the clinical enterprise seven tips that will help you run a smooth clinic
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The Clinical Enterprise: Seven tips that will help you run a smooth clinic. Robert H. Hopkins, Jr., MD, FACP, FAAP Director, Division of General Internal Medicine. Welcome to UAMS!!. Ambulatory Operations: Simple but complex…- Patient focused but need refinement…

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the clinical enterprise seven tips that will help you run a smooth clinic

The Clinical Enterprise:Seven tips that will help you run a smooth clinic

Robert H. Hopkins, Jr., MD, FACP, FAAP

Director, Division of General Internal Medicine

welcome to uams

Welcome to UAMS!!

Ambulatory Operations:

Simple but complex…-

Patient focused but need refinement…

Change rate is variable…

1 know your people
#1 Know Your People
  • Medical Director & Department/Divison Director
    • Appointments/Scheduling
    • Set up your template with your director/administrator
  • Department/Division Administrator
    • Appointments/Scheduling
    • Set up your template with your director/administrator
  • Access/Appt. Center [UH, VA, ACH: Separate]
    • Communication!!!!
    • Some Departments do not use central access center
    • Policies: Insurance; Template formats; Hospital Follow ups
1 know your people contd
#1 Know your people (contd)
  • Clinic Manager:
    • Learn the policies already set in place
    • Build and maintain a good relationship
    • Staffing, Rooms, Clinic metrics
    • Encounter Forms
  • Nurses:
    • Communicate with them about your preferences
    • Time to check a patient in
    • Overbooks
2 know mcpg faculty group practice
#2 Know MCPG (Faculty Group Practice)
  • The UAMS operating division that administers the business aspects of physicianservices, including billing, payment
  • Encounter Forms and Coding
    • Encounter forms may be paper or within EMR
    • This issue likely to be more uniform with Epic implementation [next 12-18 months]
  • Risk Management (dealing with problems)
    • Prefer to know about potential problems than to hear ‘to late..’
3 learn the computer systems
#3: Learn the Computer Systems

CENTRICITY [Current Ambulatory EMR]

  • To be replaced by EPIC [IP/OP] in 2013
    • Development beginning now
  • Not all using EMR to its capability…
  • Advantages
    • Communication between docs
    • Sign off/review all OP data [minimize ‘miss’ potential]
    • Organized, reasonably user friendly
  • Disadvantages
    • Typing vs. Dictating
    • IP and OP systems communicate but don’t integrate
    • IT glitches
4 know your clinic policies
#4: Know your clinic policies
  • No shows
  • Late patients
  • Time allotted to each patient
  • Rules for canceling your clinic
  • Administrative dashboard [EIS]
    • Data on most of these clinic metrics
    • Reviewed routinely by admin, Dean and Dept/Divison leadership
5 fgp compliance
#5: FGP Compliance
  • Learn [keep up with] changes in billing/coding
    • Check with your administrator re: specialty-specific tools
    • Please teach your learners how important/complicated this is and can be!
  • Routine random audits
    • Review your results, ask for a sit down if you have concerns…When you screw up, they will find you!
6 student resident education
#6: Student/Resident Education
  • Most clinics serve insured and underprivileged
    • Institutional policy on fees/payment for services
    • Review specific clinic policies with your administrator
  • The majority of us are on some ‘educator track’
    • Students, residents, fellow, [other learners]
    • Know rules for documentation of services w/ learners
      • What/how much of learner note you can refer to…
      • Teaching physician statements…
      • Primary care exemptions…
make the most of teaching moments
Make the Most of Teaching Moments..
  • We are all pressed by multiple demands on time
  • We are here b/c we have a passion for education
  • Most are not trained educators
  • Tips
    • Smile
    • Pick one teaching point from each patient encounter
      • One Minute Preceptor
    • Share your clinical dilemma
    • Feedback sandwiches…
7 get involved
#7: Get Involved
  • ALWAYS opportunities for improvement!
  • Committees
    • Clinical Coordinating Committee
    • Medication Policy Committee
    • Professional Standards Committee
  • Quality Improvement
  • Faculty Senate
  • EPIC development in your specialty area
  • Consider getting involved with reform
overall
Overall….
  • Introduce yourself
  • Consider volunteering for outreach-
    • Publicize what you bring to UAMS and Arkansas
  • Ask questions
  • Be proactive

Knowledge is POWER!

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