|Posted on August 13, 2018 at 11:10 AM|
As management we have a responsibility to build trust in the workplace. In order to build a foundation of trust, you need to understand the thinking processes of the employees in the workplace. Any environment where blame shifting or lying is tolerated will erode from within and the foundation will crumble.
There are four types of “thinkers” in the workplace:
1. Analytical Thinkers need data and logic. They build trust by seeing proof in factual, clear results.
2. Conceptual Thinkers look toward the big-picture. They build trust by knowing that what they are doing means something in the
greater sense and need to see how their ideas are executed.
3. Social Thinkers see work through relationships. They build trust by cultivating collaboration with others.
4. Structural Thinkers lover structure and process. They build trust by witnessing deadlines being met with precision.
As management, the way you approach and interact with each team member should be based on how they behave and what you know about your own behavior.
• Employees on the quiet side gain trust by seeing someone pause, listen, and wait for their response.
• Employees who are more assertive and vocal tend to process information out loud, and a manager who allows them space to bring their thoughts whenever and wherever will build trust.
• Employees who tend to be more focused lose trust with a manager who welcomes change since they appear weak and confusing if they do not clearly and quickly communicate the rationale behind a change
If the bond of trust is broken, rebuilding that trust takes far more focus, time, and effort than it does to initially build it, and, in many cases may not be able to be rebuilt in its entirety. The more you know about yourself and the employees who report to you, the more likely you are to establish the bonds of trust in the workplace.
|Posted on January 5, 2018 at 1:25 PM|
As 2018 begins we say goodbye to the old and in with the new. Many resolutions are made (all in good faith) and never followed through. One of the most important is to do something to improve you - professionally.
Like with everything else, the first step is the most difficult, it takes courage and determination to "put ourselves out there" and hope we can succeed. If you are unsure where to being, college career counseling departments, and continuing education counselors affiliated with professional associations are a great place to start.
Take a hard and honest inventory of yourself. Know your strengths and weaknesses. Define what you enjoy about your current position, and, what you would change if you gave yourself the opportunity.
Next, make a timeline. Give yourself a real picture of how much time you are willing and able to devote to retraining or education. Be sure before you embark on this next phase you are prepared for how long it will take to get there.
Bring your lifestyle into account. Do you concentrate better in the mornings or evenings? Is there a 'quiet place" where you can study uninterrupted? Can you honestly count on someone to assist you in other areas so you can devote the necessary time to improving yourself? Make certain not to sabotage yourself before you begin.
Finances should never be what hold you back! Do not be afraid to address career goals with your current employer to see if funding is available, provided the education can benefit the oranization. Speak with the financial aid department at your local college. Many professional organizations offer private scholarships - you will not know unless you ask.
Do not expect too much of yourself. Remember that you are only human, and, probably trying to juggle many balls in the air at one time. Do not let minor setbacks call your goals to a halt. Many times we need to reroute and end up better for it.
If one door closes...look for window...
Wishing you a Happy and Successful 2018!
|Posted on July 5, 2017 at 8:35 AM|
One of the most important factors (key components) to developing strong managers is TRUST. The strongest managers lead through trust, trust of their teammates, trust of their employees, and trust that everyone can come to them when they need help without fear of dismissal or ridicule. Strong management is developed over time, it is not based on who is right and who is wrong, it has its foundations in working together for the common goal.
Weak managers simply do not trust themselves enough to lead that way for others, or have no idea where they are going and how to successfully get them, therefore, ultimately they fail. When good employees feel that management is not strong, is not setting a sound foundation, and is not acting as a mentor and advocate for them, many move on to work for someone who will.
Secure managers will ask for help when it is needed. They welcome productive opinions from staff members, and do not become angry when those opinions differ from theirs. Strong managers listen, and make determinations, without being dictatorial. Managers that succeed and have the respect of their employees do not behave forcefully or in a domineering manner as these management styles show weakness in the ability to lead.
Strong managers lead through trust, not fear. Weak managers yell, make threats, demean and try to keep employees off balance and worried about pleasing them, rather than producing exceptional customer service and helping the organization move forward.
ADMITING WHAT THEY DO NOT KNOW
Strong managers acts honestly and are not afraid to admit what they do not know, research it, and get back to the individual employee or team with a determination to be input into the future. Weak manager are fearful and afraid to admit when they do not know something and often lie or start throwing around bad ideas to see if anything sound feasible.
