Monthly Archives: February 2015

3 Tips for Dealing with Frustrating Problems

Medical practice managers and physicians are faced with difficult, complex problems almost daily. When issues snowball into frustrating problems, your stress level is likely to increase, and your professional satisfaction is likely to decrease. Here are three tactics to help you better manage situations:

  1. Shift your focus. Sometimes when a situation you encounter at your medical practice doesn’t seem to be solvable, and you are at loggerheads, the most appropriate step might be to forsake the issue for awhile, and to focus on something completely different. For instance, it might be better for you to abandon what you’ve been doing, and seek to help someone else. Perhaps one of your colleagues needs help solving a different problem. By delving into that problem, you give yourself the type of break that you cannot otherwise experience when you’re entrenched in your own “stuff.” Helping somebody else within your office offers the side benefit of having others see you in a more positive light. After all, in the midst of your troubles you’re able to turn your attention to someone else. As a byproduct of helping others, sometimes you experience the “eureka effect,” the solution to your problem jumps out at you when you seemingly weren’t attempting to find a solution. Your mind works in mysterious ways. It’s working for you even when you’re not conscious of it. This is why you get great ideas while shaving or putting on makeup, certainly in the shower, and sometimes while resting in the hammock in the backyard.
  2. Acknowledge your emotions. When you ask yourself, “How do I feel right now?” and you’re accurate and honest with yourself, something strange and wonderful happens. By stopping and noticing how you feel, you can dissipate some of your feelings about being upset. The same works for being overly stressed or anxious. It’s as if the act of noticing how you’re feeling competes with the actual emotion itself and decreases its intensity. Perhaps competing energies cannot occupy the same space at the same time. Feeling upset and noticing that you are feeling upset, in a way, “compete” for the same space. Once you notice how you feel, you’re better able to make the leap from the raw feeling of experiencing to the potentially more beneficial one of noticing how you feel.
  3. Recognize that a problem comes with a solution. Charles F. Kettering, a co-founder of the Sloan-Kettering Institute, was a brilliant inventor in the last century, akin to Thomas Edison, but Kettering is barely known today. He perfected the diesel engine, chrome painting procedures, automobile ignition systems, and dozens of other innovations that transformed the automobile industry in the 1920s and 1930s. Kettering’s approach to problem solving was unsurpassed. He believed that the major distinction between a problem and a solution was that people more readily understood a solution. He noted that solutions involved merely a change in perception, since the solution to the problem must have existed all along, within the problem itself. A problem solver’s job was not to master a problem, but to make the problem generate its solution. When it comes to problems that you experience, perhaps even long-standing problems, a solution exists. And, as with Kettering’s insight, the solution has existed all along in tandem with the problem itself. When you lash out at someone, or experience headaches, hereafter, recognize that the solution does not lag the problem. You can explore the problem’s key questions, and the answers invariably generate solutions that you are seeking.



Five Ways to Say No to Professional Obligations

Despite a well-known songster’s suggestion that sorry is the hardest word to say, most of us find saying no even harder. Sometimes it’s because we’re uncertain about a pending decision, and other times it’s due to our own disorganization. But more often than not we hesitate to say no — even to things we know we’re not interested in — because we either don’t want to miss out on anything or, more likely, we don’t want to let someone down. As a result, many of us take the easy way out by saying yes to almost everything, which leaves us harried, hurried, and hopelessly overcommitted.

While saying a firm no can be challenging, it is also a skill that can be learned. Here are five recommendations to help you graciously get out of things you don’t have the time, the attention, or the enthusiasm for.

  1. Stop, drop, and listen to your gut. Even the smallest decision requires some soul searching. When you are presented with a choice, it’s important to stop what you’re doing, drop any distractions, and listen to what your inner guide is telling you to do. We all know at an instinctive level what we have the emotion, expertise, and energy to commit to, yet we often ignore that voice. From now on, pause for a moment to do a comparison of the rewards versus the repercussions of saying yes to yet another obligation.
  2. Ask yourself a question. No matter how enticing an opportunity may seem, participating in it is of no use to you if it doesn’t come with some degree of personal merit. While it may sound selfish, the only question that really matters when making a decision is, “Will doing this add value to my life?” That value may be emotional, financial, moral, or altruistic. Not pondering this question can skew your priorities and leave you battling to find balance.
  3. Buy some time. Snap decisions usually won’t serve your best interests. In fact, they can be detrimental to your reputation, especially when you constantly change your mind and need to back track. Many people spontaneously say yes simply to avoid the perceived awkwardness of saying no. When you reply to an invitation with a statement like, “I need some time to think about this. I’ll get back to you tomorrow with my answer,” you’ll be free to consider the consequences of committing.
  4. Stop apologizing. Do you trip over apologies every time you say no? Stop it! There’s no need to feel bad about making a decision that serves your greater good. “Sorry, I can’t make it. I’m so busy. Sorry! Did I say I’m sorry?” can be replaced with, “Thank you for inviting me. I’m unable to attend,” or, “I appreciate being included. I’m not in a position to participate.” If you feel compelled to give a reason for your unavailability, make it concise and conclusive by saying something like, “I have other commitments I need to honor.”
  5. Say it like you mean it. Confidence is the key. While some people, like author Anne Lamott, consider the monosyllabic word no to be a complete sentence, you can soften its blow by using three word responses to requests you’re unable to accept. For example, decline invitations by combining the three words no, thank, and you. Or, if someone specifically asks, “Are you available to spearhead this committee?” you can link the word no with the words I’m and not. Whatever you do, don’t say, “I wish I could, but …” unless you truly mean it. Many people will take that as the opening they need to continue to push you to change your mind.

