Pursuing Medical Practice Success: The Building Blocks for High Performance

    Posted by Katrina Slavey and Dale Gentz on Mar 27, 2018 1:32:28 PM
    Part of the Pursuing Medical Practice Success series:
    1. An Hour a Month Could Save You Many Sleepless Nights
    2. The Practice Manager as Change Agent
    3. The Heartbeat of Your Practice
    4. The Building Blocks for High Performance
    5. The Big Picture

    building-blocks.jpgWe hope you’ve been reading our Pursuing Medical Practice Success blog posts and finding them useful in your practice.

    In the previous post in this series, we discussed the value of a site-specific action plan (SSAP)—a tool that serves many purposes. The SSAP is where you will

    • document the high-priority issues you and your practice providers have agreed to address in your Practice Operations Council (POC) meetings;
    • identify the goals or outcomes you want when implementing solutions to those issues;
    • make a clear statement of the tactic you plan to use to accomplish your goal; and
    • spell out the specific detailed action steps you must take to carry out your chosen tactic.

    In order to take full advantage of the SSAP as a foundation for success, be sure to assign an accountable party for each tactic. (In other words, name the person responsible for seeing that the tactic is implemented.) Include a planned completion date—and keep in mind that “ongoing” is not a completion date. Finally, for most tactics, assign either a dollar impact or another quantifiable impact.

    The SSAP in Action

    The site-specific action plan is a living, breathing document. That means it is the practice manager’s key to-do list, keeping the providers and practice staff focused on the issues which, when addressed, will make a difference in the practice.

    At the POC meetings, the SSAP serves not only as an agenda, but also as a guide for reporting progress on accomplishing the tactic, discussing barriers encountered, and determining how they were or will be overcome. If at first you don’t succeed, it is time to adjust the plan and create additional tactics.

    Let’s look at some examples:


    Issue: The practice’s nurse practitioner (NP) is functioning below the median productivity benchmark.

    Goal: Increase the number of nurse practitioner visits by 15% in 2018.

    Tactic: Establish “return visits” in the NP schedule that decrease appointment time by 15 minutes per visit. This will allow three additional visits per day.

    Action Steps:
    1. Revise schedule template.
    2. Providers approve revised template.
    3. Set start date for change.
    4. Orient employees to change.
    5. Implement revised template.
    6. Evaluate increase in patient volume.
    7. Develop additional tactics, if needed.

    Accountable Party: Practice manager

    Planned Completion Date: See Action Plan

    Dollar Impact: $34,214.40 (3 visits per day times 220 work days per year times average revenue per visit of $51.84)


    Issue: Patient Satisfaction Survey results are currently at the 75th percentile.

    Goal: Increase patient satisfaction to the 90th percentile, a total of 15%.

    Tactic: Improve communication throughout all practice processes.

    Action Steps:
    1. Front desk will answer phones by the second ring.
    2. Medical assistants (MAs) will communicate with patients if the provider is running late and give them options to continue to wait or reschedule the appointment.
    3. Providers and staff will return all voicemails the same day.
    4. Practice manager will monitor progress.
    5. Practice Operations Council or practice manager will develop additional action steps if necessary.

    Accountable Party: Practice manager

    Planned Completion Date: 30 days from implementation (If the tactics began January 1, the planned completion date would be January 31.)

    Dollar Impact: N/A – Impact to be improvement from 75th percentile to 90th percentile in patient satisfaction scores.


    Note that each of these examples includes an issue of concern to the practice providers. These are the concerns that keep stakeholders up at night and will have the biggest impact on practice success.

    Once you have identified an issue, you must follow it up with a goal that

    1. addresses the concern; and
    2. is specific, measurable, agreed upon, realistic, and time-based (that is, it is stated as a S.M.A.R.T. goal).

    The tactic is the method you choose to achieve the goal. Again, remember that the SSAP is an organic document; your first set of tactics may or may not work. Continue to adjust your tactics over time to ensure that you meet your medical practice goals.

    The action steps describe what you need to do to implement the tactic. Many POCs make the mistake of failing to list all the key steps which must be carried out. But assuming “everyone knows we’ll do that” is not an option. This is perhaps the most important reason for assigning an accountable party.

    More often than not, the accountable party will be the practice manager— the implementer of the plan. The practice manager must be able to communicate the plan clearly, engage providers and staff in the tactics and action steps decided upon, and monitor the plan’s success.

    Here is what an update might look like for the action steps listed above in Example A. This approach gives a clear status on those items completed, underway, or pending:

    Action Steps:

    1. Revise schedule template (1/14 status: Complete).
    2. Providers approve revised template (1/14 status: Will be presented at 2/2 POC meeting).
    3. Set start date for change (1/14 status: Decision to be made at 2/2 POC meeting).
    4. Orient employees to change (1/14 status: Within 5 business days of approval by POC).
    5. Implement revised template (1/14 status: TBD based on POC decision).
    6. Evaluate increase in patient volume (1/14 status: 120 days after start date).
    7. Develop additional tactics, if needed (1/14 status: TBD following step 6).

    Building on a Solid Foundation

    Once you have attained a goal, it’s time to add another.

    As you develop your SSAP, remember to keep it realistic. Often, practices seize the opportunity to list every goal they would like to achieve—but doing so can bog down the process. Prioritize your goals and determine which to tackle first so the practice is always gaining momentum. Remember that Rome wasn’t built in a day; it’s perfectly acceptable to arrange your goals by quarter. The POC can work together to select which specific goals the practice will address first.

    You have now laid the foundation for your practice success: You have a fully functioning POC, you have hired the right practice manager/implementer, you have developed a SSAP, and you’ve put solid tactics in place.

    Now what?

    Achieving individual practice success is just the first step. If your practice is part of a larger overall organization, how can this model help it ensure its success? How does your practice fit into the strategic initiatives of that organization? How do you share best practice success? Stay tuned for our final post in the series, where we’ll discuss medical group governance.


    Topics: Physician Practice Management, Medical Practice Consulting

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