Strong managers learn quickly because they learn from successes and failures, and are able to input both into their management style. Weak managers are not usually capable of doing this, because so much of their mental and emotional time and energy goes to deflecting blame when something goes wrong.
Weak managers spend more time focusing on whom to blame for mistakes then learning from them, fixing them, and moving on. Secure managers accept the blame when something goes awry, and cultivate a workforce of individuals who operate together for the common good – with the end result of a positive environment and collaboration. Insecure managers cannot accept that responsibility and remain stuck in their leadership.
Strong managers are able to focus and not lose sight of the main goals. Weak managers are easily sidetracked with small, insignificant errors, events or things.
Weak managers often rely on measuring everything. They do not put value on positive actions but instead focus on, and call employees out on, negative behavior. If an employee is working on a large project and stays well beyond the normal workday to figure something out, resolve a problem, or meet a deadline rather than being appreciative and promoting thanks, the weak manager will make note that that same employee came in fifteen minutes late the next day, and remark to him/her about it not being acceptable.
Weak managers rely on measurement, rather than good judgment when they manage people. They have a ruler measurement for everything, and do not recognize or promote dedication.
NEVER APOLOGIZE, OR HALF-HEATEDLY DO WITH A ‘BUT….’
Strong managers have to ability to see, and sincerely deliver an apology, when they are wrong. And, if an insecure manager does come forth with an apology, it is often given with a “but clause” to be certain the employee realizes that in the end they actually caused the problem anyway.
Weak managers will not accept criticism or negative feedback, no matter how it is delivered, because they have fragile egos and are not easily capable to moving on or growing.
LOOKING TOWARD THE FUTURE
Employees can always count on poor managers to write down or mentally recall any mistake they have ever made….as it will be used against them at a future time.
The workplace should be an environment when people want to come, not a place often referred to as a “daily grind” where they count the minutes until quitting time and speak negatively about in the outside world.
|Posted on February 4, 2017 at 10:35 AM|
Mentoring can be a very fulfilling and pleasant experience. Many people believe in the philosophy of “paying forward” and mentoring is a great way to do so. But, before you make the decision to become a mentor in your profession you need to assess if you are someone who has the time to invest, the patience to train, and the ability to communicate easily.
Once you have determined that you do, you should honestly assess your personality to see if you possess the below listed traits, which are common characteristics of a mentor:
If you feel that the above personality traits describe you, the next step is to identify the objectives and challenges where your experience can benefit the person or persons you will be mentoring. It is important to remember two things, for some, not to let pride in your accomplishments come across as arrogance. For others, feelings that they do not have much to offer that would interest others. The goal is to help others learn from your experiences, so it is very important to share experiences honestly and humbly.
To be effective and motivating, you need to develop plans in advance and organize for the time you will spend mentoring. Take the time necessary to prepare for your session, look at the goals you want to discuss, and know what you want to ask or share during your sessions. Below is an example structure to follow when holding a mentoring session:
• Review the previous session (unless this is the first meeting
• Determine the goals of this session
• Have a prepared list of questions
• Make an action plan
• Recap what went on
• Decide the goals for the next session
Your session should be focused on the actions the persons you are mentoring will take to improve on the goals that have been set. Make sure you pay attention to the resulting changes and how they can be improved upon.
|Posted on December 28, 2016 at 12:55 AM|
When an employee fails, whatever the reason may be, the assumption is usually that it is the employee’s fault and responsibility. Sometimes, this is the case, for many different reasons, which may include lack of knowledge, lack of skill, lack of desire to learn, or lack of motivation. However, there are many times where an employee’s poor performance can be the fault of their direct supervisor/manager, as the person supervising the employee is often complicit in the employee’s lack of success by reinforcing a dynamic referred to a the “set up to fail dynamic”, that enables perceived underachievers to fail.
This “set up to fail dynamic” is one in which employees are perceived to be mediocre and expected to live down to the low expectations the supervisor/manager has for them, so they do, in the eyes of the supervising individual. The result is that they often end up leaving the organization, either by their own choice, or by the choice of the employer.
