Performance of medical care centres: Unused performance reserves in teamwork quality

Data, facts and instruments on the German health system

What it’s all about

Practice management indicators, the key performance indicators (KPI), are needed to condense the complexity of practice management in medical care centres, to make the circumstances and interactions of the action areas manageable, to diagnose the performance status, to identify unused performance reserves and to control the management in a targeted manner.

Only those who know the performance data of their practice management can work successfully in the long term, both medically and economically.

This also applies to staff management and cooperation in the form of a „real“ team structure.

The necessary teamwork insights

Anyone who wants to lead the staff in a medical care centre successfully as a team in the long term needs knowledge – and not assumptions – about the following facts and scores:

(1) Teamwork Quality Score (TQS).

It answers the question of how far the quality of cooperation is developed in the sense of implementing „real“ teamwork. The term „team“ stands for the ideal form of cooperation, characterised by

  • common goals,
  • largely autonomous task completion,
  • mutual complementarity and support, and
  • self-direction to solve problems and
  • self-initiated measures to improve the results of the work.

On the websites of medical care centres, the term team dominates the description of the staff. And most of the owners are also convinced that their staff practice teamwork.

But in reality, in the majority of establishments only groups work, because the average TQS is only 42% (optimum: 100%).

Cooperation, which falls in the score range between 40% and 60%, characterises the group form of cooperation. It is characterised by a low synergy of individual activities:

  • People work together, but only within the framework that is given,
  • Individual initiative or helping out with problems is rare,
  • Moreover, the cooperation is often characterised by unresolved conflicts,
  • Although every medical assistant strives to do her job well, there is no sustained commitment to continuous improvement.

The degree of co-working in this form is better than in a special-purpose association (TQS between 0% and 40%), but worse than in a community (TQS between 60% and 80%) and of course far removed from teamwork (TQS > 80%).

(2) Team Experience Portfolio (TEP)

This analysis determines the current self-image of the team members, broken down into a description of strengths, weaknesses, threats and opportunities as a result of previous cooperation experiences.

In the practice of business analysis, the strengths/weaknesses analysis, or „SWOT analysis“ for short, which is used to determine the qualitative underpinning for the TQS, is one of the classics:

  • „S“ stands for „Strengths“,
  • „W“ for „Weaknesses“,
  • and an extension to include a perspective assessment of a company’s opportunities („O“ stands for „Opportunities“) and its potential threats („D“ stands for „Threats“).
  • and its potential threats („T“ stands for „Threats“).

The SWOT analysis as part of a staff survey provides a clear picture of the strengths, weaknesses, opportunities and threats of the company from the staff’s point of view. It shows to what extent there is an internal consensus and to what extent the SWOT position of the management and the staff harmonise. The study thus provides important starting points for necessary activities to correct or strengthen the basic attitude of the staff.

(3) Overall Team Satisfaction (OTS)

It indicates how the staff generally assesses its framework of action in comparison with the requirements.

(4) Team Harmony Balance (THB)

This score provides an insight into how pronounced the degree of agreement is among team members in evaluating their working framework. The information can also be used as an indicator of the potential for conflict within the team.

(5) Return on Management (ROM)

Teamwork does not come out of nowhere, but is the result of professional leadership. The KPI „Return on Management (ROM)“ with its various options provides information about the impact success achieved with practice leadership in relation to team building.

For this purpose, the leadership instruments used are determined, condensed in the KPI „Leadership Management Score (LMS) and put in relation to the TQS:

  • a score of less than 1 indicates only below-average leadership effectiveness, in which case there is an acute need for action,
  • a score greater than 1 indicates a disproportionate effect and it can be checked whether the commitment in sub-areas can be slightly reduced in order to free up resources for other uses,
  • if the score is 1, any intensification / weakening of staff management leads to linear reactions in teamwork quality.

In most MVZs the score is below 1.

(6) Team Development Options (TDO)

In addition, a professional team analysis determines which ideas and suggestions exist from the staff’s point of view that could help to further improve teamwork. In many cases, employees know where the concrete problems of everyday work lie and often even have suggestions for solutions. In addition to gaining knowledge, involving staff in this way helps to increase job satisfaction and intensify the sense of togetherness. All of this contributes to increased patient orientation as well as efficiency, productivity and corporate success.

The approach for the practice

A team analysis equipped with these elements is thus a central optimisation and development tool for medical care centres and a component of the benchmarking-based KPI analysis of practice management for these forms of operation. It is a component of the benchmarking-based KPI analysis of practice management for large practices, outpatient centres and medical care centers. The analysis tool makes it possible to analyse and optimise management in large-scale outpatient care operations without the need for an on-site consultant and, above all, to identify all previously undiscovered opportunities for improvement in practice work.