1. The Expanding Role of Today’s MSS Department Presented by: Lynn L. Buchanan, CPMSM, CPCS President, Buchanan & Associates Consulting Operations Manager, Edge-U-Cate, LLC For Alaska Association Medical Staff Services June 9, 2010 1Edge-U-Cate, LLC

2. OBJECTIVES  Understand why the traditional scope of services isn’t sufficient to meet today’s increasing demands and expanding responsibilities  Identify current barriers to optimal performance by your department and/or individual employees  Discuss transitioning from a traditional medical staff office to a “best practice” staffing model 2Edge-U-Cate, LLC

3. Objectives (con’t)  Define what skill sets, training, education are needed for optimal performance  Learn how to get the resources you need to achieve optimal performance within your department 3Edge-U-Cate, LLC

4. “Traditional” Medical Staff Office  Comes in many sizes, shapes  Director, Manager, and/or Coordinator plus…  Office “management” background, certified or not, college degree or not  Processed application, reapplication, and privilege requests; prepared meeting agendas and minutes; planned annual staff party and doctors’ day; recorded CME credit; worked on bylaws amendments; maintained a medical staff roster  Above “model” through mid-late 90’s 4Edge-U-Cate, LLC

5. “New MSO” - Increasing Demands & Expanded Responsibilities  Delegation agreements with health plans  Coordinated health system services Centralized credentialing verification Larger, single medical staffs Data integration for collection and reporting  Performance improvement initiatives  More sophisticated software Demographics (original use) Report writing Activity tracking, monitoring Expiration monitoring Privileging development including criteria 5Edge-U-Cate, LLC

6. “New MSO” - Increasing Demands & Expanded Responsibilities  More frequent advancements in medical treatment technology requiring additional defined privilege delineation and criteria  Additional requirements for monitoring and reporting FPPE OPPE Core Measures  Increased awareness of physician behavior, impairment issues and methods to address  Web site development and maintenance 6Edge-U-Cate, LLC

7. TODAY - Increasing Demands Expanded Responsibilities  WHAT ELSE?  What’s been added to your job within the last year, two years, five years, ten years?  How much has your level of expertise been tested? Your staff’s?  How comfortable are you TODAY that you (and/or your staff) have all the training, knowledge, experience needed to operate a functioning-at-optimal level department? 7Edge-U-Cate, LLC

8. Rate Yourself / Your Department  Confidence level in terms of experience, training, knowledge for you/your staff: ___ highest degree of confidence in all areas related to job/s ___ missing some degree of confidence but are in process of making changes ___ really in need of expertise, training, and/or knowledge in some critical areas 8Edge-U-Cate, LLC

9. Current Barriers to Optimal Performance  Staffing Insufficient Diversity of knowledge, training, experience; e.g., clinical, technical  Attitude “Always done it that way” Can’t see the forest for the trees Intimidated by others with talents you don’t possess  Administrative Support Don’t understand what you do MSD is not a revenue producing department 9Edge-U-Cate, LLC

10. Current Barriers to Optimal Performance  Technology deficient Older software Not high on IT or IS priority list for updates, improvements Not fully utilizing software because………… Software doesn’t interface with others in the organization and/or you don’t have access The idea of “paperless office” is foreign to you  Physicians less willing to serve in voluntary, time-consuming leadership positions 10Edge-U-Cate, LLC

11. Current Barriers to Optimal Performance  Budget Constraints Education, training  On site (speakers, webinars, on line, consultants)  Off site (conferences, seminars, college) Upgraded software Paid medical staff leaders More diverse, qualified staff  What else? 11Edge-U-Cate, LLC

12. Transitioning to a “Best Practice” Staffing Model  How do you define “best practice”? Be all things to all people Be all things to some people Be some things to all people Be some things to some people Hmmmmm……… 12Edge-U-Cate, LLC

13. Transitioning to a “Best Practice” Staffing Model  Now is a good time to contemplate Value v. Volume  What are you doing – does it add “value” to the services you provide  What should you be doing 13Edge-U-Cate, LLC

14. Transitioning to a “Best Practice” Staffing Model  What services do you currently offer? Make an all-inclusive list  What services do you want to offer? Make a list (it may/may not include currently offered services; e.g., sending medical record suspension letters)  What will it take? Re-negotiation Justification (for staff, increased budget) “White paper” Re-organization Different talents 14Edge-U-Cate, LLC

15. Transitioning to a “Best Practice” Staffing Model  What resources do you currently have? Make a list  What resources do you need? Make a list – current and additional resources  What will it take to achieve “best practices?” 15Edge-U-Cate, LLC

