COVER STORY
Create a Sense of Urgency.
reimbursement—and livelihood—was at stake if they did not revamp their processes to incorporate outcome measures.
staff plus Kannenberg and Russell Lundstrom, director of clinical research and services at Ottobock. They came up with a new “audit-resistant” process that requires staff members to administer seven standardized, validated, and internationally recognized tests at defined points in time: at the initial evaluation of the patient, one month postdelivery, and then every six months until the patient needs a new prosthesis. They also collaborated with several other patient-care facilities—all Ottobock clinical partners—to standardize data collections across all of those facilities. This new process became a requirement when treating all lower-limb patients, according to Sabolich.
The first step in implementing change in an organization, says Kotter, is to explain that a “big opportunity” is imminent. Building Build a Guiding Coalition. urgency is about concentrating on Kotter recommends assema window of opportunity that can bling a team that includes bring people together, “aligning them representatives of different levels and around a commonality, and clarifying functions—an “accountable, diverse where energy should be directed,” group bound by opportunity, strategy, according to Kotter. and action.” For example, many O&P profesIncluding several staff in the decisionals believe the need for thorough sion making and asking employees documentation, to prove to payors for their input can lead to successful the efficacy of O&P interchange management. When vention, is indeed urgent. selecting the change manage“The documentation ment team, don’t rely solely requirements that are on the current leadership being imposed upon or management, says Pam us, particularly for Lupo, an industry consulForm a Strategic Vision custom care,” have tant based in Michigan. and Initiatives. made it necessary to “Sometimes there are people A good strategic vision, revamp office procedures who are important to the according to Kotter, should be commuTeri Kuffel, JD to ensure that every step is success of the company” who nicable, desirable, flexible, feasible, documented and easily availcontribute a lot but do not have imaginable, and simple. able to submit to insurance companies, leadership titles. Lupo also suggests Start by meeting with your team says Teri Kuffel, JD, vice president including new staff members who and explaining the necessary change, at Arise Orthotics & Prosthetics in recently worked at other O&P compaand then solicit ideas for how to bring Minnesota. Facilities must implement nies, or even in other industries, who that change to life, suggests Perrone. changes to ensure they are organized can offer a different perspective. Be clear about what must change by and meticulous, with detailed guidIn O&P specifically, your guiding fully explaining the situation and by ance sheets and flowcharts to assist coalition may expand beyond your staff allowing staff to ask questions, she says. staff in their work, she says. members, says Joyce Perrone, director Information from dashboards and Scott Sabolich, CP, owner of of business development at De La key performance indicators should Sabolich Prosthetics & Research, Torre Orthotics & Prosthetics “lead the way” in forming noted a crucial need for change a few and an industry consultant. the vision and initiatives, years ago, when a massive audit in Just as hospitals and large suggests Lupo. “Some stakelate 2014 prompted him to shut down healthcare companies holders aren’t comfortable his operations for several weeks to are now run by business with trusting the data,” make institutional changes to become professionals and MBAs, she says, but it’s important an evidence-based practice. Sabolich some O&P facilities for the guiding coalition to sought to make his facility “more should employ or contract consider this information in Pam Lupo audit-proof, and to try to prove that with individuals with busiits planning. patients are at a particular activity ness expertise to oversee change Communication is key when level,” he explains. After working initiatives—and also to manage the sharing a strategic vision, advises closely with Ottobock—primarily with day-to-day operations going forward, Kuffel. “Explain the new process—but Andreas Kannenberg, PhD, executive suggests Perrone. It’s simply not also explain the ‘why,’” so that staff medical director, North America—“we possible for O&P owners or managers members understand that the changes decided to track, from the first visit on, to see a full schedule of patients and are being made, for example, to ensure seven different outcomes tests for each run all of the business aspects of a future reimbursement and to continue patient,” Sabolich explains. successful O&P facility, she says. to treat existing and future patients, Shutting down his facility During Sabolich’s change initiaKuffel says. “Explain that we have to created an extreme sense of urgency, tive, he relied heavily on a “coalition” amend the way we work to make sure convincing his staff that their made up of a few members of his own we get paid.” 24
JANUARY 2020 | O&P ALMANAC