Developing a New Provider Orientation Program...Developing a New Provider Orientation Program...

Developing a NewProvider

OrientationProgramPresented by:

Barbara Warstler, MBA,CPMSM, FASPR

Associate VP, Client Relations

Presenter

Presentation Notes

Verity’s 2019 Annual Report on Medical Staff Credentialing: 23.9% of respondents stated that providers were extremely or very satisfied with the quality of the onboarding processes by their organization. 42.6% were somewhat satisfied. 33.5% were either dissatisfied or the respondents didn’t know. Only 3.5% indicated that their onboarding process was “best in class.” The orientation program that I developed at a large academic medical center consistently received 4.7 out of 5 over a period of 5 years.

Barbara A. Warstler, MBA, CPMSM, FASPR

In addition to organizational and process restructuring, Ms. Warstler established a career ladder program and created a student intern program with Health Care Administration students from the University of Toledo and Ohio University to increase awareness of the Medical Staff Services profession. In 2014 and 2016, the department earned perfect scores on its National Committee for Quality Assurance (NCQA) Central Verification Organization (CVO) survey as well as the Morrisey Innovation Award and Quest for Quality Award, respectively. In 2018, Ms. Warstler received the Credentialing Resource Center Collaboration Award.

Ms. Warstler has more than 19 years of experience in credentialing, medical education, physician relations and physician recruitment. She also has five years of medical practice management experience. Barb is a Medical Staff Development Fellow, has earned hercertification as a physician recruiter through the American Academy of Medical Management, is a certified Fellow in the Association for Advancing Physician and Provider Recruitment, maintains her Certified Professional Medical Services Management (CPMSM) status, and is certified in Lean-Six Sigma. Barb earned her undergraduate degree from Kent State University in Kent, Ohio, and her Masters of Business Administration degree, specializing in Human Resources from Ashland University in Ashland, Ohio.

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Associate Vice President, Client Relations

Ms. Warstler joined The Hardenbergh Group in 2019 as the Associate Vice President, Client Relations. Prior to joining The Hardenbergh Group, Ms. Warstler was the Director of Medical Staff Services, Credentialing and Provider Enrollment for the University Hospitals Health System in Cleveland, Ohio. She joined UH in 2007 as Manager of the Medical Staff Office. In that role, she developed and implemented a comprehensive physician onboarding and orientation program. In 2010, she was promoted to Director of Medical Staff Services and Credentialing when the Medical Staff Office merged with the Credentialing Department. Under Ms. Warstler’s leadership, the UH Medical Staff Services and Credentialing Department centralized its disparate hospital medical staff offices into a system-wide corporate department that now serves as the system’s single source of practitioner data. Following this integration, Ms. Warstler reduced expenses by more than 25% in a single year and lead the transition to a paperless, system-wide reappointment process in 2011-12. As Director, Barb led the integration of six new hospital medical staffs into the system, focusing on implementing best practices and increasing efficiency. In 2017, she helped lead the integration of Provider Enrollment into the Medical Staff Services and Credentialing Department.

Confidential and Intellectual Property of Hardenbergh Group ® 2019

3 Confidential and Intellectual Property of Hardenbergh Group ® 2019

Learning Objectives


Describe how to develop a newprovider orientation program.

List three (3) factors in determiningwhat to cover during orientation.

Discuss three (3) best practices indeveloping an orientation program.

Describe why an effective orientation is an on-goingexperience, rather than one finite session.

What is the role of the Medical Services Professional?

Help onboard qualified providersHelp keep good, qualified providers• 54% of physicians leave within the first five years


Presenter

Presentation Notes

Keeping great providers is in everyone’s best interest. Patient safety and continuity of care, patient satisfaction, referral patterns Conservatively, it costs about $50,000 to recruit a new provider and it’s about $10,000 a day in lost revenue when a position is vacant Audience question – what things have you done to help keep qualified providers at your facility?

Causes of Turnover


Within your control Outside of your control• Practice Issues • Mismatch between the provider and

the organizational culture• Broken promises • Location• Compensation • Lifestyle

Presenter

Presentation Notes

Other?

The cost of physician turnover (Source: New England Journal of Medicine Career Center)

• Compensation – salary, sign-on bonus, recruiting and relocation costs• Administrative – on-boarding, credentialing,

provider enrollment, training• Lost revenue – a PCP can generate over $1 Million annually

for a hospital• Other – effects on patient satisfaction, quality improvement initiatives,

impact on other providers/referral patterns


Presenter

Presentation Notes

A May, 2019 article in Annals stated that approx. $4.6 billion related to physician turnover and reduced clinical hours. Approximately $7600 per employed physician each year. Comment here about the cost of physician recruitment, too.

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Why is orientationimportant?