The “set up to fail dynamic” usually begins with a triggering event. This can be something the employee does (eg, miss a deadline), it may be an event cast upon them (eg, a mediocre recommendation from a previous manager), or, it may be an inability to get along on a personal level (eg, a lack of compatibility based on attitudes). No matter what the reason, the syndrome is set in motion when the supervisor/manager begins to worry that the employee’s performance is substandard.
The supervisor/manager then increases his/her time and attention paid to the employee. While the supervisor/manager is using these actions to increase performance and prevent errors, the employee can view this as a lack of trust or confidence. Eventually these concerns and feelings, on the part of the employee, cause them to doubt themself and their ability to perform. This starts a domino effect culminating in a lack of motivation to succeed, as they feel that nothing they do will please the supervisor/manager anyway. These actions cement the concerns of the supervisor/manager so he/she, in turn, puts even more pressure of the employee to perform. The supervisor/manager begins to give more specific instructions, double check all the work done by the employee, question everything they do, watch their every action, etc.
This chain reaction causes the employee to go one of two ways; the employee either responds by withdrawing emotionally, figuring the supervisor/manager will just question everything they do, or do it him-/herself anyway. The employee then begins to spend most of their time and energy on self-justification, anticipating that they will be personally blamed for failures anyway, Or, the employee will fight to prove himself/herself, trying to reach goals that are not achievable, committing to deadlines that cannot be met, or moving too quickly to be effective, increasing the number of poor decisions or errors they are making.
At this point the supervisor/manager and the employee usually fall into a routine that is not conducive to either of them, or the organization. In the worst-case scenario, the supervisor/manager’s intense micromanaging, and continual scrutiny of everything the employee does, ends up paralyzing the employee into inaction, and, consuming so much of the supervisor/manager’s time, that the employee quits, or is released.
The good news is that the “set-up-to-fail syndrome” is not irreversible. The first step in solving a problem is recognizing that one exists. Reversing the syndrome requires that a supervisor/manager understand the dynamic involved, and, accept the possibility that his/her own behavior may be contributing to an employees underperformance. This is where the Human Resources Department, or an external Conflict Resolution Coach, should become involved and establish a “coaching framework” to train the supervisor/manager in better management techniques.
There are generally five steps to this coaching plan: 1.Select a time and place to conduct a coaching meeting, in a neutral location (eg a conference room) with the supervisor/manager. Only use affirmative dialogue, emphasizing the knowledge that the supervisor/manager is valued, and reassuring the understanding that you realize they only have the best interests of the company at heart. 2. Next, recognize that what you may think the supervisor/manger knows and understands may not be the case. Be sure there is a mutual understanding of the specific training responsibilities and expectations, and a means for which to provide regular feedback to the employee, and the company, of and employee’s progress. The employee must be allowed, and encouraged, to defend his/her performance, point out areas in which he/she feels they are strong, and request guidance for areas where he/she feels they are weak. After all, just because it is the supervisor/manager’s opinion does not make it a fact, and upper management needs to be keenly aware of this. The supervisor/manager should be shown how arrive at a common understanding of what might be causing the weak performance in certain areas, and how to determine the reasons for the weakness (eg limited skills, time management, poor communications, etc.) 3. The supervisor/manager should then be taught to establish reasonable priorities and timelines, and, identify outside factors that may be affecting the poor performance (eg, cultural differences, stress factors, fear of looking foolish, etc.) 4. Now it is time to train the supervisor/manager to develop a plan, with the employee, to come to an agreement about their performance objectives, and, their desire to have the relationship move forward, by fixing the root problems they have jointly identified.This plan should be viewed as a “contract” to identify the ways they both can improve on their skills, knowledge, experience, or personal relationship, and, include an explicit discussion of how much and what type of future supervision the employee will need. 5. Lastly, the supervisor/manager should understand how to encourage the employee to feel comfortable communicating freely, and to be viewed as approachable and open to change.
There are times where intervention is not always the best course of action. Sometimes, intervention is not possible or desirable. There may be, for instance, overwhelming evidence that the employee is not capable of performing the job. He/she may have been a hiring or promotion mistake, which is best, handled by removing him/her from the position. In other cases, the relationship between management and the employee is too far-gone, and, too much damage has occurred to repair the relationship. There are times, as well, when supervisors/managers are too busy and under too much pressure to invest the kind of resources that intervention requires.
