Robert Sutton is one of my favorite thinkers. Anyone who would write a book entitled The No Asshole Rule: Building a Civilized Workplace and Surviving One That Isn’t is okay with me. Bob is Professor of Management Science and Engineering at Stanford University and he writes honestly about management on his blog “Work Matters.” Here are his 12 Things Good Bosses Believe and my comments.
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Yep. Give an anonymous satisfaction survey to your employees if you think you know what they are thinking. As managers, we create our own little world based on what we think employees need and want and what we are doing in response to our perceptions of them. It’s a beautiful world we create. It can be a rude wake-up call when we find we don’t really understand what our employees think about us, our decisions or our management style.
2. My success and that of my people depends largely on being the master of obvious and mundane things, not on magical, obscure, or breakthrough ideas or methods.
My mentor taught me “Take care of people’s paychecks and their vacation time – get it perfectly right or fix it quickly, and you’ll be fine.”Anyone who has ever done payroll or staff scheduling can tell you that these “mundane” tasks are two of the most complex and frustrating, yet critical jobs in management.
3. Having ambitious and well-defined goals is important, but it is useless to think about them much. My job is to focus on the small wins that enable my people to make a little progress every day.
Your staff want to know that the group is moving forward, but ultimately they don’t relate the big projects to their day-to-day job. What they want (just as you and I do) is to have the small irritations, the glitches, and the bugs to be fixed. They want to be able to stop wasting their time doing workarounds because the manager won’t take the time to fix something.
4. One of the most important, and most difficult, parts of my job is to strike the delicate balance between being too assertive and not assertive enough.
One of my Mary Pat-isms is to say that the only time I tell people exactly what to do without getting their input is when the building is on fire. This is a bit of an exaggeration, but I do think employees get tired of me asking “What do you think?” when all they want is for me to tell them what to do. If I tell them what to do though, how do I know that their input might not produce a better answer? I also want them to think about solving the problem themselves or getting input from others.
5. My job is to serve as a human shield, to protect my people from external intrusions, distractions, and idiocy of every stripe and to avoid imposing my own idiocy on them as well.
I interpret this as my effort to make it safe in the organization to make mistakes and to be human. The tricky part is walking the line between making it so safe that people feel that mistakes don’t matter, and making it safe enough to stand the pressure of healthcare every single day. I tell the staff that my job is to free them to do their job.
6. I strive to be confident enough to convince people that I am in charge, but humble enough to realize that I am often going to be wrong.
An employee once told me that she really likes a boss who says “I don’t know the answer, so let’s see if we can find the answer together.”
7. I aim to fight as if I am right, and listen as if I am wrong and to teach my people to do the same thing.
I would amend #7 to say that I tend to rely on my experience to guide my decisions, but I often want to hear what others’ thoughts are to make sure the best solution is achieved.
8. One of the best tests of my leadership and my organization is “what happens after people make a mistake?”
See #5.
9. Innovation is crucial to every team and organization. So my job is to encourage my people to generate and test all kinds of new ideas. But it is also my job to help them kill off all the bad ideas we generate, and most of the good ideas, too.
Innovation is crucial in delivering healthcare. One of my favorite techniques is to see how problems are solved in other fields and try to apply them to healthcare. Teaching others to seek inspiration and to be comfortable with test-driving solutions is critical to giving a practice the competitive edge.
10. Bad is stronger than good. It is more important to eliminate the negative than to accentuate the positive.
I agree. I hate it, but it’s true.
11. How I do things is as important as what I do.
Or maybe more important. How I speak to staff, how I speak to patients, how I demonstrate compassion, how I deal with frustration, how I relate to someone who is going through something tragic, how I talk about my boss, how I ________ (fill in your answer here.)
12. Because I wield power over others, I am at great risk of acting like an insensitive jerk and not realizing it.
Being a manager carries with it an almost bone-crushing responsibility for doing the right thing for the organization AND the right thing for the employee. Trying to achieve a win/win in as many situations as possible is a noble calling, but one that can wear you down to a nub, which is when most of us may be accused of acting like insensitive jerks. Acknowledging this state (apologizing is good) and taking a time out is the right thing to do.
If you describe what you want in a boss, and you’re not describing you…think about it.
