Journal of Healthcare Management - May/June 2013 - (Page 211)

211 7. Mistrust of management “I know they’ll never admit it [but] the full-timers [hospital-based physicians] have been told to send to other full-timers [hospital-based physicians], and so therefore the patients are not being sent [outside to community-based physicians]. . . . They’re not going to send their patient outside the institution [their hospital].” “If it’s not in my head, like an active patient, I have to refer to the record.” “I read the form, I open the chart, enter the information, and it goes back in the envelope that’s pre-addressed and pre-stamped.” “I don’t mind filling out the form if the form came in. [But if] there is some disconnect at the front desk . . . then it doesn’t get anywhere.” “No one called me. . . . All I need is one phone call.” “We just don’t have the physical space to keep five years’ worth of charts . . . because it costs us per month for every cart.” “So I don’t mind doing it, but my resources are extremely limited. I am already stretched.” “So I don’t have anyone to do that for me except myself. We have been wanting to add someone, but the way reimbursements have been going . . . .” “To provide that documentation for every breast, we would actually need another body, another person, someone who can keep track of what’s going on with a particular patient.“ “The challenge here has been building the kind of confidence that’s required for people to really integrate those programs in a meaningful way.” “I’m not sure if there’s a bit of an organizational distrust in the systems and in the spirit of the endeavor.” ”[The ideal situation would be] if a lot of this information could be downloaded into our database . . . so we could clearly identify which patients received chemo as opposed to looking through a long list of medications.” “The office isn’t that large. . . . So . . . if someone doesn’t come, then we know that someone’s missing and then we’ll call them.” “I think it’s very, very financial. I think that the whole trust–control issue is bottom line related to reimbursement, and whether or not the hospital is really going to capture those charges, and where is it going to get posted, and what’s going to be the tax on the faculty.” “If this could be electronic it would really make our lives much easier.” “It is very labor intensive to go through the chart every single time.” “I have to say there’s e-mail exhaustion. There is a glut of e-mails.” “Physicians were telling me they were not the managing physician. Then we would have to go back and re-review the abstract that was partially the problem, then we would go back and we would say, ‘Well no, you are the managing physician.’ ” “We don’t have [nurse practitioners]. We don’t have the resources for that.” “You can’t directly communicate with other departments. It’s really annoying.” “It’s just the man-hours at this point in time to do it.” “You need people power. And I mean with the way medicine is going now . . . we try to do more . . . with less. . . . We’re not hiring data managers . . . we wouldn’t be able to afford it.” to 6. Information technology limitations 5. Communication issues 4. Resource constraints H ow I MProve B rea St c ancer c are M eaSure Ment /r e Port I ng

Table of Contents for the Digital Edition of Journal of Healthcare Management - May/June 2013

Journal of Healthcare Management - May/June 2013
Contents
Interview with Thomas C. Dolan, PhD, FACHE, CAE, President and CEO, American College of Healthcare Executives
Equity in Care: Picking Up the Pace
How Might a Reforming U.S. Healthcare Marketplace Threaten Balance Sheet Liquidity for Community Health Systems?
Assessing the Productivity of Advanced Practice Providers Using a Time and Motion Study
A Positive Deviance Perspective on Hospital Knowledge Management: Analysis of Baldrige Award Recipients 2002–2008
How to Improve Breast Cancer Care Measurement and Reporting: Suggestions from a Complex Urban Hospital
The Fear Factor in Healthcare: Employee Information Sharing

Journal of Healthcare Management - May/June 2013