How will this module help me?
Provides a simple three-step framework to prioritize and choose the right change opportunity.
Answers questions to commonly asked questions.
Includes downloadable resources to guide your practice through the decision-making process.
When physicians and their teams lead change initiatives to address important goals within their practice, it can result in both improved patient care and improved physician satisfaction. When the desire for change comes from within the practice, it can counter change fatigue and make the results energizing and unifying for team members. Identifying the right opportunities for change by following three simple steps can help the practice ensure the thoughtful selection of successful initiatives that will produce meaningful and sustainable change.
These steps are meant to provide a framework for selecting change “wins” for your practice and all of your stakeholders: your patients, the care team, and the practice as a whole.
Three STEPS to help choose and implement successful, sustainable change
Determine the Benefits for the Care Team.
Determine the Benefits for Patient Care.
Determine the Resources Needed to Support the Change.
Step 1 Determine the Benefits for the Care Team.
A successful change should make it easier for everyone to do their work in the most efficient manner. The medical assistant, nurse, and physician each have to be able to see “what's in it for them.” This will help generate buy-in and commitment.
Quiz Ref IDWhen considering whether a proposed project will save time and make work easier, you might ask:
What aspects of the daily work frustrate the physicians and care team?
What do physicians and the care team do that seems counterproductive or unnecessary?
In what areas are the results of care delivery disappointing?
Creating a respectful team environment where everyone's voice is heard is important. Remember that everyone on the change team may not agree with everything that is said during the team's meetings. Start by setting ground rules, so everyone has the same expectations of how they can expect to be treated and how they should treat each other.
“I have a lot more fun with my practice because I am doing the things I love to do. To me, the journey was definitely worth it. It is worth it for me, personally. It is worth it for my staff and for my patients.”
—Richard Fossen, MD, Chair, Internal Medicine, Marshfield Clinic, Minocqua Center
Step 2 Determine the Benefits for Patient Care.
Quiz Ref IDMost initiatives identified by the team will likely benefit patients. For example, eliminating duplication or repetition in a process or increasing efficiency will translate to more time available to spend with patients, increased access to care, and other measurable benefits. For the project to gain and maintain traction, it is helpful to measure and demonstrate the benefits. First, measure the current state. Then, over time, continue to measure your results to show improvement after implementation.
Measurement gives the team a goal to work towards; showing improvement helps the team maintain enthusiasm and support for the project. If the team anticipates saving 20 minutes by implementing a certain process, they will likely remain motivated until they accomplish that goal. Even if the goal is exceeded, many teams will continue working to surpass their original goal. Seeing improvement is a positive energy builder.
Step 3 Determine the Resources Needed to Support the Change.
Dedicating resources (e.g., people, time, and energy) to embark on an improvement initiative needs to make financial sense. If the benefit will not outweigh the cost of preparing for the change and implementing it, the practice should not make the change. It is easier for a practice to commit to change when the costs of not changing—of maintaining inefficient operations or poor patient outcomes—are made clear.
Work with your financial manager or someone who can do some financial modeling for you to see the potential benefits of implementing your change project. Use indicators such as revenue from increased patient appointments or savings from increased patient health and reduced re-visits. To determine the financial benefits of implementing other STEPS Forward modules, see the calculators in the pre-visit lab, pre-visit planning, team documentation, prescription management and expanded rooming and discharge protocols modules.
Selecting a change initiative to improve your practice can be challenging, but when you choose the right project, assemble an enthusiastic change leader and team, and engage the entire practice in its implementation, it can have a profound effect on patient care, practice efficiency, and physician and team satisfaction. Keep in mind the three-pronged framework when selecting a change initiative—how will it benefit the care team? How will it improve patient care? What resources are needed to support the change? Identifying opportunities for practice improvement, implementing a focused change, and using the most appropriate metrics to track and evaluate the direct effect of change on the patients, practice, and team will allow you to achieve effective and sustainable change.