Conduct a Self-Assessment Before Leaping Into the New Year

Posted by: Lori Walsh, MHSA on Thursday, January 10, 2019


Last week we discussed some of the industry trends and growth strategies that practice administrators are focusing on in 2019, as well as some ways to apply them. I thought a good follow up would be to encourage members to take a step back and assess how their organizations are doing on the inside before they start tackling new initiatives.

So often, physicians and administrators start talking about strategy before first evaluating whether operations are efficient, staff are optimized, and benchmarks and measurements have been put in place to measure progress and success.

I think this is common because there are so many issues and challenges to address on a daily basis that it’s difficult to cut through the noise and consider things such as: Are all the physicians strategically aligned? Are staff working effectively as a team, to support patients and the organization? Are billing operations optimized to support the cash flow required to take on new initiatives?

So this is the time of year we recommend that members conduct a Heart Program  Self-Assessment.

Like an annual physical or check up, an annual self-assessment gives you an opportunity to step out of the weeds you are standing in everyday, and take a look at the bigger picture. It can help you prioritize the organizational aspects of the business that need a boost. Or, identify the steps you need to take to prepare for bundled payments. As well as, tease out communication issues that may be keeping your program from achieving the quality and patient engagement metrics you’ve set. An annual assessment can also help you assess the success of initiatives within your program. If you’ve already completed your strategic planning for the year, use the assessment tool to make sure you are on track.

Our online self-assessment tool covers four key areas: Organizational, Operational, Clinical, and Transformational. Here are the high points of what these include:

  1. Organizational

Components of this area include strategy, governance, and performance management.

For instance, have you developed a strategic plan and if so, are you circling back to review it and stay on track? When was the last time you reviewed your governance and decision-making? Have you adequately empowered managers and leaders so they can execute on that strategy? Or do you require layers of approval before anything can get done? What’s on your monthly performance dashboard, and who receives and reviews that each month?

Assessing organizational aspects of your program may uncover things you didn’t even realize were an issue, but that are causing negative outcomes. For example, we were called in to assess a group’s physician compensation model. The younger physicians felt the model incentivized the wrong things. But when we dug in, it turned out that compensation disagreements were actually just an outcome of a deeper root issue: the organization had no strategic vision. Without a strategy, competing priorities were causing problems in the compensation model. It was a snowball effect. So we provided information about how the organization could align itself for future success. Once leadership moved everyone onto the same strategic page, the organization could move forward with clarity and alignment, and the compensation disagreements abated. 

The point is that, without an assessment, you may be missing the most critical part of an issue. Taking a look inside your program annually can alert you to issues before they have a snowball effect.

  1. Operational

Operations are the core of any program. But they are messy and let’s face it: not as exciting as strategic discussions about the future. So they are often overlooked. Asking operational assessment questions forces you to drill down and determine what can be tweaked and adjusted so that processes support people and systems, which subsequently support patients and revenue.

Assess systems and processes first. Are you sure that essential tasks are being done accurately and consistently? Is the team regularly trained on front-end processes to ensure efficient revenue cycle? Are you using technology to streamline process and add patient convenience?

Once your assessment identifies key areas that need improvement, be sure to include milestones and evaluation checkpoints to measure progress.

Last year we worked with a program that had launched a call center to centralize phone answering and appointment scheduling for more than ten office sites. After six months of operations, new leadership wasn’t convinced that it was working, and engaged MedAxiom to assess whether staff and processes were optimal. Using benchmark data and other evaluation criteria, we determined that in fact, the call center was more than 90% of the way to success. Staff were doing a good job and new systems were effective.

The takeaway here is to not to overlook the assessment of process improvement and other initiatives, in order to evaluate outcomes and measure success.

  1. Clinical

Most practices administrators and physicians will tell you that their highest priority is delivering “excellent care.” But what does that really mean? Can it be articulated in your organization? And how is it quantified?

For starters, all staff must have the same understanding of quality, and the same vision about what delivering high quality care means. And, the clinical team must be operating at their “highest and best use." That requires regular performance reviews, competency assessments, and training.

In addition, how well has the program coordinated patient care across providers, settings, and conditions? Best practices, clinical pathways, and disease management programs require ongoing measurement and fine-tuning. We take that famous quote, “you can’t manage what you can’t measure,” seriously. Assessing yourself using a consistent feedback loop is vital to measuring clinical success.

  1. Transformational

Programs are facing an astounding number of external changes that are forcing physicians and practice administrators to think differently. From quality programs, to bundled care and other risk sharing arrangements, to new technologies including artificial intelligence (AI).

How prepared is your program to face these market changes? Do you have the right population data to adequately manage under a value based arrangement? Is your organization optimizing the use of technology, from the use of say, automated recurring payment options, to device data stream management? Are you considering telehealth as a way to follow patients and improve access and convenience?

These are just a few of the questions to ask yourself as you prepare for what’s ahead.

We recognize that you can’t zero in on and fix all issues in all areas by the end of the year. Rome wasn’t built in a day. What a self-assessment is intended to do is help you identify and prioritize 3 - 5 “big rocks” to focus on in 2019. Without a focus, you will flounder, and nothing will be accomplished in the coming year.

So set aside the time to use our Heart Program Self-Assessment. Once you identify the “big rocks,” establish a current state benchmark for each and clearly define what the future state of success will look like. Then, establish measurements and key milestones and create a work plan to help get you there, one positive step at a time.

Remember too that we have experts who can work with you to determine your top priorities. We have tools to help you reduce the noise and optimize your opportunities. After you’ve completed the self-assessment, contact us to review the results.

Make it a standing agenda item in each staff meeting to check-in with staff on workloads and be sure everyone is taking care of themselves physically and emotionally. You might even launch a committee that meets regularly to develop ideas for increasing morale and satisfaction.

We know your job is hard. We plan to continue offering webinars, conference sessions and other stress and burnout resources to support our members. If there are specific issues, you’d like us to address, please let me know.


With an obvious passion for what she does, Lori has worked in healthcare for nearly 20 years, including nine years as the Director of Operations for Heart Clinic Arkansas. In her role as Vice President of Membership, Lori uses her healthcare background to help our current and prospective members build relationships within the industry and maximize the benefits of MedAxiom's exclusive educational and research support services to improve their programs. As a senior consultant, Lori takes her vast operations experience and applies it towards our client practices in the areas of operational efficiency, financial performance, workflow redesign, strategic planning and business development. You may contact Lori at

MedAxiom Consulting is the nation’s leading cardiovascular-specific consulting group, working with a range of private practices, hospitals and health systems across the country to improve the delivery of CV health care. Learn more about our team.

Illustration: Lee Sauer

 MedAxiom Consulting is the nation’s leading cardiovascular-specific consulting group, working with a range of private practices, hospitals and health systems across the country to improve the delivery of CV health care. To learn more about our team, please visit our website.                     


Leave a Comment

Go Back