As part of her series on starting a practice – the critical start-up phase, KAREN CROUCH explains the third and final component to ensure the business begins on the right foot.
By now, you should have completed preliminary steps that ensure the practice will provide high quality healthcare from a demographically appropriate, selected location.
You’ll also be confident that it will eventually return a reasonable profit for the effort and risk involved.
“A sound practice is based on efficiently documented policies, procedures, reference documents and manuals.”
You’ve probably selected a descriptive, catchy practice name and administrative and clinical staff have been engaged under relevant employment contracts.
Essential technical equipment has been installed and telecommunications are in place along with fully functioning facilities for administrative, personal and clinical use. Of course, everything has already been tested under a comprehensive ‘test plan’ to ensure employees are familiar with their roles and use of equipment. Additionally, various manuals and reference documents have been created and are conveniently located whenever they need to be consulted.
Your website contains images of the practice, details of services and key clinicians. And other forms of marketing (local newspaper ads, letter box drops, perhaps even an opening day) have been identified.
Finally, the waiting/retail space is well equipped to welcome and accommodate the most important people of all – patients and families – and you are itching to provide best-in-class healthcare supported by a well-managed, efficient team of employees.
And the telephones are ringing off the hook for appointments too.
This is the critical point from which all future successes will flow, provided prudent clinical, administrative, practice and business management ‘foundations’ have been thoughtfully established.
While practitioners and support staff inevitably focus mainly on high quality healthcare, as they should, time consuming and complex administrative systems often receive less scrutiny.
And yet the structure and thoroughness of those very systems are the source of all information and knowledge, including details of the practice owners’ values and culture they wish to inculcate in the business – the organisation’s cornerstone.
Examples of ‘foundation’ actions that support efficiently run practices are:
• Vision, mission and values: while these are sometimes briefly expressed, they should embody the essence of the business, reflecting values, principles and business goals of owners for employees to adhere to;
• Organisation chart: clearly defined roles and responsibilities including reporting lines, to enable employees to understand the practice’s ’chain of command’;
• Staff management (human resources): detailed job descriptions for every position, provided to each staff member, including measureable key performance indicators to support performance assessments and enable employees to appreciate key aspects of their jobs;
• Staff appraisals: consistently undertake programs to assess job performance and serve as a useful, periodical communication channel to promote staff relations with two-way feedback;
• Induction programs: carefully documented for each position, to ensure new employees are methodically introduced through training materials and job descriptions so they confirm understanding of their roles and expectations;
• Exit interviews: questionnaires from employees who leave the business to enable owners to gather useful feedback on positive or negative aspects of the practice;
• Rostering procedures: for larger practices with complex clinician attendance habits that must be supported by front desk staff. Short notice availability to cover unplanned absences is a necessary part of any back-up plan to ensure patients and clinicians are adequately supported;
• Policy & procedure manuals: These mission critical records, worthy of a full, separate article, are the ‘practice bible’ and should include instructions on all policies and procedures;
• Legal: details of WHS programs, other medico-legal compliance requirements including ‘case histories’ of incidents that may have occurred during daily operations, be they actual oversights/ errors or ‘near misses’, all of which should be included in group meetings, training or ‘work smarter’ planning sessions;
• Practice management operations:
– Supplier management program to ensure supplier relationships and cost effectiveness are optimised and that contracts are renewed on time or new suppliers explored;
– Regular budget monitoring and various performance targets diarised for review;
– Complaints registers to record patient issues from lodgement to resolution;
– Delegation schedules clearly defining authorities assigned to any staff, including dual authorisations where applicable e.g. payroll;
– Staff records should be securely stored, ideally in the hands of the owner/s.
A sound practice is based on efficiently documented policies, procedures, reference documents and manuals – the foundation on which high quality front desk service supports healthcare administered by clinicians.
At a senior, management level, establishment of a well-documented clinical governance program will ensure cooperation and dispensing of highest quality, well co-ordinated, and consistent healthcare. For larger practices, establishment of a sound corporate governance framework is an important initiative to ensure meaningful and progressive oversight of the overall practice business.
ABOUT THE AUTHOR: Karen Crouch is Managing Director of Health Practice Creations Group, a company that assists with practice set-ups, administrative, legal and financial management of practices. Contact her on 0433 233 478, email kcrouch@hpcnsw.com.au or visit www.hpcgroup.com.au.
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