Performance Improvement

Business Management, Human Resources, Performance Appraisals, Performance Improvement

A Couple Final Thoughts on Employee Appraisals

As a follow up from our last two posts, BRB Consulting has strategies five and six to consider when conducting a performance appraisal.

Strategy five is to discuss options for further growth and development. Even if the employee does not bring this up, you need to have thought about this ahead of time. Employees who are given opportunities for growth and development tend to be productive, motivated employees.

The final strategy is to provide management with information to make job assignment and compensation decisions. If you have the “perfect employee” for a promotion that may become available in your company, or a special assignment, you need information from the performance appraisal to support your suggestion.

Want more information on performance appraisals? Please contact us for more information.

Performance Improvement

Business Consultation

BRB Consulting is pleased to share an expansion of our services. Recognizing the ever-changing financial and regulatory environment in which today’s rehab and social service providers function, we are adding a unique solution.

We now offer a comprehensive product to support corporate planning, human capital management and business inefficiencies. Through a coordinated analysis, our team has discovered methods to improve these areas. The most exciting aspect of this – sometimes the benefits can occur without spending any additional dollars!

Intrigued? Great!

We’ll be sharing more about the process in our next blog. But if you can’t wait, give us a call or contact us directly to learn more. Stay tuned!

CMS, Legislative Issues, Performance Improvement, Rehab Physical Medicine

Keeping Track of CMS….

As 2012 begins, everyday life seems to be getting more complicated. Not only have the political campaigns taken hold of the airwaves-yes there is an election in 9 months; the weather has many of us trying to choose between shorts and parkas; and as part of the regular day-to-day quality care practices, Rehab providers strive to deliver optimal care in this increasingly complex environment. This month’s topic focuses on one of CMS’s newly revised regulations designed to “improve service delivery”.

Sometimes- new revisions simply DO NOT appear to that.

For example, CMS Transmittal 72 11182011 was released in November 2011 under no special circumstances or with any requests for comments. The transmittal states that all orders for rehabilitation therapies both inpatient and outpatient must be written by a practitioner aka doctor or nurse practitioner who is a part of the hospital staff where the patient is to be treated. On inpatient- this is not a big deal. It actually works, when patients receive care in a hospital, every doctor who delivers care in that space is a part of the staff. Even if the patient came from another state, that new patient will become part of the admitting doctor’s service and be under her care for orders.

BUT on outpatient, the interpretation and implementation of this transmittal can be VERY BIG deal…so let’s consider a real life situation and analyze that.

For a patient who has received special hospitalization in other city, county or even state, the special therapy orders written by the discharging doctor would not be valid at the patient’s local hospital. Like a person who suffers a spinal cord injury while driving from SC to Florida, is injured in Atlanta and receives care at the special rehab spinal cord center in Georgia.

Once the discharge plans were set, the patient going back home to SC would have to see the hospital staff doctor in SC to get new orders to be treated at the local hospital in his hometown town. Probably- not too quickly either- you know how long it can take to get a non-emergency appointment….plus there is that additional financial cost of co-payments plus the real effort for the patient and family in arranging an additional trip to the new “hospital” doctor. Clinically, the first doctor knew the patient and his history and wrote the outpatient treatment orders based on those needs; but the new doctor must start at the beginning….maybe giving similar orders- BUT may not.

Maintaining quality care and improving access are concepts regularly stated by CMS. We are just not sure this transmittal’s regulations meets those two goals…what do you think?

AMPRA is actively monitoring the next steps from CMS and the response from the Rehab industry on Transmittal 72111802011. If your organization has have you been affected by this practice – Please contact AMPRA.

Looking to learn more about regulations, quality care and how to positively impact your organization- BRB Consulting would welcome hearing from you. Contact us today.

CARF Preparation, Performance Improvement

Can you believe it- the New Year is around the corner?

Where does time go? It’s hard to believe that 2012 will be here in just two weeks. The year has held numerous challenges for rehabilitation providers. These may have been in the form of funding issues, staffing issues or even in a clinical nature.

For some of us, there were challenges of a personal nature. Yet, part of the beauty of rehabilitation is the hope that it inspires. As you look to begin the next year, consider the projects that need to be done, the opportunities for improvement that need to be addressed, and take a deep breath.

Taking first things first, start thinking about the plan. Then consider activities that need to occur to achieve the goals. Maybe it’s time to start thinking about CARF, or quality improvement plans or alternative staffing patterns. Over the last couple of months, we have offered several ideas for planning in previous blogs. We’ll be happy to talk with you to develop a specialized approach for your organization-feel free to contact us anytime for a free consultation.

BRB Consulting thanks our clients, our associates and our friends for a great 2011.

We wish you and yours a happy and healthy new year!

Performance Improvement

A Season for Change Part 2

So the process has begun and the team is ready to tackle an issue. With the problem identified, now creating solutions can begin.

After finding that one thing, even if it is small, to change; let the group brainstorm and discover 2 or 3 ways it could look different. Using the team to develop the tactics to address the problem allows broad perspectives and can help find novel ways to approach a common issue. The team should pick a combined and agreed upon approach, and get everyone on board to fix the issue. Next establish the plan of action and the time table to make at least one of the steps for change.

Don’t forget to select your change agent, pick someone who is committed to making this happen. In many ways, they are the champion and can help cheer folks on!

Then as the Nike ads say…Just Do IT!

Do the thing to make the change! Once that process is underway, the actions need to be reviewed. Yes, it is very important to step back and look at what is happening.

Many organizations use PDCA– Plan, Do, Check, Act, which is a simplified pathway to make sure that the changes made lead to the results desired.

The team should evaluate to see if the change worked, if it did- then offer everyone a hearty congratulations! And maybe keep working to make that process even better. But, if the change didn’t work to get the desired results… well then – it’s back to the drawing board and PDCA starts all over again.

BRB Consulting hopes these ideas can help your team manage change as a natural part of the cycle of work. As each team member gains understanding and begins to incorporate the process knowledge from each project, change just might get a little easier.

If you’re still not sure on how to get started on a change or if your plans are not working- BRB Consulting is here to help. Contact us today and let us be your change agent.

We look forward to hearing from you soon!

Performance Improvement

A Season for Change

As the weather begins its transition into fall, and the leaves begin to turn colors, it is a perfect time to think about change on a larger scale. Many of us reflect from time to time on what we or our organizations could do better or even about things we wish we could stop doing altogether.

So where to begin? Start with something that matters, a facility problem, an employee issue or maybe a challenge for patients/clients. Once you decide what it is you want to tackle, gather a team to help; successful change requires analysis and planning; for that two, or even more heads are definitely better than one.

Next try a brainstorming session to first define the issue, then let loose creative ideas on what might be a fix. (Do have someone take notes!) Then begin analyzing and weighing the team’s thoughts, it is okay to take time. Give your group permission to “reflect” on the concepts that have been shared.

After thoughtful consideration, the team’s imperative is to select the best approach to address the change desired. Now the work should focus on creating the actions for making something different happen.

As the team defines these procedures, establish just one goal for one small change. Although it may not seem like much, targeting that will lead the team to achieving the larger goal.

“Rome was not built in a day” may become a mantra for the team. Working together, know the change can happen -there’s proof – Rome still exists today!

With those beginning steps, you are ready to become a change agent. Join us again in two week for the next installment of A Season for Change.

To learn more now or want some help in starting change in your program- contact BRB Consulting today.