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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