Sometimes, he biggest obstacle to effective intervention is management’s mind-set. When a supervisor/manager believes an employee to be a weak performer, and, there is a personality conflict with the employee, the supervisor/manager is not capable of hiding their feelings. The supervisor/manager must separate emotion from reality. The supervisor/manager must teach him-/herself to mentally be open to the employee’s views, even when the employee challenges him about any evidence regarding his/her poor performance. Once the supervisor/manager becomes aware of the problems and acknowledge the possibility that he/she might be part of the problem, he/she can initiate a clear, focused intervention. Such an intervention demands an open exchange between the supervisor/manager and the employee, based on the evidence of poor performance, its underlying causes, and their joint responsibilities. The intervention should always end on a positive note, with a joint decision on how to work toward resolving the problems identified.
Supervisors/managers that consistently avoid the “set-up-to-fail dynamic” have several traits in common. They are more involved with some employees than others, and, even monitor some employees more than others. They remain actively involved with all their employees, gradually reducing their involvement based on improved performance. They provide frequent contact in the beginning of the relationship giving the supervisor/manager the opportunity to communicate with employees about priorities, performance measures, time management, and expectations of the type and frequency of communication and formal reviews. They also challenge their own assumptions and attitudes about employees on an ongoing basis, resisting the temptation to stereotype employees. They examine whether they are expecting things from employees that have not been clearly communicated, and, they try to be objective about when and to what degree the employee has really failed. Finally, they create an environment where employees feel comfortable discussing their performance and their relationships.
As with most things in life, you can only expect to get back when you put in. It can take one hundred “atta boys/girls” to erase one demeaning remark. If you desire the people you manage or lead to respect you, you must respect them.
|Posted on August 19, 2016 at 10:05 AM|
Coaching through effective results and report writing is a critical element in auditing and compliance plan. The results should be structured toward who your audience is.
Preparing the Right Reports - When possible it is best to review each record independently with the provider, rather than in a group setting. Include an overall summary to aid in education. Start with the type of audit that was performed (random or selective), also note whether this was an evaluation and management (E/M) note, procedure or surgery note.
The audit report should include summary notes and findings - Terminology such as “agree” and “not supported by documentation” or “supported at a higher/lower level than selected”explain the determination of the auditor without put the provider on the defensive.
- Provide enough information in the summary to explain any notes that do not agree with the code selected by the provider.
- Provide a bell curve report to shows providers how they are coding relative to their peers.
- Bring copies of the 1995/1997 guidelines with you, as well as any special audit rules or regulations from your Medicare Local Carrier.
Make the Meeting Positive and State the purpose of the meeting - Use a general and positive statement, such as: “On the whole you all did very well.” “We agreed on a majority of the chart note codes chosen.” “Several notes were of excellent detail.”
Begin with the records you agree with the coding of to open the meeting on a positive note - It is important to inform the provider know what he/she did right on these records so that strong correct documentation continues. Always provide positive information prior to any constructive education. When reviewing a surgical record annotate areas that led to the correct procedure code(s).
Delivering Bad News - Education and positive reinforcement are the key issues to any audit. Remind the providers that elements not documented cannot be incorporated into an audit. Never “imply” that something was not done, only state that it was not documented.
Never Make It Personal - Keep the focus on the documentation and not the person. Use generic phases that express what is present in the chart record. An example of how to do this is to state “The examination only had 5 bullets documented; however, the chosen code requires that all 10 body systems be examined.”
Know What’s Missing - When discussing documentation that supports a lower level of service than the provider selected know exactly which elements are missing. When discussing documentation that supports a higher level of service than selected by the provider the clinical guidelines and the Table of Risk are key.
Explaining the Bell Curve - Review the provider’s bell curve report with him/her. Explain what this report is and how Medicare and other insurance providers utilize it. Explain that exclusively using one code may trigger an audit. Explain that even being on a Bell Curve will not preclude the provider from being audited. If a provider is not on the Bell Curve explain that there may be reasons for this, such as:
- Seeing sicker patients than his/her peers
- Performing more office procedures than his/her peers
- Performing more intricate procedures than his/her peers.
|Posted on July 29, 2016 at 3:45 AM|
Every successful organization must start with a sound and strong foundation. Anchors provide a sense of security. Accepting that you cannot please every employee, and acknowledging that not everyone will agree with every executive decision is a “known”, however, management guidelines need to be set in place, observed and respected for an organization to move forth and prosper.
