HMGT RESP PART 7

1

Ashlie 

Consider the importance of relationships for freestanding ambulatory centers, identify at least two stakeholders that you, as the practice manager, would need to ensure are managed appropriately, and why?

As a practice manager of an ambulatory care center two key stakeholders that I would need to build a good relationship with in order to successfully manage an ASC facility would be Surgeons and patients. Surgeons can better position him/herself to negotiate higher rates from commercial payers and receive bonuses for surgeries done in an ASC setting from several insurance companies (Madhavan, 2020).  Moreover, surgeons are better equipped with ASC ownership and potential leadership positions and practice managers who partner well with the surgeons will help to ensure for a better managed ASC. Furthermore, relationships with patients are critical and bring in the income for the ASC. Practice managers must build exceptional relationships with their patients in order to gain understandings of patients needs and wants to provide an efficient facility.

Would you rather be a practice manager of a freestanding ambulatory center or a department manager of a ambulatory center within a hospital, and why? 

I personally would prefer to be a practice manager of a freestanding ambulatory care center over a department manager of an ambulatory center within a hospital. A freestanding ambulatory care center is significantly smaller than a hospital and can allow for a more efficient relationship between stakeholders. Moreover, the smaller setting allows for a more specialized care and high patient satisfaction due to a smaller and more personalized team. Smaller teams are easier for practice managers to mange and provide a more efficient ASC (AAOS, n.d.).

References

Madhavan, K. (2020, January 28).  Ambulatory spine surgery: Understanding stakeholders and benefits within a unique setting for a novice surgeon. AANS Young Neurosurgeons News. https://newsletters.aans.org/ync/winter-2020/ambulatory-spine-surgery-understanding-stakeholders-and-benefits-within-a-unique-setting-for-a-novice-surgeon/

AAOS. (n.d.).  Ambulatory surgery centers versus hospital-based outpatient departments: What's the difference? AAOS. https://www.aaos.org/aaosnow/2019/sep/managing/managing02/

Reply to Thread

Chris

When we look at partnerships with our stakeholders these consist of both our internal and external forms. Internally, we need to look at the physicians, nurses, and ancillary staff. Additionally, our external stakeholders include our patients, the various EMS response agencies in the community, as well as pharmacies, and home medical suppliers (Transitions of Care, 2019). Furthermore, as a healthcare provider maintaining relationships with the US Department of Health and Human Services [HHS], Centers for Medicare and Medicaid Services [CMS], and the State's Department of Health [DoH] is essential and serves a more "Regulatory Stakeholder" role than the traditional internal and external Stakeholders noted above. 

To maintain these relationships one would need to practice both good internal and external customer service. Without the care team in place, you are unable to provide for the patients. Without the patients, none of the other relationships are relevant. Additionally, without partnering with HHS, CMS, and/or DoH the providers and the practice cannot function to offer care to the patients as well. This means to manage these relationships a healthcare organization and, by extension, its Practice Manager needs to ensure good human resources and benefits to their teams, as well as ensure compliance with all regulatory measures and provide outstanding customer service both to the patients and those agencies they contract for other services (Solomon, 2018).

This also includes maintaining a good relationship with both the 9-1-1 Call Center and the area's EMS Agencies. Many times EMS will be dispatched to the clinical setting at an Ambulatory Care Center when a patient arrives there but needs the services offered at a hospital. This can be due to "chest pain" that they don't think is bad but shows an ST Elevation, it can be due to asthma that is continuing to worsen, or any other number of items. Having this relationship helps to assuage the patients when there is no "friction" between the care team and the EMS responders (Jollis, 2015). If the patient "feels" that this is normal, and that the EMS team is part of the Care Team on site, then they are less likely to be agitated or worried by their arrival. Additionally, partnering with the local EMS agencies allows for a number of Public Health Events to be offered by that facility that helps to improve the overall community health of the area and decreases the various Social Determinants of Health. Furthermore, if partnered with the EMS Agencies can offer various services to community members and patients that might not be able to access the Ambulatory Care Setting and help to decrease the loads suffered by the area's hospitals (Jollis, 2015).

Having worked in both Ambulatory Care Settings as well as Hospital Settings, my preference is more toward Ambulatory Care. While you see a greater number of cases in addition to types of cases in the Hospital Setting, you become better acquainted with your patients in the Ambulatory Care Setting. This allows you to get to know them more intimately, their likes and dislikes, their families, their vocations... in essence they become part of your family at the practice. There is a greater joy to be found in seeing a patient's ups and downs and seeing them become well after not being such. Working for Virginia Blood Services and American Red Cross for over a decade I became acquainted with a great many of our donors and patients. We laughed and cried with each other, and even two to three years after leaving that employment I still converse with many of them either online or if I see them in the community.

This, by its nature, cannot exist in a hospital setting. Hospitals are dealing with more critical patients and you are not afforded this capacity to know your patients. They exist in your care for only the most grievous of ailments and for the shortest of times. An empathic provider does not want to get to know them this way in the hospital. If they did get to know them to this extent, then that would mean the patient would be suffering from a serious illness for a long period of time. Thus, my choice will always be to be in the Ambulatory Care Setting - because I get to know my patients :) 

REFERENCES

Jollis, J. (2021, August 31). Ems & Hospital Collaborations Strengthen Relationships and improve care in North Carolina - JEMS: EMS, emergency medical services - training, paramedic, EMT News. JEMS. Retrieved November 28, 2022, from  https://www.jems.com/administration-and-leadership/ems-hospital-collaborations-strengthen-relationships-and-improve-care-in-north-carolina/

Solomon, M. (2018, August 3). Internal Customer Service vs. External Customer Service. Forbes. Retrieved November 28, 2022, from  https://www.forbes.com/sites/micahsolomon/2018/08/01/internal-customer-service-vs-external-customer-service/?sh=1123dc2d3b3e

Transitions of Care. (2019, February 5). Transitions of Care Standard 5.0. Transitions of Care. Retrieved November 28, 2022, from  https://transitionsofcare.org/standards/standard-5/#:~:text=These%20stakeholders%20may%20include%3A%20patient%20and%20caregivers%2C%20regular,securely%20maintained%20framework%20for%20communication%20transfer%20is%20used.