A Stitch In Time…

A Stitch In Time Saves … Lives?

Proactive management and the value of documentation quality initiatives

I read with great interest Ed Yoder’s article “If We Had a Crystal Ball” on page 50 in the January/February 2014 issue of Radiology Management. It’s worth your time to check it out – AHRA members should have received a hard copy of the magazine, or they can read it on line. Mr. Yoder, who is currently the President of the AHRA Board of Directors, discusses “proactive management.” His definition: “[Proactive management] refers to an open and engaging management concept that involves gathering and using information before making a decision. It breaks down processes and systems and identifies flaws and issues before they become out of control.” (emphasis mine)

More simply, proactive management is the modern management version of the old proverb: “A stitch, in time, saves nine.” When we are able to work on our processes instead of in them we are more effective. Putting out fires is a management style, but an exhausting one, and firefighters occasionally get burned up – or burned out.

The hypothetical examples provided in the article will ring true to anyone with any management experience. Mr. Yoder explores the benefits of proactive management in staffing schedules and resource allocation, and the part effective communication plays in enabling proactive management. Managers at all levels fight the tendency to focus on short-term problems rather than more strategic, long-term solutions, and the focus of the article is how to help support staff think proactively rather than reactively.

Nowhere is the value of proactive management demonstrated more clearly than in the management of documentation quality. When I served as the Vice President of Operations for a medical transcription company (remember those?) one of my directors pushed back when I implemented a quality assurance program for transcriptionists. Worrying about quality would make the transcriptionists slower, she said, and cost them money.

Can you imagine?

Fast forward to the present day when most radiology reports are produced with speech recognition. If a quality program was needed to proactively manage the quality of transcribed documents, why would a similar program NOT be needed for reports produced with speech recognition? I can’t think of a reason, and I bet you won’t be able to think of one, either.

So why aren’t documentation quality improvement programs common practice? Mr. Yoder gives us a clue. “Generally,” he says, “the data needed is at hand, but departmental operations pull support management staff away from it.” I submit to you that – when it comes to document quality – the data needed for proactive management is not at hand.

As a Quality Ambassador for SpeechCheck, I talk to radiology departments around the country every day. Almost without exception, I find they have no reliable way to measure documentation quality. No measurement = no management. Administrators at all levels tend to manage what is known – quantifiable data is the easiest to understand and is the most actionable. Unknown metrics tend to be ignored.

At SpeechCheck, we believe that documentation quality can be objectively quantified. So the final question is: If the quality of your radiology reports was quantified and actionable, what would you be able to do with that data?

Feedback on this article, or ideas on how to use quality data once quantified. Email me at this contact page

Posted by: “Peppermint Patty” Barrett

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