Best Practices in Developing an Orientation Program for Your New Medical Practice Employees


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My personal list of new employee orientation best practices has been shaped by my experiences in private practices as well as hospitals. Every organization has different resources to draw upon, but each group has core goals that must be fulfilled by a good orientation:

  • completion of paperwork including federal and state W-4s, I-9, direct deposit and benefit elections
  • emergency contact information (included in hospital employee health intake)
  • orientation to the organization, including designations, specialties, departments, sites, affiliates and an organizational chart
  • completion of mandatory annual training such as safety, standard precautions, and HIPAA
  • mechanics of name tags, parking tags, lockers, keys and codes
  • signing off on understanding and agreement to confidentiality, compliance and personnel policies

In addition to these core goals, critical information to be shared during this time should minimally include:

  • personnel policy review with emphasis on important (typically abused?) policies
  • code of conduct/ shared basic competencies (mission and values, professionalism, communication, chain of command)
  • computer security (passwords, internet policy, protection of PHI)
  • workstation ergonomics and patient lifting policy (sadly lacking in many medical practices)

Important training that is rarely covered:

  • Customer service (what is it and how do we measure our success or lack thereof?)
  • Cultural sensitivity and diversity training
  • Non-clinical employees’ role in medical emergencies
  • Personal safety (coming in early or leaving late, patients threatening staff by phone or in person)
  • Expectations for the first 90 days (training, communication, questions, problems)

Making Orientation Memorable


Posted in: Human Resources

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Where I’ve Been and Where I’m Going


A Great New Job (© Frenta | hope that I am fortunate enough to have been missed by my readers while on an unintentional sabbatical these last several weeks. I have been moving to my new home in North Carolina and starting a new job. Our house temporarily has no television, no land line, no cell phone reception and no internet access so I’ve been cloistered from the news, my blog, Twitter, LinkedIn, email, FaceBook and listservs. It has been INTENSELY quiet, if there is such a thing.

I’ve been doing a lot of thinking about my new community, my new job and my chance for a fresh start. A television commercial I saw recently says something about being able to be more yourself where no one knows you. It’s true. Here in my new community I can be a better me as no one knows any different. A new job is always an opportunity to do things differently and I’ve made a list for myself of the things I will do differently, better, or not at all:

1. I will stop rolling my eyes. I don’t like it when someone rolls their eyes at me, yet I think I roll my eyes without even realizing it. I will become aware and stop it.
2. I will arrive to meetings on time. I have the compulsion to do “just one more”¦” that compels me to read one more email, squeeze in one more phone call and so I don’t arrive places on time. It’s rude and it sends the message that I think my time is more valuable than the time of others. Nope.
3. I’ll work a normal amount of hours per week, as soon as I can find out what that is. Boy, is this a can of worms. I’ve always heard that you have to put in more hours if you want to advance and that managers should be the first ones in the office in the morning and the last ones to leave. The problem is, of course, that you will be exhausted, sick, cranky, unfocused, estranged from your family and one-dimensional if all you are is a workaholic. It is a disease and I want to be on the road to recovery.

I have lots of new stuff to share.  For one thing, I just completed the best orientation I’ve ever had, and several readers have expressed an interest in creating a stronger orientation program for their practices, so I’d like to expand on this.  I also kept extensive notes on my job search process and will write about searching for a job in 2009.

As always, I thank you for coming along for the ride with me and I welcome your comments and feedback.

Posted in: A Career in Practice Management

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More Practice Management Resources to Help You Get Your Community Illness Plan in Place


© Cammerayda... | Dreamstime.comNow is the time to follow-up on those good intentions of yours to make sure your swine flu/pandemic illness policy is all that is should be.  Things are calming down a bit (although US numbers are rising, cases are mild) and as we might have a bit of calm before the next storm, it is the ideal time to give yourself a policy and training check-up while the topic is fresh.

