Data, facts and instruments on the German health system
What it’s all about
Attempts to optimize practice management are often very difficult for general practitioners and specialists due to its complex structure and the multiple interactions of the action areas. The use of visualization technology solves this problem.
Practice management, the transmitter of quality
The term „practice management“ refers to the totality of all regulations. instruments, measures and behaviors,
- which are used in the fields of action planning, organization, market research, leadership and cooperation, time and self-management, patient management, marketing and controlling by physicians of all specialties and
- whose interaction ensures the operation of the practice.
Practice management functions as a transmitter of the medical competence of physicians, the activities of medical assistants and the resources used (equipment, rooms) into the actual care of patients. The quality of its design determines how comprehensively the skills of the physicians and the abilities of the staff are made available to the patients in the form of comprehensive assistance.
It also determines how quickly practice teams can react to changes of any kind, implement them and benefit from them (example: digitization). Practice management thus determines the operational convenience of practice work and the future agility of a business.
The practice management insufficiency.
If the practice management regulations selected by practice teams are not suitable for shaping practice operations in such a way that they meet the requirements of everyday work and function smoothly in principle, this is referred to as practice management insufficiency (PMI). The reason for its occurrence is that
- the selection of precautions taken and measures implemented is incomplete and / or incorrect, or
- their implementation is insufficient and / or incorrect.
This creates a vacuum, because internal and external requirements for practical work are not adequately met.
The consequences of persistent PMI
The nature and intensity of the effects of PMI vary from practice to practice depending on the particular causes and their manifestations, but the most common are the following five general consequences:
- Patient care and support are worse than they should be because medical services do not fully benefit patients. For example, physicians who are pressed for time interrupt their patients‘ symptom descriptions after only a few seconds and make decisions without knowing all the facts. In addition, there are information and communication deficits in cooperation with other service providers.
- The team’s workload is greater than necessary, they work long hours and long hours, but the work output is sub-par in comparison because the work is unmanageable. Efficiency and productivity of the practice team are limited, creating a hamster wheel effect. Over time, staff develop mechanisms to deal with PMI and its consequences, but these selective adjustments do not solve the underlying problems. In some cases, they actually exacerbate the negative PMI effects.
- PMI generally limits the performance and development opportunities of a practice, because important activities are neglected because there is no time for them (e.g., qualification of the MFA, implementation of necessary changes, etc.), flexibility and responsiveness decline, as does work motivation.
- The evaluation of the practice performance deteriorates due to a successively growing dissatisfaction of the patients, the willingness to recommend the practice also decreases.
- The practice result does not correspond to the possibilities.
The prevalence of PMI
Approximately 2/3 of German medical practices are affected by PMI to varying degrees and degrees.
This large number results from the fact that general practitioners and specialists on average do not even use almost half of the best practice standard. It describes the regulations, instruments and behaviors that ensure practice operation without difficulties, so that internal and external requirements for practice work are met.
Problems of practice management optimization
The central problem for general practitioners and specialists in practice management is predominantly that „practice“ management is a conglomerate of many different areas of action that are closely interrelated and, to a large extent, condition and influence each other. Only when these areas mesh like finely tuned cogs do management excellence and synergies emerge.On the positive side, most misalignments – once they have been identified – can be corrected without outside help. The task for practice owners is therefore less about concrete optimization, but rather about identifying the causes of insufficiency.
The practice management visualization as a solution
The experiences of business and private life show that with the complexity of contexts the benefit of a visual representation of the facts increases. Therefore, a practice management visualization offers physicians the appropriate approach for the analysis and development of their work. It is based on the generation of key performance indicators (KPIs), which
- solve the problem of the complexity of practice management mentioned at the beginning of this article by deriving mappable orientation variables,
- thus enabling the actual state of practice management to be clearly determined without much effort and
- at the same time to identify strengths, but also deficits as well as unused chances and risk factors.
How the indicators are created
KPIs are key performance indicators that are created by comparing the practice management data of a medical practice with objective and representative measured variables. For this purpose
- using structured analysis forms (physician, MFA, patients, referring physicians, if applicable), the design of the entire practice management is first described in a 360-degree view, and
- This is quantified in the subsequent evaluation by means of scaling.
In this way, it is not only possible to record the type and intensity of the regulations used for practice management, but also their effects.
Insights via benchmarking
These data are then subjected to a best practice and a specialist group benchmarking:
- the best practice comparison shows whether all regulations, instruments and behaviors that ensure smooth practice operation are actually implemented,
- the specialist group ratio provides additional information on the extent to which the practice management examined meets the minimum market standard.
The KPIs identified result in a detailed status overview of the strengths, weaknesses, threats and opportunities of the practice under investigation, with a detailed action plan for improvements, changes and developments. In addition, individual practice management development goals can be formed on the basis of the practice strategy and monitored with regard to progress in implementation.
Various forms are available for visual implementation here, for example:
- Deviation diagrams
- Category grid
- Cockpit and dashboard displays
Using these forms of visualization, a KPI status report corresponds to a kind of MRI image of the practice work and its results.
Easy-to-use“ and „Ready-to-go“.
The special feature of the KPI concept is that the necessary information can be collected solely with the help of specially developed, tried-and-tested questionnaires and without the need for an on-site consultant:
- the physician’s questionnaire takes about 30 minutes to complete,
- the MFA document is completed in about 20 minutes,
- In addition, a patient survey is carried out, in which up to 100 practice visitors can be questioned.
No expertise or supplemental materials are needed to complete the documents.
High analysis quality
Due to its comprehensive scope and depth of analysis, the visualization approach identifies significantly more unused optimization opportunities for practice work in the shortest possible time than an on-site consultant, on average just under 40. It can be carried out at any time without the need for an appointment and is of course – by saving on on-site presence – significantly more cost-effective.
In addition, there is no disruption to the day-to-day running of the practice and objective standards are used instead of subjective consultant criteria.
The Practice Management Comparison©: The instrument for determining KPIs
The assessment approach, which was developed in cooperation with physicians, is suitable and validated for all specialty groups and is implemented without an on-site consultant and, above all, without his costs, offers physicians in private practice the unique opportunity to
- to describe their practice management cost-effectively and quickly by means of a simple structure (checkbox scheme),
- to visualize and compare in a double benchmarking with the representative-objective conditions of the Best Practice- as well as the professional group standard as well as
- to obtain concrete approaches for hitherto unused optimizations and avoidable risk factors of their work in an expertise, in order to strategically develop their practice with the help of this information.