The Critical Feedback Loop in Healthcare Back Offices

Why is the feedback loop important? Why is there a struggle with creating it in a healthcare back-office setting? The Modern Healthcare Back Office podcast talked with infusion back-office expert Tina Ratliff about why a functioning feedback loop is often the most needed but least applied tactic in healthcare back-office processes. An overview of the discussion is below.

Auditing Process

Often, the number one reason why feedback loops don’t get created is due to a lack of time. Leads and managers are often so tied down by managing data that they don’t have time to review things that would create that feedback loop in the first place.

Say you manage to get through that hurdle. How do you decide what to audit first? What’s the best way to send feedback to your team? You don’t just want to audit something and send back the completed spreadsheet. You want to provide feedback on what was done wrong, so they can do better next time.

Develop an auditing process that includes time for giving feedback. Start by deciding who the auditor is. If your organization is small, the lead and auditor could be the same person. If your auditing team is big enough, you may want to get an auditor for the auditors. If your team is severely understaffed, even having someone check on work occasionally will make a difference. In any case, the people auditing need to know more than those they’re auditing.

What does an auditor’s day look like?

Step 1: In Tina’s experience, the best approach is to have a lead or manager pull a list of randomized work consisting of different payers and therapies. If possible, the auditor shouldn’t be the one choosing what to look at. 

Step 2: The auditor then gets the list of which accounts they need to audit with a questionnaire to work through. The questionnaire can be created on a program like Microsoft Forms.

Step 3: Once the auditor submits the questionnaire, it can feed into a spreadsheet. The auditor then continues to re-fill out the form for every new audit. 

Step 4: After all audits are complete, the lead or manager can take the spreadsheet and turn it into data. You can then see how many things each team member got wrong and discover trends that allow you to reexamine your team’s back-office processes.

Tip: To make the audit quicker, when creating the form, put the questions in order of where you will go in your patient medical records system to find the answers. It also helps to have one form per back-office process.

How should you send feedback?

Once the audit is complete, the lead on the team will go to the person whose work has been audited and let them know what was done incorrectly. Though it could be easily fixed during the audit by someone else, going back to the person who made the mistake will allow them to remember how to do it right the next time.

Sometimes, you don’t have to call that person out at all. In many cases, it’s even more helpful to set up a training the next day for all the people who do the back-office work or a specific process. You can then go over the trends found during the audit, so everyone is aware of the trending mistakes. The training is a refresher for those who know the processes, and a big help for those who are struggling.

Other tips

1. Set attainable goals. When it comes to the questionnaires, a good idea would be to put a question at the bottom of the form such as: How long did it take for you to fill out this form? This way, you will quickly have an idea of how many accounts can be reasonably audited per day.

2. Decide what your key performance indicators (KPIs) are. What is your accuracy expectation? One hundred percent is unrealistic, so decide what your expected numbers should be.

3. Understand what on your audit form is critical versus not critical. What is going to get you denied versus what is simply not the process being followed?

What’s the worst thing you could do when rolling out a feedback loop? Not creating one at all! As is the case when implementing any organizational change, it takes time at first for everyone to get used to it. Once in place, it will save your organization time and revenue. It will also create a stronger feedback loop for your team.

Have questions about this topic? Please feel free to ask Tina Ratliff directly at Listen to the full episode below:


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