New Provider Onboarding

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Amberly Williamson
5 years ago
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New Provider Onboarding A comprehensive onboarding program represents a proactive retention strategy Why We Are Here Our Core Purpose To make lives better together

1 New Provider Onboarding A comprehensive onboarding program represents a proactive retention strategy Why We Are Here Our Core Purpose To make lives better together through health and healing. Our Vision We will make high quality healthcare affordable and convenient, by reinventing how, when and where patients receive their care. 1

2 2014 Strategic Goals In five years TEC will be: The essential outpatient-focused health care system serving patients in Snohomish and North King County through integrated care-management and efficient episodic care. We will achieve 30% market share and distinguish TEC from competitors by providing convenient, high quality, affordable healthcare and integrated care management services. Key Element for strategic success Successful onboarding of new providers TEC Onboarding Program Goals To make our new providers feel welcome and supported as they build their practices. Process designed to: Integrate new providers into our culture and to develop behaviors that will be the foundation for a providers long term success. Define and communicate organizational expectations. Provide training and mentoring to assure the delivery of quality results, efficiently, effectively, and on target. Establish a program for mentor development and support 2

3 Current state Variability in approach to onboarding, follow up and accountability Variable skillset of mentors No standard checklist for content or cadence No visibility New providers felt unsupported and were not able to meet their production targets Quality was assumed ACP turnover 18.2%; Physician turnover 8.5% (2014) Elements Standard onboarding process with content and cadence that supports service line goals (multidisciplinary team) Leadership Checklist Mentor Checklist Mentor evaluation (chart review, visit observation, proctoring, etc.) and summary at 6 months Standard schedule template ramp up that matches financial targets Defined accountability and audit process Mentor training program Scorecards and new provider reports allow for visibility of process New Provider surveys to assess outcomes New cultural symposium 3

Tools For Evaluation Documentation Audit Clinic Visit

Surgical Proctoring process 360 Survey Focus on

Ramp up previous success in Medical Specialty and

4 Tools For Evaluation Documentation Audit Clinic Visit Observation tool Ambulatory Procedure Observation Surgical Proctoring process 360 Survey Focus on Practicing Excellence patient satisfaction Standard Ramp up previous success in Medical Specialty and Surgery but a challenge in Primary Care Onboarding Checklist and Tools 4

