that said, HCPro wants to provide MSPs with a way to share their knowledge at the 15^th annual Credentialing Resource Center Symposium. As part of the conference offerings, a poster session will be held; it’s an informal way for hospitals to share their medical staff office successes with each other, network, and exchange ideas and information.

Accepted poster presenters will receive a 50% discount off the price of two symposium admissions. Sorry, but those already registered for the symposium are not eligible for the 50% discount (but you could send someone else from your organization).

Any and all ideas are welcome. Some poster topics to consider include the following:

• How to train or incentivize medical staff leaders
• How to avoid negligent credentialing and malpractice claims
• How to conduct OPPE and FPPE
• How to develop a thorough and efficient credentialing processes
• How to develop privileging criteria and delineation of privileges

If you have a great idea for a poster and want to present it at this year’s conference, please  download the attached CRC poster application, complete it, and e-mail it to kkondilis@hcpro.com. Thanks, and I look forward to receiving your application.

Free Form Friday: FPPE proctor evaluation form

Congratulations to Vicki Tauer, our March winner of the 15th Annual Credentialing Resource Center Symposium free seat contest. Tauer, MSM, CPCS, CPMSM, is the supervisor of medical staff services at Fairfield Medical Center in Lancaster, Ohio. Her medical staff office recently revamped its FPPE proctor evaluation form to make it more user-friendly for proctors.

Here is a copy of the FPPE proctor evaluation form.

For more information on the CRC Symposium, which takes place May 10-11 in Orlando, click here.

Patient Satisfaction Blog Series for CRC 2012

Easier?  It can make my job easier?

You are now experts at improving the three physician-specific questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey:

• During this hospital stay, how often did doctors treat you with courtesy and respect?
• During this hospital stay, how often did doctors listen carefully to you?
• During this hospital stay, how often did doctors explain things in a way you could understand?

I mentioned last week that this would make your job easier. How can that be? The following are some of the benefits that come from having satisfied patients:

• Fulfills patient priorities and wants
• Improves professional standing
• Improves compliance with recommended treatments and follow up
• Reduces liability risks and costs
• Improves staff retention and satisfaction
• Improves physician satisfaction
• Reduces unnecessary calls, returns to the ED, and professional aggravation
• Improves clinical outcomes and measures

There are other benefits as well. If you think back, you can probably find an example for each of the above from your own journey in the medical profession (as either a patient or provider). Happiness (satisfaction) is contagious!

Hopefully this series has whetted your appetite to do further reading, research, and reflection on improving patient satisfaction. Although “because the government says so” may be adequate motivation for some, the real motivation should come from our desire to provide the best patient care possible. After all, isn’t that what we are all about?

Editor’s note: William Mills, MD, MD, MMM, CPE, FACPE, CMSL, FAAFP, is a featured speaker at the 15^th annual Credentialing Resource Center Symposium, May 10-11. He will be speaking on using patient satisfaction scores to drive improvement as well as how to privilege low- and no-volume practitioners. For more information, click here.

Free Form Friday: New Agenda Topics

Thanks to Shirley Petry, CPCS, for submitting this form showing how she keeps track of new medical staff meeting agenda items during her busy day. By keeping this form near her phone, Petry is able to quickly get the pertinent information from the requestor regarding the agenda item, and can then put it in the appropriate medical staff meeting file when she has time. To read about how this form has helped Petry, click here.

To see a copy of the form, click here.

Patient Satisfaction Blog Series for CRC 2012

Blah, Blah, Blah?

As I mentioned in my last post, there are three physician-specific questions on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey:

• During this hospital stay, how often did doctors treat you with courtesy and respect?
• During this hospital stay, how often did doctors listen carefully to you?
• During this hospital stay, how often did doctors explain things in a way you could understand?

This post will deal with tips to improve your scores on the explanation question. By now, I’m sure you would make Emily Post proud of how polite you are. (For those much younger than I, she was the queen of etiquette.) I also expect you have made some brilliant diagnoses as a result of your improved listening skills. Now it is time to focus on how you explain things to patients and increase those scores at the same time. Your patient shouldn’t feel like Charlie Brown talking to his parents and just hear “blah, blah, blah,” when you are explaining important health related issues.

Patients (those are the horizontal people in hospitals) are often not at their intellectual peak while hospitalized. Remember this is our workplace—not theirs—so we need to be a little more diligent when explaining complex, emotionally charged issues.  Here are a few pointers that will help you with your ability to explain what’s going on in a way that the patient may understand:

• Provide more information than you believe is necessary
• Provide the option of having another person in the room to hear the information, take notes, and ask questions
• Encourage patients to write down their questions in between visits. This allows them the opportunity to think about the previous interactions and formulate questions that specifically address their fears and concerns
• Ask patients if they need any more information

Remember that we often get caught up in our jargon and patients “appear” to understand as they don’t want to disappoint their physician or appear not so bright.  Ask follow-up questions that probe their understanding. You may be surprised by how much your patient did not understand once you start asking them these questions.

So go forth and improve the satisfaction of those we serve, while simultaneously improving quality, publicly reported measures and making your job easier. I couldn’t resist. This will make your job easier. Read next week’s post to see how.

Editor’s note: William Mills, MD, MD, MMM, CPE, FACPE, CMSL, FAAFP, is a featured speaker at the 15^th annual Credentialing Resource Center Symposium, May 10-11. He will be speaking on using patient satisfaction scores to drive improvement as well as how to privilege low- and no-volume practitioners. For more information, click here.

Patient Satisfaction Blog Series for CRC 2012

I’m Sorry, What Did You Say?

As I mentioned in my last post, there are three physician-specific questions on the Hospital Consumer Assessment of Healthcare Providers and Systems HCAHPS survey. They are:

• During this hospital stay, how often did doctors treat you with courtesy and respect?
• During this hospital stay, how often did doctors listen carefully to you?
• During this hospital stay, how often did doctors explain things in a way you could understand?

This post will deal with tips to improve your scores on the listening question.  Hopefully you have tried to be a little more respectful (as discussed in my last post) and have found it rewarding.  So let’s improve your listening skills now.

You have probably figured out this is a perception issue, and you are correct. The following tips have been shown to improve the patient’s perception that you are listening:

• Sit down during the conversation portion of the visit
• Ask open-ended questions and listen with empathy
• Use “reflective” listening (paraphrase, clarify, ask for understanding)
• Offer a physical gesture, such as a handshake, a touch on the shoulder, or a pat on the knee
• Make eye contact with the patient and family
• Pay attention to the patient and not the chart or cell phone

Although these tips improve the perception that you are listening, you actually do need to listen carefully.  Remember back to medical school when the wise attending said that the patient will tell you what is wrong with them if you will only listen?  My experience is that they were right.  How about your experience?

Editor’s note: William Mills, MD, MD, MMM, CPE, FACPE, CMSL, FAAFP, is a featured speaker at the 15^th annual Credentialing Resource Center Symposium, May 10-11. He will be speaking on using patient satisfaction scores to drive improvement as well as how to privilege low- and no-volume practitioners. For more information, click here.