Including employees in the process of establishing these management guidelines can help to ensure their compliance, or “buy-in.” Policies and procedures that are collectively established, discussed, documented in writing and followed have a much greater likelihood of being followed. Consistency is key, and it starts from the top management all the way down the chain of command.
Below is a 5-step plan to help you implement compliance with your organization wide policies:
1. Establish your guidelines.
Reassess your compliance model. Make certain that it addresses the most important components – time factors, positive attitudes, clear and concise communication, a unified appearance, and steps for dealing with discord.
2. Communicate what the expectations are.
Set reasonable boundaries and time lines, and clearly convey that you expect them to be adhered to. Ask for input when establishing them from the people responsible for doing the work and meeting the time line so that they have a strong onus of responsibility in meeting their commitment.
3. Treat staff as “team members”.
Including the ideas of employees in developing policy manuals provides the employee with a sense of ownership in the success of the policy. When communicating policies be conscious of your communication skills. Executive management rules often come across as orders rather than policies, and are viewed very differently. Remember the goal is to have everyone buy into the success of the organization.
4. Conflict Resolution
Acknowledge, in advance, that there will always be dissenters. Have a sound policy in place to deal with conflict resolution, in a positive manner. Remember that it is impossible to please everyone, but success is when everyone walks away from the table feeling that they were heard and compromise was offered. Deal with facts, not feelings or preconceived impressions. Always refer to a written policy or procedure.
5. Review your policies annually, or whenever change is needed
Any manual that sits on a shelf for over a year “collecting dust,” without reassessment, will become outdated and forgotten. Manuals should be treated as “living documents” that are kept up to date with industry changes and organization needs. Healthcare is an ever-changing field and to become stagnant is to be left behind. Proactive not reactive is imperative for continued prosperity. Share with business plan for the future with your employees so they want to do their part to assure the organization’s continued success.
Clear communication, employee input, leading by example (not by words alone), and strong written and adhered to guiding principles are the foundations of a strong and thriving organization that can attract the best employees. Make sure your organization operates smoothly by demonstrating a commitment to professionalism.
|Posted on May 9, 2016 at 8:40 PM|
Brownout is a term that is happening in organizations/companies faster than burnout. Brownout symbolizes the loss of fire and passion for one’s job at a slowly dissipating rate over time. The key to preventing brownout is to keep your employees engaged. Some surveys show that more than one-third of highly valuable star employees feel disengaged and are seeking other employment everyday.
Brownout can be very hard to spot because many workers that are afflicted by brownout appear to be performing fine, putting in excessive hours, contributing to team efforts, and having valuable input at meetings. However, many of these employees are operating in a silent state of continual overwhelm, and the predictable consequence is disengagement.
It is important for managers and supervisors to understand how they contribute to this brownout phenomena. Managers tend to blame their turnover problems on everything under the sun instead of accepting that employees do not leave jobs…they leave bad management.
The following actions contribute to brownout:
Stupid rules – rules are a given and are necessary in the business environment; however, unnecessary rules can make employees crazy. Top talent would often work somewhere else than tolerate being micromanaged and having the feeling that “big brother is always watching.”.
Equality – this trait does not always work in the business environment. Top performers can become resentful of being treated the same was a clock watching under performer is treated. Top perfotmers want and need to be recognized and rewarded for their efforts. Rewarding individual accomplishments shows that you’re paying attention
Poor performance - when you permit weak links to exist without consequence, they drag everyone else down, especially your top performers. It is important to remember when assembling your “team” that you are only as strong as your weakest link.
Caring - over half of all employees who leave their jobs do so because of their relationship with their boss, managers, and/or supervisors. Strong effective managers know how to balance being professional with being human and showing care and concern. Management that celebrates their employees’ successes, empathize with those going through hard times, and challenges them to go further and achieve more are the managers who retain top level employees. Bosses who fail to really care will always have high turnover rates.
Sharing the big picture – keeps employees engaged and feeling that they have purpose and are a part of the goals of the organization. Leaving out the big picture is a deal breaker for star performers. Failure to know and share in achieving the big picture makes employees feel alienated and aimless. For many star performers this is a true “deal breaker.”.