5 Standard Scheduling Accounting Based 20min Template- Month One Accounting Based 25min Template- Month One Notes Monday Tuesday Wednesday Thursday Friday Notes Monday Tuesday Wednesday.25min AM PM AM PM AM PM AM Afnoon Eve AM PM.20min AM PM AM PM AM PM Template 8:00 1:10 7:05 1:05 Off Off 8:00 1:10 4:50 8:00 1:10 Template 8:00 1:00 8:00 1:00 Off Off AMGA Median- 8:25 1:35 7:30 1:30 8:25 1:40 5:15 8:25 1:35 AMGA Median- 8:20 1:20 8:20 1: Long Long Long Long Long Long Long Long Long :40 1:40 8:40 1:40 9:15 2:25 8:20 2:20 9:15 2:30 6:05 9:15 2:25 Long Long Long Long Visits per day Long Long Long Long Long Long Long Long Long Visits per day 9:20 2:20 9:20 2:20 needed :05 3:15 9:10 3:10 10:05 3:20 10:05 3:15 needed- 11 9:40 2:40 9:40 2:40 Long Long Long Long Long Long Long Long 10:00 3:00 10:00 3:00 10:55 4:05 10:00 4:00 10:55 10:55 4:05 Long Long Long Long Long Long Long Long Long Long Long 10:40 3:40 10:40 3:40 11:45 4:55 10:50 4:50 11:45 11:45 11:00 4:00 11:00 4:00 Long Long Long Long Long Long 11:40 11:40 4:40 11:40 4:40 Long Long 5:20 5:20 5:40 5:40 End of Day 12:10 5:45 12:05 5:15 12:10 4:10 6:55 12:10 4:55 End of Day 12:00 6:00 12:00 6:00 Hours per session ####### ###### Hrs per session #VALUE! #VALUE! Lunch break 12:10-1:10 12:05-1:05 12:10-1:10 12:10-1:10 Lunch break 12:00-1:00 12:00-1:00 Dinner break 4:10-4:50 Dinner break Tt. Daily Hours Tt. Daily Hours Avg. Weekly Hours: Mentoring meetings over lunch Avg. Weekly Hours: Mentoring meetings over lunch Accounting Based 25min Template- Month Two Accounting Based 20min Template- Month Two Notes Monday Tuesday Wednesday Thursday Friday Notes Monday Tuesday Wednesday.25min AM PM AM PM AM PM AM Afnoon Eve AM PM.20min AM PM AM PM AM PM Template 8:00 1:10 7:05 1:05 Off Off 8:00 1:10 4:50 8:00 1:10 Template 8:00 1:00 8:00 1:00 Off Off AMGA Median- Long Long Long Long Long Long Long Long Long AMGA Median Long Long Long Long :50 2:00 7:55 1:55 8:50 2:00 5:40 8:50 2: :40 1:40 8:40 1:40 9:15 2:25 8:20 2:20 9:15 2:30 6:05 9:15 2:25 9:00 2:00 9:00 2:00 Visits per day Long Long Long Long Long Long Long Long Long Visits per day Long Long Long Long needed :05 3:15 9:10 3:10 10:05 3:20 10:05 3:15 needed- 14 9:40 2:40 9:40 2:40 10:30 3:40 9:35 3:35 10:30 3:45 10:30 3:40 10:00 3:00 10:00 3:00 Long Long Long Long Long Long Long 10:20 3:20 10:20 3:20 11:20 4:30 10:25 4:25 11:20 11:20 4:30 Long Long Long Long 11:45 4:55 10:50 4:50 11:45 11:45 11:00 4:00 11:00 4:00 5:20 11:15 11:20 4:20 11:20 4:20 11:40 Long Long Long Long 5:00 5:00 End of Day 12:10 5:45 12:05 5:15 Off Off 12:10 4:10 6:55 12:10 4:55 5:20 5:20 Hours per session :40 5:40 Lunch break 12:10-1:10 12:05-1:05 12:10-1:10 12:10-1:10 End of Day 12:00 6:00 12:00 6:00 Dinner break 4:10-4:50 Hrs per session #VALUE! #VALUE! Tt. Daily Hours Lunch break 12:00-1:00 12:00-1:00 Avg. Weekly Hours: Mentoring meetings over lunch Dinner break Tt. Daily Hours Avg. Weekly Hours: Mentor meetings over lunch Accounting Based 25min Template- Month three Accounting based 20min Template- Month Three Notes Monday Tuesday Wednesday Thursday Friday Notes Monday Tuesday Wednesday.25min AM PM AM PM AM PM AM Afnoon Eve AM PM.20min AM PM AM PM AM PM Template 8:00 1:10 7:05 1:05 Off Off 8:00 1:10 4:50 8:00 1:10 Template 8:00 1:00 8:00 1:00 Off Off Long Long Long Long Long Long Long Long Long AMGA Median- Long Long Long Long Visits per day 8:50 2:00 7:55 1:55 8:50 2:00 5:40 8:50 2: :40 1:40 8:40 1:40 needed-17 9:15 2:25 8:20 2:20 9:15 2:30 6:05 9:15 2:25 9:00 2:00 9:00 2:00 9:40 2:50 8:45 2:45 9:40 2:55 6:30 9:40 2:50 Visits per day 9:20 2:20 9:20 2:20 Long Long Long Long Long Long Long Long needed-17 9:40 2:40 9:40 2:40 10:30 3:40 9:35 3:35 10:30 3:45 10:30 3:40 Long Long Long Long 10:55 4:05 10:00 4:00 10:55 10:55 4:05 10:20 3:20 10:20 3:20 For Primary Care: Template supports accounting ramp up and visit targets set at AMGA median by specialty in PC The Everett Clinic New Physician Onboarding Production Needed to Meet Contract Salary Physician: AAAA Specialty: Internal Medicine 1st Year Contract Salary: $ 200, Specialty RVU Conversion Factor Scale: >=4,707 $ ,472-4,706 $ ,236-4,471 $ < 4,236 $ Misc Salary Components (based on dept avg): Codes with no work RVU Salary $ 4, Accounting Report supports transparency around Provider Production and ability to meet salary guarantee RVU's needed for Contract Salary: 4,600 Monthly Average: Current Monthly Average for Physician: Based on Dec '14 - March '15 Patient Visits needed for Contract Salary: 2,805 Based on Dept Avg of 1.64 RVU's/visit Monthly Average needed: 234 Other Salary Components you may Qualify for: 1% Access Component Patient Satisfaction - $1,500 - $3,000 Highly Profitable or Profitability Improvement Component Citizenship - $1,500 5

Accountability and Audit Process Medical Director and Manager training Oversight by Service Line Leadership with monthly audit of onboarding process Monitoring of New Provider visits or RVUs based on

6 Accountability and Audit Process Medical Director and Manager training Oversight by Service Line Leadership with monthly audit of onboarding process Monitoring of New Provider visits or RVUs based on specialty at Clinical Operations Physicians ACPs Total Section # Green # Red % Green # Green # Red % Green # Green # Red % Green Primary Care % % % Sub-Specialty % % % Surgery % % % Total % % % New Provider Tracking 6

of a Coach Skills Training Escalation process Resources Cultural Integration Elements

7 Mentor Education Training program- 4 hours Recruiting mentors selective process Focus on elements: Characteristics of an Effective Mentor Setting expectations of mentor/mentee Role of a Coach Skills Training Escalation process Resources Cultural Integration Elements Symposium Dinner with team All Provider event Meets with Board Director New Employee Orientation 7

TEC Cultural Symposium Clinician led set tone and culture Mandatory High level Not about how but about why Intentional about culture Rotating 6 month series Core Values and Compact driven New

8 TEC Cultural Symposium Clinician led set tone and culture Mandatory High level Not about how but about why Intentional about culture Rotating 6 month series Core Values and Compact driven New Provider Survey and Feedback Revised New Employee Orientation process Increased EHR/Epic training and changed format Gaps in accountability at sites addressed: I have never met my [local] medical director Overall satisfaction with onboarding and mentoring process: Feb-May 2015 June-Sept 2015 Oct-Dec % top box 50% top box 80% top box Meeting with my Facility Medical Director/Chair and Clinical Practice Manager made me feel welcome and part of the team in my area Feb-May 2015 June-Sept 2015 Oct-Dec % top box 29% top box 100% top box Comments have improved 8

9 Next Steps Mentor Education Program in process Cultural Symposium launch Continue to improve process quarterly assessment of meeting targets: Trend New Provider Surveys Audit onboarding process results Financial Targets Provider Attrition 9

The Customer Relationship:

View the Replay on YouTube The Customer Relationship: Behind the Scenes with Managed Privacy Services September 10 th 2015 Executive Series Webinar Today s Speakers Ann Marie Harvey Privacy Manager Baptist