Orientation• Establishes a good first impression• Sets expectations regarding job performance• Helps new providers adapt to their new environment quicker• Improves retention• Helps with problem solving• Promotes communication (eliminates ‘5-minute frustrations’)• Is consistent• Reinforces organizational values


Developing your Orientation:

Getting Started


What are your goals for new provider orientation?

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Social• Build relationships• Identify resources• Build referrals

Training• Regulatory

compliance• Computer training• Risk/Legal

Logistics• Problem-solving• Facility tour• Benefits, ID badge,

Lab Coat, scrubs


Presenter

Presentation Notes

What do you want to achieve?

What tools/resources are needed?• Time• Available computers• Meeting space / food• Content experts• Collateral materials• Bylaws, Rules

and Regulations


What approach are you going to take?


Labor intensive

Approach ProsCons

Painful for providersTime intensive to schedule

ImpersonalMust be kept current

Inconsistent

Difficult to schedule

May be difficult to customize

One-on-One

Classroom

Electronic / on-line

Just in Time

Multiple sessions

One session

Provider-centricCustomizable

Consistent content

ConvenientConsistent messaging

Provider-centric

Shorter time commitment

Easy to schedule

Presenter

Presentation Notes

In the Verify survey, about 40% of provider orientation are ‘owned’ by the Medical Staff office, followed by physician recruiting, physician services, physician onboarding/navigator services and HR.

Developing the content


Presenter

Presentation Notes

In the Verity survey, 84.8% of orientations contain EMR training, 77.4% contain information about employee health (vaccinations, drug testing, TB testing, etc) and 69.4% contain some sort of learning – compliance, coding, onboarding and clinical standardization. My challenge to each of you as you design your orientation programs is to make the content meaningful to the provider!


What is importantto the newprovider?

Be prepared, concise, helpful

Respect his/her time

Be enthusiastic about your

organization

Anticipate his/her needs

Show them where their resources

are

Help them find their way

Allow new provider to set

prioritiesfor the

orientation

The Details

• Welcome sign• Notify key stakeholders• Effectively utilize time• Practical logo items


The regulatory content


Facility content

• Mission and vision• Service lines /

patient care services• Referring patients• Problem solving• CME/Grand Rounds• Doctors’ Lounge• Wayfinding• GME programs• How to use the computers/phones/paging/ secure texting• Operating Room orientation for surgeons/anesthesia


Conductingthe Orientation


Social aspects of orientation


Presenter

Presentation Notes

Does every new provider need orientation? What about tele-medicine providers or an ambulatory-only provider? Can certain groups of providers attend certain parts or orientation rather than all of it? These decisions need to be made before you roll out an orientation program. If the provider perceives that there is no value in attending orientation, he/she will find ways to avoid it. Remember: a provider is not caring for patients and generating revenue while in orientation. You need to make good use of their time! Always answer the question “What’s in it for me”(meaning the provider)

Attendance at Orientation


Is orientation required?

• Pros and Cons• Sample policy for

requiring orientation• What if the provider

doesn’t complete orientation?


Orientation Follow-up

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When is orientation complete?

• When they sign their orientation checklist?

• After the first year?• After 3 years?• After 5 years?


Presenter

Presentation Notes

Have a template for follow-up. If there are things that a provider needs to do/follow-up on, give them a visual reminder. This is an investment in time, but it’s time and money well spent for a high-quality provider. Be cognizant of the things that you can and cannot change (e.g., and unhappy significant other, location of facility, etc)

Check in at regular intervals

• Use a multi-disciplinary approach

• Put meeting reminders on your calendar

• Check in utilizing different modalities

• Check in often at the beginning and then less often as time goes by

• Organize a “New Provider Mixer” monthly or quarterly

• Head off ‘issues’ before they become deal-breakers


Presenter

Presentation Notes

If you use others to help with the check ins, be sure to train them. You want consistent messaging and tone. Leverage your resources. You may note be able to check in on every new provider. Consider their activity or potential for activity at your facility or if, for example you’re interested in the provider taking on a leadership role. Note: There needs to be a central place that feedback is maintained. Consider One Note Also consider having a few significant others who would be willing to check in with new significant others from time to time and report back on any issues Weekly for the first month Monthly for the next 4-6 months Approx every other month for the remainder of year one Approx once a quarter for years two and three

Final Thoughts

• You have the opportunity to make your orientation program amazing!• A customized program is far more beneficial to the

provider than a group setting• Follow-up is the key to the success of your program• A high-quality orientation program leads to retaining high-quality• providers and better patient care in your community


Sample Documents

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Supplemental Materials


Orientation attendance policy

Orientation checklist

Orientation feedback

Sample talking points for follow-up

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www.hardenberghgroup.com

[email protected]: 734-743-8432


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Developing a New Provider Orientation Program...Developing a New Provider Orientation Program...

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