Case Management

Mentor moment: Educating the medical staff

Case Management Weekly, December 5, 2012

“It’s like herding cats.”

This is the description hospital staff give when describing efforts to educate the medical staff regarding current Medicare or other payer policies. The greatest challenge faced by hospital staff members is persuading physicians to attend meetings. Typical physician responses include “it’s a waste of my time,” “I’ll do my best to attend,” and “I don’t have time.” 
 
Nothing surprises experienced medical staff educators with respect to physicians’ excuses for skipping payer-related discussions; they have heard it all.  Inexperienced educators should not be daunted.
 
The following strategies can help you provide effective medical staff education:
  • Use public report cards and tell a clear and concise story. Be well prepared and anticipate questions.
  •  Focus more on the medical decision-making process for inpatient or observation level of care decision than educating physicians about the specific criteria.
  • Don’t begin a one-on-one educational opportunity by saying “this admission does not meet criteria.” Explain how an incorrect level of care determination affects the patient. The potential patient cost of an inappropriate outpatient surgery or observation status order often surprises physicians.
  • Small group or individual meetings with physicians over lunch offer time to encourage interest and provide a portion of the information they need. Start small and expand your target audience as you experience success.
  • Remember that hospitalists, physician assistants, advanced practice nurses, residents, and interns are in the best position to affect level of care determinations. The best time is during orientation for hospital-based practitioners with admitting privileges.

Editor’s note: This article is adapted from Observation Status: A Guide to Compliant Level of Care Determinations, Second Edition, published by HCPro, Inc.

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