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DMAIC TABLE ASSIGNMENT
DMAIC Stage
Define
My current place of employment is Cancer Specialists of North Florida, a physician-owned hematology/oncology practice, with 13 locations spanning the North Florida area. As many healthcare organizations face issues within their own walls, one major issue my company faces is the breakdown of consistent and effective communication when it comes to an individual’s correct insurance information between the clinic sites and the central business office, where all the authorizations, billing, and scheduling departments are located. As CSNF prides itself on providing high quality oncology care, there are times CSNF must sacrifice profits or correct insurance payments due to a breakdown of communication between the site where the patient receives care, and the main office in which billing and claims are processed. Measure
Currently, when new patients enter a clinic location, they provide the site with their necessary insurance information and usually a referral from their primary care provider. CSNF also works
with current patients, making sure that all insurance information is correct within our electronic medical record system and our billing system. All information must be loaded before the patient
sees the necessary provider. "Effective communication across all phases of care, including the proper transfer of all patient information, is important for patient safety and quality of care" (Nedelcu et al., 2022). Over the past six months, CSNF has lost approximately $375,000 due to issues in communication amongst all sites and the central billing office, leading to many insurance billing issues. To measure this process over the long term, CSNF will review all adjustments moving forward into the next quarter, noting the one in which it calls out the issue of incorrect insurance.
Analyze
The root cause of this communication breakdown is turnover at our clinic locations. Healthcare organizations generally have a high turnover rate. In recent years, we have seen "increased turnover rates among healthcare respondents, with about 41% of clinic staff no longer working in the same system 2 to 3 years later" (Willard-Grace et al., 2019). As my company has very much grown over the past 5 years, we have had the opportunity to grow and open new locations
to serve various parts of the North Florida market. As we have designated trainers, the central business office has noticed that not all clinic locations are implementing the same processes communicated by our trainers and that each location is coming up with its own processes to complete various simple tasks throughout their days. Noticing this change, our business office implemented group training sessions to create similar habits across all clinic locations, but additional training has not resolved the issue.
Improve
Resolving this issue has proven difficult for the Cancer Specialists of North Florida. Creating an employee or manager check-in at a monthly or quarterly meeting may be a way to increase employee satisfaction and reduce turnover. Implementing more frequent training to further enforce proper processes for uploading patient information as well as appropriate record keeping will challenge the new patient coordinators and the front desk teams to maintain the electronic medical record more effectively. A recent study has shown that "the occurrence of these communication breakdowns can be avoided by changing communication in relation to the
context, process, and content of change, respectively, at the organizational level" (Saxena & McDonagh, 2022). During this time of change, communication between the central business office and the clinic locations must be heightened, as overcommunication will assist in any training gaps with newer employees.
Control
To maintain improved communication, all parties involved will have to continue to increase