  1. Do you have a policy for dealing with a community illness that is more than your typical flu season?
  2. Does your policy include detailed information that most anyone in your organization could follow if you were not able to give directions?
  3. Do you know what the local hospitals’ plans and policies are?
  4. Have you clarified roles for each of your clinical and administrative staff and provided them with detailed information on their responsibilities during a community illness?
  5. Do you understand what your practice is required to do to report information to local, state and national authorities?
  6. Have you located resources for or designed patient education materials appropriate for your population?
  7. Have you integrated community illness information into your new employee orientation and your annual staff training materials?

If you answered “no” or “maybe” to any of the questions above, here are some resource links to help you (more…)

Posted in: Day-to-Day Operations

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TED stands for Technology, Entertainment and Design.  TED started in 1984 as an annual conference held in Long Beach, California with the goal of bringing together people from the three fields to give 18-minute talks about innovation and possibilities.  The TED Talks site has more than 400 talks by people from an expanded array of fields and the videos of their talks are available to be shared and reposted without cost.

From the TED Talks site:

Our mission: spreading ideas.  We believe passionately in the power of ideas to change attitudes, lives and ultimately, the world. So we’re building here a clearinghouse that offers free knowledge and inspiration from the world’s most inspired thinkers, and also a community of curious souls to engage with ideas and each other. This site, launched April 2007, is an ever-evolving work in progress, and you’re an important part of it

TED has also spawned the TED Prize which is “designed to leverage the TED Community’s exceptional array of talent and resources. It is awarded annually to three exceptional individuals who each receive $100,000 and, much more important, the granting of “One Wish to Change the World.” After several months of preparation, they unveil their wish at an award ceremony held during the TED Conference. These wishes have led to collaborative initiatives with far-reaching impact.”

Posted in: Definitions

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Can Your Employees Change If You Don’t Believe They Can?


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Most of us have heard that interviewers make up their minds about applicants in the first minutes, or even seconds of an interview.  But what about once the applicant has been hired, or even once an employee has been with us for several years?  Do we base our beliefs on an employee’s ability to take on a new challenge or improve their performance on something real, or things we believe to be real?

New research shows that managers with a fixed view of people’s attributes tend to “ignore improvements or deterioration in the performance of their staff, and are also less likely to ensure they receive the training they need.”  The research findings, reported on the British Psychological Society Research Digest Blog, are as follows:

One study, for example, gave managers negative background information about a fictional employee before they were shown that same person performing well at a negotiation task. Managers with a fixed view of personal attributes (they tended to agree with statements like “As much as I hate to admit it, you can’t teach an old dog new tricks. People can’t change their deepest attributes”) subsequently rated the employee less positively than managers with a belief that people can change.

Another study found that managers who think people’s attributes are fixed gave their staff less coaching, presumably because they think such interventions will be ineffective.

The good news is that once managers become aware of these findings, they can change their minds about employees being able to change and improve!  Read the article here.

Posted in: Human Resources, Leadership

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Voice Recognition


Voice recognition (VR), sometimes called speech recognition (SR), is a technology that translates the spoken word into the written/electronic word.  In healthcare it is most commonly used for physician notes in the medical record.  The physician dictates the information and either edits the information himself/herself, or a staff member edits the information.  The physiican note can be printed for inclusion in the paper chart, or can be imported into the electronic chart.  Some electronic medical record (EMR) software products have speech recognition built-in, and some have the ability to integrate with speech recognition software.

Posted in: Definitions

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Gorilla on the Basketball Court


A short film demonstrating the “surprising limits of perception, attention, and awareness.”  Viewers are instructed to count bounces or baskets made by one team, and in doing so, completely miss that a person in a gorilla suit walks among the players!  Viewers are astounded when viewing the video a second time and seeing the gorilla.   The video is part of a 2003 DVD Surprising Studies of Visual Awareness, Volume 1 produced by Viscog Productions, Inc.

