MANAGING THE FAMILY MEDICINE PRACTICE

dr. Merry Tiyas A.

THE FIVE STAR DOCTOR

    

CARE PROVIDER DECISION MAKER COMMUNICATOR COMMUNITY LEADER MANAGER OF HEALTH CARE

MANAGING THE FAMILY MEDICINE PRACTICE

    

Managing People and Resources Managing Facilities and Utilities Managing Information Managing Finance and Managed Care Managing Quality

MANAGING PEOPLE AND RESOURCES

BEING A MANAGER
  

The doctor is often the manager of the practice Managing is to get work done through the efforts of others. Managing producing an output from input and processes.

 

Input

3M : manpower, money and materials. Process operational work, developmental work, and organizational work. Output technical care and patient satisfaction

BASIC FUNCTION OF A MANAGER



Planning
Process of setting objectives and formulating the steps which will be necessary to attain these objectives.  Long term strategic planning  Short term operational planning

Organizing
Process of getting activities, people, materials structured to meet organizational objectives. It includes :

setting of job description Authority to act departmentalization

Leading

process of influencing staff to meet predetermined objectives. The skills to be an effective leader:
 communication

and feedback skills  motivation of staff  use appropriate leadership style.

Control

Process of ensuring that things happen according to plan and taking corrective actions where necessary. 3 steps :  setting standards  comparing performance against standards  correcting deviations.

SKILL SET OF THE MANAGER



 

Conceptual skills skills of perceiving how the part of the organization link together in structure and processes. Human skills skills involved in working with people. Technical skills skills in managing things rather than people and are often learned through on the job training programs.

MANAGING PEOPLE


From entry to exit of staff, there are many aspects in managing people :

Recruitment Selection Induction training Motivation People handling Structure Leadership Personal effectiveness Change management Staff development delegation, appraisal, courses Separation promotion

STRATEGIC MANAGEMENT


Basic of strategic planning

five steps:

Identification of current objectives and strategy Analysis of the external environment Analysis ot the organizations strengths and weakness Strategic decision making to decide on services to introduce, services to scale down Strategic implementation at functional levels.

SWOT Analysis  Strengths, weaknesses, opportunities and threats.  Opportunities and threats exist in the external environment.  Opportunities are prospect to fill existing or new service needs.  Threats come from competitors, policies and economic outlook,and changes in public.  Strengths, weaknesses are state of the organization to sustain itself.

MANAGING FACILITIES AND UTILITIES

SUPPLIES AND STORES MANAGEMENT PRINCIPLES

 

Deals with ordering; receipt; maintenance; and issue when required. The supplies can range from drugs and pharmaceuticals to syringes and needles as well as general use items like stationery. Stocks of pharmaceuticals and medical require close monitoring to ensure they do not deteriorate or reach expiry dates.

MAINTENANCE AND STORAGE



Some rules are needed in the issue of drugs and pharmaceuticals:

Proper accounting of items issued Restriction of number of people having acces to stores Regular inventory taking and action taken to explain discrepancies.

DRUGS. The operations management principles are:

Use principle of first in, first out (FIFO) its important to avoid running of date. Circulate information on maintaining shelf life through proper storage. Do spot checks and regular inventory taking reduce wastage from date expiry, poor storage and pilferage.

VACCINES. The operations management principles are :

Maintain the cold chain. Transport to outlying places must be carefully planned. Keep every one knowledgeable of the cold chain, down the driver. Review the cold chain regularly to ensure that the cold chain works.

MANAGING DISCREPANCIES


Discrepancies the differences between recorded and actual quantity of money or inventory. Reasons :

Human error Machine counting error Incomplete recording Pilferage Fraud

Action to be taken for all discrepancies

   

Take immediate action Parties involved to explain what they know of the matter Conduct the necessary investigation Take uniform decision as has been laid down as standard operating instructions.

MANAGING INFORMATION

MEDICAL RECORDS

Documentation of clinical details. Properly kept and used, allow us to see the problem solving process form which we can deliver better care. An effective record keeping system contributes to the standard of care. Attention paid to how medical records are organized, filed and maintained is integral to effective practice.

System of filling records :  Numeric  Alphabetical  Address or company  Color coding

MANAGING FINANCE AND MANAGED CARE

FINANCIAL MANAGEMENT
      

Keeping proper records of income, expenditure and profit. Preparing financial statements at the end of accounting period. Analyzing financial statements and taking the necessary actions. Implementing inventory and stock control processes. Acting on discrepancies. Ensuring that financial records are audited. Developing financial plans.

Income :

Consultation Sale of medicine Fee for service House calls Investment from surplus revenue Staff cost as salary, bonus etc. Occupancy cost such as rents, repair, telephone, utilities.

Expenses :

Profit : difference between income and expenses.

Financial Audit
The purpose of financial audits is to ensure accountability in the use of financial and material resources.
External audit  Internal audit


MANAGED CARE


Refers to a variety of techniques for influencing the clinical behavior of health care provider and/or patients, often by integrating the payment and delivery of health care. Aim : to place administrative control over cost, quality, or access to health care services in a specific population covered enrollees.

Managed Care Systems

  

The prototype managed care system is the Health Maintenance Organization (HMO). Capitation system of payment is key feature. Capitation involves paying physicians a fixed, prospective amount for each patient regardless of the cost of caring for the patient.

Capitation is one example of managed care practices that seek to control costs of health care. Some managed care practices seek to impact the quality of care.

Managed care is structured around a variety of incentives to encourage the practice of cost-effective medicine, and to minimize variation in clinical practice pattern.

In its ideal state, money is saved through several mechanisms:

Standardization of fees Reduced variations of care Cheaper alternatives without undue sacrifice of quality or convenience Exclusion of non effective treatment Reduction of unnecessary tests and treatments

MANAGING QUALITY

QUALITY AND QUALITY ASSURANCE

 

QUALITY : care that meets or exceeds expectations. Two aspects :

technical patient satisfaction.

 

Evaluated by structure, process and outcome indicators. Based on the result of these indicators implement improvement programs to close the quality gaps.

 

QUALITY ASSURANCE is an attempt to protect and enhance quality. Concerned with patient care that is high in professional quality, and satisfying to the patient.

Quality holds the promise of being able to :  Deliver the most appropriate and up to date medical care.  Reduce the chance of unsuitable treatment and care, and an appropriate variation in care between doctors.  Encourage accountability between providers, consumers and founders of health care.  Save unnecessary costs by reducing waste, duplication and increasing efficiency.

TUGAS INDIVIDU


 

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