MDNews - Minnesota

" An organization that improves its care team's efficiency may be able to see more patients, and perhaps, add to its line of services," Poore says. "If, for example, an organization reviews its team members' training and credentials and finds a clinician is highly trained in wound care, there may be a business opportunity to provide that service." — TRACI POORE, JD, CPHRM, SENIOR RISK AND PATIENT SAFETY CONSULTANT AT MMIC + Utilizing technolog y such as EHR a lerts so team members can notify patients of normal test results, overdue results functionality to track whether patients follow through with ordered tests, and patient portals to release test results + Using team members rather than clini- cians for tasks such as ordering previsit lab tests and reminding patients of upcoming appointments "In team-based care, direct commu- nication of critica l test results is still important," Remo says. "Teams shouldn't completely rely on technology, especially since many physicians end up getting alert fatigue because they're notified of so many actions to take in the EHR in a given day. It's important to pull clinicians aside if there's a result they need to be made aware of, such as if an abnormal imaging result comes back and a protocol ca lls for the radiologist to contact an individua l within the clinic — either the physician who ordered the test or a designee to ensure the informational loop is closed." RESHAPING DIAGNOSTIC PROCESSES WITH RELIABILITY AND RESILIENCE IN MIND Ill-defined, inefficient processes open the door to follow-up system failures a nd diagnostic errors, but with self- examination, clearly defined roles and plenty of communication, organizations can reengineer their follow-up systems to be more dependable and resilient. As with adopting team-based care, process improvement should begin by ta king stock of the current state of workflows. "If you were to ask people on the same care team to recite your process, you might get five or six different answers," Poore says. "It 's impor tant to def ine the process and determine the team's understanding of it. Then, map it and look for vulnerabilities and gaps — not just human errors, but deviations. Conducting a failure modes and effects analysis is a useful way to identify weaknesses. What happens if someone is sick or equip- ment breaks down or lab results aren't immediately obtainable? It's important to decide how to handle those sorts of deviations from the normal process so the organization doesn't increase risk for its patients when they happen." One way to delineate what is expected of each team member is to make a swim lane flowchart — a graphic representation of who is responsible for what. "Swim lanes can help organizations identify who may be overworked and who may be underutilized," Poore says. "If one individual has 10 tasks in her lane and another individual has three tasks in his, there may be an opportunity to reorganize and offload certain responsibilities. Some tasks may be more appropriate for a medi- cal assistant to take on instead of a nurse, or a nurse instead of a physician." Com mu n icat ion i s t he g lue t h at holds processes together and ensures their reliability. "The most important aspects of any follow-up system are clearly def ined roles and expectations for the care team and patients," Poore says. "Often, a care team may think a patient understands what he's supposed to do next when he doesn't, or a patient may wrongly assume the care team knows who her primary care physician is and will communicate test results. Communication between providers, team members and patients is what helps orga nizations ma nage expectations and ensure everyone knows his or her role." MMIC is a member of Constellation, a growing portfolio of medical profes- sional liability insurance and "beyond insurance" companies formed in response to the ever-changing realities of health care and dedicated to reducing risk and supporting physicians and care teams, thereby improving business results. To learn more about the services MMIC provides to physicians, hospitals and health systems, visit MMICgroup.com. n M D N E W S . C O M /// M D N E W S M I N N E S O TA ■ 2 019 2 7

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