Passion – is a quality that is critical for talented employees. Providing opportunities for employees to pursue their passions improves their productivity and job satisfaction. Managers who fear that productivity will decline if they let people expand their focus and pursue their passions have unfounded thinking. Studies have shown that people who are able to pursue their passions at work experience something referred to as “flow.” Flow is a creative state of mind that is five times more productive than the norm employee possesses.
Enjoyment – if employees are not having fun and enjoying their time at work the organization may be doing something wrong. People don’t give their all if they aren’t having fun, and fun is a major protector against brownout.
Employees who enjoy what they are doing, who they are doing it with, where they are doing it, and why it is important to the growth of the organization tend to perform better, spend longer hours at work, and regard their work as a “career” not a “job.”
|Posted on February 6, 2016 at 2:05 PM|
Did you know that PHI (protected health information) and patient account information is more valuable to thieves than credit card information because it can be used to access bank accounts and obtain prescriptions for controlled substances.
Minimize Your Threat
Minimizing the theft starts with identifying all the areas where there is vulnerability, including security for the practice's premises, records and equipment. Desktop computers, laptops, tablets, smartphones, USB’s and centralized servers must be protected with passwords and encryption. Loss or theft of such devices is one of the most common breach risks, and encryption is the best defense. All practice staff must be trained, at least annually, on how to protect PHI, using HIPAA compliant policies. The practice should also test thee physical, electronic, and procedural security policies on a regular basis, including the steps that will be taken if a breach occurs. It also is a good idea to purchase insurance in case a data breach should occur.
Move Quickly If A Data Breach Should Occur
It is critical to minimize the damage within the first 24 hours after a breach is recognized. Doing so can influence how the government and your patients react to the breach, and shows everyone that you take the incident very seriously. If the practice is found to be guilty of willful neglect, the practice will face higher civil money penalties. If it is determined that the breach involves criminal activity the police must be notified. If the protected information has been placed on the Internet, it must be immediately removed. Contact an attorney experienced in understanding HIPAA obligations. Perform the four part risk assessment described in the HIPAA Breach Notification Rule to determine whether PHI was truly compromised.
Answer the four important questions: 1) What was the nature and extent of the PHI involved? 2) Who is the person(s) to whom the PHI was exposed? 3) Was the PHI was actually received or viewed? 4) What was the extent to which the risk has been mitigated?
If you conclude that PHI was compromised, federal and state laws have specific rules that must be followed. Your attorney can advise you in this matter. If more than 500 persons records have been breached, you must inform the HHS and be prepared to notify the local media, as required by the HIPAA Security Rule.
Notifying The Patients Involved
When notifying the patients involved, the basic message should be honest and apologetic, not sound like you are trying to hide the facts of the incident. State what happened, what steps already have been taken, and what steps will be taken in the future to prevent this from happening again. This letter must be sent within 60 days of discovery of the breach. The HHS will question what is being done to prevent this from happening again, including new policies and physical and electronic controls, as well as privacy and security training for employees.
Compliance Officers Responsibilities
Notify all staff and business associates of the breach as well, as soon as possible. Remind staff that they must be prepared to respond to the questions they are likely to receive from patients regarding the breach. This should include the staff forwarding inquiries to the appointed compliance officer.
Document, Document, Document
Prepare for an investigation by the Office for Civil Rights. Document all actions taken and preventive changes made. Keep a copy of all risk assessments performed.
|Posted on December 26, 2015 at 8:35 PM|
As 2015 comes to an end and we prepare to usher in 2016, I want to take this opportunity to thank all of you who put your faith into me and in PPM, LLC. PPM had a very successful year and I thank each and every one of you for making that a reality and allowing me to help make you successful as well.
Congratulations to my newest group of CMAA's, CPC's, and CPMA's. I am proud of all of you and wish you great success as you embark on the next path of your professional journey. Many of you overcame great obstacles to reach this point and I admire your tenacity, your strength, and your perseverance!
I also want to say welcome to the new group of CPC's that I am working with in a professional coding and auditing division. I see wonderful opportunities for growth for this division and for each one of you in it. I am thrilled to be a part of this endeavor.
May all of you have a successful, happy and healthy 2016! I know I will see many of you as you continue your education with me and advance your certifications.