16. Transitioning to a “Best Practice” Staffing Model  How do you change the perception of who the MSD is and what you offer?  How will you know if your department has a “best practice” staffing model? 16Edge-U-Cate, LLC

17. “Change happens and if you do not change, you can become extinct” from “Who Moved my Cheese” by Spencer Johnson 17Edge-U-Cate, LLC

18. Skill Sets / Training / Education Needs for Optimal Performance  Role of the MSD is to not only support the medical staff and administration, but to develop new areas of support (now an expectation!)  Requires constant monitoring of industry to anticipate changes, plan strategy, and optimize/obtain resources  “Today’s Generation” MSDepts require skill sets in unexpected or unfamiliar areas 18Edge-U-Cate, LLC

19. Skill Sets / Training / Education Needs for Optimal Performance Opportunities abound as we improve and expand the services we provide (voluntarily or involuntarily!) 19Edge-U-Cate, LLC

20. Change is Organizational Structure  Have you seen your department merge or come under direction of: Quality Department Risk Management Department Human Resources Department Other  Have you been asked (or volunteered) to take over some or all responsibilities for: Medical Staff Quality Physician Recruitment Physician Contracting Risk Management Other “non-traditional” MSD support services __ 20Edge-U-Cate, LLC

21. Skill Sets / Training / Education Needs for Optimal Performance NEW SKILL SETS NEEDED: (requires formal training/degree)  Complex Data Management – IT expertise for management and integration of multiple data sets or internal data management  Complex Competency Management – Data analyst for statistical / data analysis and data collection for PI reporting  Clinical Expertise – clinical/quality expertise (nursing?) for developing and managing FPPE/OPPE, and ongoing development of privileging criteria and delineations 21Edge-U-Cate, LLC

22. Skill Sets / Training / Education Needs for Optimal Performance NEW TRAINING / EDUCATION NEEDED: (adjunct training)  HR Management Skills – team building, personnel issues, competency assessment  Project Management Skills – management technology  Communication / Presentation Skills  Practitioner Recruitment  Contract Management  Provider Relations  Physician Referral Systems  Organization-wide Regulatory Compliance 22Edge-U-Cate, LLC

23. Example – Staffing Model DIRECTOR MEDICAL STAFF AFFAIRS Medical Staff Coordinator Credentialing Specialist(s) CME Planner Recruitment & Contract Specialist PPE Coordinator Data Management Coordinator Department Assistant 23Edge-U-Cate, LLC

24. Skill Sets / Training / Education Needs for Optimal Performance  Recruitment (for specific skill sets): Where are you looking / advertising for the skill sets you need?  Local, professional associations, internet Do job descriptions accurately reflect scope of requirements? Is pay comparable to skill set requirements?  HR department, AHA salary survey, professional association salary survey 24Edge-U-Cate, LLC

25. Skill Sets / Training / Education Needs for Optimal Performance  Education / Training (for new or existing staff): Have you identified skills sets that can be obtained by existing staff? Where are you looking for the training?  Google it!  On-line courses  College courses  Seminars / Workshops  Webinars  Books / Periodicals  Consultants Is the training “general” or “specific” (how- to)? 25Edge-U-Cate, LLC

26. Obtaining Resources to Achieve Optimal Performance BUILD YOUR CASE:  Define scope of service (enhanced or new)  Define benefits of improving/offering service (e.g., effectiveness, physician satisfaction)  Define consequences if service not improved/ added  Conduct cost-benefit analysis (may be intangible costs)  Will new service eliminate existing service?  Will new service increase organization’s revenue?  Define criteria/skill set required to provide service 26Edge-U-Cate, LLC

27. Obtaining Resources to Achieve Optimal Performance OTHER CONSIDERATIONS:  Proposed Staffing Model & Method to Achieve (provide brief description of each position)  Reorganize/redefine - re-apply for positions?  In-house transfers from other departments  Additional FTE(s)  Timing  Attrition  Immediate need  Plan for next budget year  Long-term plan (multi budget years) 27Edge-U-Cate, LLC

28. Obtaining Resources to Achieve Optimal Performance PRESENT YOUR CASE:  Have your ducks in a row!  Identify stakeholders / decision-makers  Find a champion  Be succinct  Professional presentation Written plan, graphs/charts, PPT, verbal  Timing is everything 28Edge-U-Cate, LLC

29. Transitioning to a “Best Practice” Staffing Model  How do you change the perception of who the MSD is and what you offer?  How will you know if your department has a “best practice” staffing model? 29Edge-U-Cate, LLC

30. Crystal Ball (2003) 30Edge-U-Cate, LLC

31. QUESTIONS? 31Edge-U-Cate, LLC