Issue link: https://viewer.e-digitaledition.com/i/1111492
THE HIGH PRICE OF FOLLOW-UP SYSTEM FAILURE Follow-up system failures often result from two common flaws: an approach that places the burden of communicat- ing diagnostic information to patients at the feet of a small number of providers rather than distributing it throughout the entire team, and inefficient processes that are vulnerable to gaps and deviations. Non-team-based care and poor processes resulting in diagnostic errors can have deep, lasting effects, not just for patients whose health may be at stake, but also for healthcare organizations, which may experience lost revenue and productivity. "Organizations can lose their accredi- tation if they don't ma nage tests a nd notif y patients properly," Poore says. " They may a lso receive poor patient experience scores that can affect reim- bursement if patients have to wait a n inordinate a mount of time to receive test resu lts or don't receive t hem at a ll. Diagnostic errors can lead to hos- pita lizations a nd readmissions, a nd poor communication and coordination between providers — often, primary care physicians and specia lists — can result in duplicate lab testing." The uneven distribution of diagnosis- related follow-up tasks can lead clinicians to perform work far below their level of tra ining, which may contribute to provider burnout and turnover. " Physicia ns may become overbur- dened and fatigued because they don't have the cognitive streng th to look at absolutely ever y repor t or data point every day," Poore says. "Organizations ne e d t o en g i ne er b e t t er pr o c e s s e s t o en s u r e t he work phy sici a n s a r e doing is releva nt a nd necessa r y, a nd increase cognitive offloading — ta king the burden of certain tasks that could be ha nd led by someone else, such a s communicating norma l test results to patients, off providers." WORKING BETTER TOGETHER: THE BENEFITS OF TEAM-BASED CARE I n s t it ut i n g t e a m-ba s e d c a r e — a n approach to the diagnostic follow-up pro- cess in which every team member takes an appropriate amount of ownership of the process through working to his or her level of credentialing and training — is an effective way to close the loop and prevent follow-up system failures. Every team member is a resource with specific skills, and adopting team-based care to allow every individual to focus on work he or she is credentialed or trained to do optimizes individuals' value, especially physicians'. "It's estimated that every hour physi- cians spend with patients requires two hours of administrative time, and physi- cians simply can't work that many hours each day," Remo says. "There is a shortage 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 5 " When determining how to appropriately delegate work within a team, it's important to conduct a time study to establish the volume of work and how much time is devoted to various functions, such as prescription refills, medical triage and rooming patients. That's the starting point of allowing physicians to transfer administrative work to other staff so they can focus on direct patient care." — KASSIE REMO, MHA, PMP, FACMPE, CPHQ, DIRECTOR OF HEALTH CARE AT CLIFTONLARSONALLEN LLP