Our daily decisions either limit or liberate us. And, as challenging as it can be to turn people, opportunities, and adventures down, remember this: Saying no to something you’re not primed for will always leave you open to say yes to something you’re passionate about.



Reducing Re-admissions with Care Transition Planning

Nearly one in five Medicare patients returns to the hospital within thirty days of discharge. With more than three quarters of these re-hospitalizations the result of preventable circumstances, providers have scrambled to identify areas of improvement. Recent research has shown that nearly a third of physicians blame hurried or incomplete hand-off procedures for an adverse event during hospitalization.

There are four major issues that often lead to readmissions:

  1. Lack of communication among providers and between the provider and the patient.
  2. Poor reconciliation of multiple drug regimens.
  3. Inability to exchange health information in a timely, electronic manner.
  4. Failure to educate patients about self-care programs to follow at home.

Research confirms that by working in a concerted, collaborative effort, providers can significantly improve care and reduce re-hospitalization by following these guidelines:

  1. Compare medication plans
  2. Communicate critical information
  3. Teach patients how to manage their own care

“Traditionally, doctors are trained in medical school to interview a patient and write daily summaries of the care plan but though vital to patient care, they rarely receive communication or handoff training,” said lead author Amy J. Starmer, MD, MPH, from the Division of General Pediatrics at Boston Children’s Hospital.  When trained in the use of a mnemonic device and EHR tool to help prompt more thorough communication, physicians were able to cut the number of preventable adverse events in half and significantly reduce medical errors. Instituting uniform procedures for common issues such as medication reconciliation and self-management for patients after discharge were effective in keeping patients out of the hospital.


Source: EHRintelligence



Six Ways to Foster an Environment of Patient-Centered Care

Building strong relationships with patients that take into account their needs, desires, quirks, and questions can be a daunting proposition. The Patient Experience Council (PXC) at The Sullivan Institute has released a set of guiding principles to aid healthcare organizations as they transition to a service-oriented mentality. These principles reinforce the notion that patients are the owners of their own health, and must be encouraged to create partnerships with healthcare providers in order to achieve the goals of the Triple Aim: reduced costs, improved quality, and a better patient experience.

  1. Clearly define roles for the care team and the patient: Patients should be educated about their responsibilities and accountability for their own health, but providers must also learn to adapt to their new role as coaches and partners, not just the writers of prescriptions or the givers of bad news.  Providers and patients must both clearly communicate their roles throughout the relationship wherever the patient touches the continuum of care.
  2. Conducting assessments of skills and competencies: Some patients are more able to take responsibility for themselves than others, and providers must establish a baseline of engagement, health literacy, and decision-making abilities before diving into a complicated care plan.  Providers must also match their skills and expertise with the level and type of services being provided in order to reduce the opportunities for misdiagnosis, mistreatment, or patient harm.
  3. Putting patients in the driver’s seat: The patient is ultimately responsible for making final decisions about his or her health, and providers should not force their opinions onto the patient.  Choices should be framed in a neutral manner with the support and expertise of the clinician providing a strong foundation for informed decision-making.
  4. Providing patients with access to their data: Patients must have the right and ability to access their personal health information, establish restrictions on who can view and edit their data, and decide how their data should be used.
  5. Ensuring data accuracy: Patient data must be as current and accurate as possible, and should be in a format that is easy and intuitive for the patient to understand.  Providers should ensure that patients have the opportunity to ask questions about their data or make corrections to applicable information in order to ensure accuracy and veracity.
  6. Adhering to privacy and security: Healthcare providers have the responsibility to ensure that patient data is stored and transmitted securely.  Only authorized, authenticated persons may access patient information, and providers must adhere both to HIPAA regulations and to patient access preferences across the care continuum.

By adhering to these guidelines, providers can foster better relationships with patients who feel more in control of their own care.  Healthcare organizations may see a significant return on their investment through better engagement, improved performance, lowered costs, and fewer health emergencies from responsible, accountable patients.