Posted in: Definitions

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CfC (Conditions for Coverage)


UPDATE: 2/11/2010

Clarification on H&P Requirement Prior To ASC Procedure (Angela Mason-Elbert of CMS:

“Each patient that is seen in an ASC must have a comprehensive medical history and physical assessment (H&P) not more than 30 days before the date of the scheduled surgery. The H&P is to determine if the patient has any underlying conditions that would put the patient at risk for having such a procedure or to identify any new or existing co-morbid conditions that would require additional interventions. Additionally, the H&P could provide evidence that the ASC is not the appropriate setting for this particular procedure. The H&P, as long as it is comprehensive, can be completed the day prior to the procedure and even on the day of the procedure. It does not have to be completed prior to scheduling the procedure.”

UPDATE 5/18/2009

Medicare announced that it will allow an exception for the patient notices required in advance of the day of the procedure in certain cases. Specifically, the Centers for Medicare and Medicaid Services (CMS) said:

It is not acceptable for the ASC to provide the required notice for the first time to a patient on the day that the surgical procedure is scheduled to occur, unless:

  • the referral to the ASC for surgery is made on that same date; and
  • the referring physician indicates, in writing, that it is medically necessary for the patient to have the surgery on the same day, and that surgery in an ASC setting is suitable for that patient.

In such situations the ASC must provide the required notice prior to obtaining the patient’s informed consent. Cases of surgery occurring on the same day it is scheduled are expected to be rare, since ASCs typically perform elective procedures. Frequent occurrence of such cases may represent noncompliance with the advance notice requirement.

This information and new interpretive guidelines are available at As the ASC Association analyzes these guidelines more information will be available on the web site.

(Finalized October 30, 2008)

The OPPS/ASC (Outpatient Prospective Payment System for Ambulatory Surgery Centers) final rule modernizes Medicare’s ASC Conditions for Coverage (CfC).  The rule reflects current ASC practice by focusing on the care provided to patients and th impact of that care on patient outcomes.  Specifically, the new CfCs:

  • Define an ASC as a distinct entity that operates exclusively for the purpose of providing surgical services to patients not requiring hospitalization and in which the expected duration of services would not exceed 24 hours following admission.
  • Strengthen Patients’ rights regarding disclosure of physician financial interests in the ASC; advance directives; the grievance process; and confidentiality of clinical records.
  • Impose stronger obligations on the governing body of an ASC to oversee its quality assessment and performance improvement (QAPI) program, while allowing ASCs flexibility to use their own information to assess and improve patient services, outcomes, and satisfaction.
  • Emphasize the importance of infection control practices.
  • Strengthen the requirements for assessing the patient’s condition at admission to verify that the surgery is appropriate and safe for the patient in an ASC setting, and at discharge to ensure appropriate post-surgical care for the patient.
  • Require the ASC to adopt a disaster preparedness plan.

Posted in: Definitions

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Learn This: File Extensions and the Generation Gap


Abraham WhaleyPeople of my generation (the author is in the late afternoon of his twenties) don’t get it.  What we don’t get is how relatively new and modern personal computing technology is.  We don’t realize that we were one of the first generations to have computers in our classrooms when we started kindergarten, one of the first to have internet access in our libraries, and one of the first to have networked computer interaction as a fundamental part of our lives from a young age.  We don’t understand why other generations don’t find computing as intuitive as we do.

Learning to use computers effectively is a process of repetition, immersion, and is ideally started early in life, just like learning a new language.  I think there is both a challenge and an opportunity – for all generations – in the generational computing gap.  The younger folks who can find ways to tailor their products and services towards usability, approachability and friendliness can often make big strides in taking new technologies mainstream.  Boomers and older have tremendous opportunities to separate themselves from their peers and their competitors by balancing a willingness to be open minded about embracing technology with a keen eye towards results.

In this spirit I would like to talk about a basic computing concept: file extensions.  First, what is a computer file? (more…)

Posted in: Learn This: Technology Answers

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