Healthcare reform is a top priority of the Obama administration and as a result the government will be watching closely to make sure healthcare providers are getting on board with Electronic Health Records (EHR). And while the 2014 deadline may seem like plenty of time to make the conversion, in reality its a pretty ambitious target date.
Its likely that most of the focus for healthcare organizations over the next four years will be placed in three areas:
- getting a comprehensive EHR application in place within the organization
- making sure it can freely exchange data as part of the national system
- converting the existing paper records into electronic files
But theres one other critical area that could be easily overlooked: faxes. Every day, healthcare providers exchange thousands of pages of patient, insurance and other data by fax. There are several reasons for this preference for faxing over email.
The big one is the requirements of the Health Information Portability and Accountability Act (HIPAA). According to HIPAA, email is not secure enough to transmit confidential patient information. It can be intercepted and read too easily, thus violating a patients right to confidentiality. Faxing is the only form of electronic transmission acceptable under law.
Even if they could use email, many physicians would still choose not to. They dont like to have their email in-boxes filled with a lot of information theyd prefer be handled by their staff, and they fear being inundated with SPAM.
Another reason for the preference for faxes is many healthcare providers still use paper charts, which is the reason President Obama is pushing for the move to EHR. If a paper record needs to be forwarded from one provider to another, or to the same provider working out of multiple locations (two offices, a clinic, a hospital), the easiest way to get it there is to fax it.
One of the drawbacks to a fax machine is that although it transmits the documents electronically, the readable output is still on paper. If you want to store it electronically, either as part of an EHR or in anticipation of one, someone will need to scan it and save it. Turning paper into electronic documents can quickly become a time and resource sink.
There is a solution that both keeps the legal and practical advantages of faxing while eliminating the need for additional scanning an Internet fax service. With these services, documents are transmitted using fax protocols (thus meeting HIPAA requirements), but are sent and received as attachments in email accounts. The default format is PDF, but better services give you a choice of document formats so you can integrate them into your EHR.
With an Internet fax service, electronic documents can be easily forwarded, attached to electronic medical records and stored. Theres no paper to misplace, no ink to smear, and no chance that a document relating to patient A will end up in patient Bs file because two faxes got mixed together.
On the sending side, an Internet fax service can be tied into the providers contact management system, eliminating the need to dial a phone number on a keypad and stand at the machine while the fax goes through. This method not only saves time, it also prevents a patients confidential medical information from being accidentally faxed to Petersen Auto Body avoiding another potential HIPAA violation.
Unlike many improvements in the medical world, which tend to cost more to implement, an Internet fax service can help seriously reduce costs over using fax machines. Elimination of the paper used to print faxes alone can save thousands of dollars. Add in the elimination of the machines, the dedicated fax lines, toner and electricity and youre potentially saving thousands more.
I asked Steve to expand on the MyFax product.
Q: What EMR systems is your product currently working with?
A: We have integrated with many EMR systems including NextGen and eClinical Works.
Q: What is involved (time, money) in interfacing your product to an EMR?
A: We have very robust APIs that enable us to complete the integration within a few weeks. If the integration is delayed, its usually due to business issues such as contract negotiations or legal matters.
Q: Can you explain in more detail the process to fax electronic medical records to a party outside the practice?
A: A doctor or nurse working within an EMR can fax directly from it. The document is then securely sent through our infrastructure. All data is encrypted in transit and then delivered to the recipient.
Q: What benchmarks can you give for the time it takes for a medical office employee to receive a fax, identify it as belonging to a specific patient, and index the fax into the EMR? Number of faxes one employee can receive, identify and index in an hour? A day?
A: Faxes are delivered right to the EMR. MyFax provides an indexing file which the application reads, and then puts the file in a work folder where the user can action it. From this point of view, it is then a question of the efficiency or capability of the employee and/or the actual EMR system.
For even greater efficiency, if the EMR system has OCR or Bar-coding capability, the fax can be directly attached to the patient record.
Q: Is your product priced by subscription or transaction volume, or some other way?
A: MyFax is Software-as-a-Service (SaaS) and is subscription based. We work with customers to create tailored subscriptions based on their business and fax needs.
Steve Adams is the vice president of marketing for Protus, a provider of communications tools for small-to-medium-businesses and enterprise organizations, including the MyFax (www.myfax.com) internet fax service; my1voice, a virtual phone service; and Campaigner, an e-mail marketing service. He can be reached at sadams@protus.com.
