Successful Human Resources Management

Until recently, the correlation between human resources management and better patient outcomes was all but lost on healthcare leaders. In part, because the industry has been slow to adopt the business principles of corporate America, but also because so few medical practices have the resources to hire a dedicated HR person. Thus, administrators have been forced to shoehorn recruiting, reviews, and staff development initiatives in between tasks considered more pressing - like budget planning and accounting. Not anymore.

As medical groups seek out ways to succeed in the pay-for-performance environment, managers have increasingly adopted HR strategies to foster a more functional office environment - one in which teamwork prevails and providers are free to focus on patient care, says Barbara Sack, executive director of Midwest Orthopaedics, PA, in Overland Park, Kan. "Successful HR management is what sets the tone for the culture of your practice," she says. "If that culture is collaborative, cooperative, and patient-centered, then you're going to be more successful."

Regardless of whether you outsource HR functions, like HIPAA compliance, payroll, and benefits, the following personnel policies, borrowed from big business, can set the stage for a better patient and employee experience.

Square peg or round hole?

Start by sizing up your staff to ensure that all the people on your payroll are in the right position on the floor, says Susan Childs, president of Evolution Healthcare Consulting in Rougemont, N.C. Observe your employees on the job to identify areas of strength, and review their resumes for educational background to determine whether they might be better utilized in a different department. When positions become available in your practice, you should also invite your staff to interview for the job. "Everyone has their niche, where they naturally fly," says Childs, a former administrator. "Hopefully that's the job we hired them for, but if not we want them to be happy so we find another place." When you support your staff and show concern for their job satisfaction, she notes, it "makes it very hard for them to leave."

Of course, it helps to hire the right fit from the start. Before you begin recruiting, identify the personality traits and skill set you are after so you know it when you see it, says Childs. And never hire someone who doesn't measure up, no matter how badly you need to fill the position, she adds. It's often better to pay temporary workers and hold out for the person you want. Some practices also use personality tests in the recruiting process with great success, while others ask staff members to sit in on the final interviews. For her part, Childs says she had prospective employees spend half a day in the office so she could observe their interaction with patients and the staff. She took note of whether they made eye contact with the patients, how well they worked independently, and whether they seemed comfortable with the team. "It was [a] chance for both of us to see how well they fit," she says.

Crack your door

As simple as it sounds, an open-door policy can have a profound impact on patient care, says Childs. How? Employees who feel free to voice concerns, she says, are more likely to resolve small problems before they affect morale - and thus, more apt to stick around. Lower turnover leads to a more experienced and efficient staff, with whom patients develop relationships and feel more comfortable disclosing relevant (and often personal) health information during office visits.

Likewise, adds Childs, patients who feel comfortable calling you directly with financial concerns, are more likely to work out a payment plan and stick with their treatment program - which can help improve their medical outcome. "Show your employees and patients that you're always willing to listen," says Childs. "That builds loyalty, which equals better continuity of care."

Develop your staff

Redundant and unnecessary tasks are a major time suck, not to mention a source of frustration for your team. Take an axe to any job that doesn't contribute to quality, says Cameron Cox, president of MSOC Health, a practice consulting firm in Chapel Hill, N.C. "We're seeing more practices use Six Sigma and Lean Six Sigma methods [developed by manufacturers] to analyze processes," says Cox. With the help of their staff, he says, managers can construct work flow charts to spot inefficiencies in the system. You can also examine job descriptions to eliminate duplication and redistribute tasks in a way that makes sense, enabling your staff to focus on work that helps drive growth, says Cox.

You must also, of course, invest in your team. Ensure that clinical and nonclinical support staff have the tools they need to stay current and work smarter. Keep certifications up to date. Allow staff members time off to attend training seminars and conferences. And find out what office equipment or software tops their wish list. "One of the biggest challenges facing medical practices is that they don't usually reinvest in the HR component," says Cox. "Just like natural resources, if you don't reinvest, it'll dry up and eventually burn out."

At the same time, he notes, managers should provide feedback to their staff to reinforce positive behavior, using annual reviews to reward progress and set new goals. Lastly, he says, be sure your staff is cross-trained to perform multiple jobs, which creates greater scheduling flexibility when someone calls in sick. The other benefit is that it invites new perspectives. "The more ideas the better," says Cox. "Extroverts and introverts see the world differently. When you rotate employees that opens up some fantastic discussions [about operational efficiency]."

Play fair

Recognize, too, that everyone on staff contributes to the practice's success - not just those who drive revenue, says Sack. Reward fairly or not at all. "If everyone is not paying attention and working together then it doesn't matter how much they collect in the business office," says Sack. "Their ability to collect depends a great deal on whether the demographics were put in correctly by the front desk, and pre-verification of benefits were done correctly." Bonus or incentive programs that single out individual departments, or employees, can quickly breed resentment.

Favoritism is even worse, says Sack - and can expose your practice to discrimination claims. You can't, for example, call one worker into your office for coming in late, and let it slide for someone else. Discipline and reward (including verbal praise) evenly, says Sack. "Everyone gets treated equally," she says. "You should be loved and hated equally among all departments."

Step up

Your employees need a leader. Someone with vision. Someone skilled in conflict resolution. Someone they can trust to communicate honestly. But they need it most during times of transition. Even the most watertight practice can spring a leak when rumors start swirling about potential buyouts, or financial distress. A good HR rule of thumb? Always tell your team as much as you can as quickly as you can, says Cox. The truth, even when it involves layoffs or a reduction in benefits, is better than the unknown.

"Open communication between staff and management is important, and that goes both ways," says Cox. "In medicine, there is a shift from the paternal model to a more facilitative model in which patients are more actively engaged in their own care. The same shift is taking place between management and staff."

Likewise, leaders in all industries must hold their staff accountable for professional conduct, says Cox. Don't let employees get away with poor performance. Nip personnel problems in the bud the moment they arise. And communicate your expectations clearly, establishing measurable goals for each position. Those who don't make the grade should eventually be cut loose, he says. "If you're trying to institute a new culture in your practice and someone doesn't buy in, then move on," says Cox, noting it doesn't make sense to keep people who aren't team players on the payroll.

As the healthcare sector evolves, medical practices that embrace the HR management tools of larger organizations have an opportunity to set themselves apart. Those that advocate for their staff and reinvest in their growth will be well positioned to improve both productivity and patient care. "Setting the tone for your practice is not something you can outsource," says Sack. "You are the one responsible for creating the culture for your practice."

Shelly K. Schwartz, a freelance writer in Maplewood, N.J., has covered personal finance, technology, and healthcare for more than 18 years. Her work has appeared on CNBC.com, CNNMoney.com, and Bankrate.com. She can be reached via editor@physicianspractice.com.

This article originally appeared in the June 2013 issue of Physicians Practice.