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OPHTHALMOLOGY BUSINESS 84 March 2019 by John B. Pinto and Corinne Wohl, MHSA, COE • All payable invoices have been signed off by the relevant agent in the practice and paid. • Staffing schedules have been matched to patient volume in all areas (or side work assigned). • The phones have been covered satisfactorily this week. • All insurance policies (health, life, disability, facility, key-man, staff bonding, vehicle, general liability, directors, etc.) are adequate, up to date and paid. • Emergency procedures (for fire, patient slip-and-fall, patient code, earthquake, robbery, etc.) are written and drilled at intervals appropriate to the risks. • Safety gaps are closed: non-slip surfaces, sidewalk shoveling/ salting, loose carpet, handrails, lighting, evening staff and patient escorts for the parking area. • Exam rooms are tidied up throughout the day by technical staff. • There is a rational and fair distri- bution of new patients among the doctors. • Emergency patients have been worked into the schedule and seen cheerfully. • There is no more than a 5-day delay to the next surgical consult or urgent appointment. • There is no more than a 15-day delay to the next routine appoint- ment. • Patients have been called 24 to 48 hours in advance to remind them of their appointment. • The no-show rate this week has been at or less than 5%. • All no-show patients have been called within an hour. • Primary waiting time has not ex- ceeded 20 minutes for any doctor. • New patients have been fairly distributed among the doctors this week. • Payment type and eligibility has been checked before each exam and surgical case. • Patient information is updated accurately at check in or earlier via phone registration. and how particular you are about the details. The managing partner of the practice is going to be interested in high-level, long cycle issues. "Are we on track with succession planning?" "Are we adopting and staying current with clinical and surgical technology?" The administrator necessarily gets more granular. "Is our new doctor credentialed with Medicare yet?" "Did our roofer fix the leak?" A department head has to largely keep his/her head down in the weeds with the fussy details. "Have we printed off enough intake forms for this week?" "Did the slit lamps get covered last night?" The sample, generic list that follows is not meant to be a finished form for you to directly adopt, but a general template to get you started in developing—then evolving—your own checklist or lists. Depending on your role, you may have one master list that you go through each month, like the bookkeeper who has to generate a standing suite of reports. Or you may find that you need daily, week- ly, monthly, and even quarterly or annual checklists. Sample items to help you build checklists • The managing partner has partic- ipated actively this month with the management team. • All appropriate meetings have been held. • Any protocol or policy changes have been put in writing and distributed. • Personnel records have been updated as necessary. • New staff are mentored by an assigned "peer buddy" in addition to their direct supervisor. • All staff have worn their uniforms and name tags. • A formal cross-training makes sure all critical positions are covered by two or more people. • An administrator walk-through has been conducted daily and any problem areas addressed. • A staffer patrols the office three times a day to straighten up. • OSHA and general safety require- ments have been met this week. the wrong buttons and you could be faced with a half million dollar fine. Make a sloppy turn and your insurance will be canceled. Sound familiar? That brings us to the point of this month's column. Your practice can't be skippered from place to place, and you proba- bly don't buy much diesel fuel, but your clinic has systems and stan- dards aplenty. It's a stationary bat- tleship. Like Castella's owners, you have to stay on top of the details, and poke around often to make sure everything is shipshape. Whether you drive a boat or a plane or a practice, it helps to have a generalized checklist to run through from time to time to make sure you're not forgetting anything. The frequency with which you use this list depends on the complexity and fitness of your practice, your role, "I'm the type to over-analyze everything. If I was to rob a house, I'd have a checklist to make sure nothing goes wrong." —Israel Broussard "The art of simplicity is a puzzle of complexity." —Douglas Horton W hen we're not at our day job as advisors to practices, doctors, and administrators, we live on and operate a 40,000-pound trawler based in San Diego. Her name is Castella, and she's a beast, with 950 gallons of diesel fuel, three finicky engines, miles of wiring and hydraulic lines. There are almost as many federal, state, and local rules governing how she has to be operated as are present in an ophthalmology practice. Push Launching a personalized management checklist continued on page 86 To the point: simple practice tune-ups for complex times " Whether you drive a boat or a plane or a practice, it helps to have a generalized checklist to run through from time to time to make sure you're not forgetting anything. "

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