1. Issues we are facing Many schedule changes Vague requests
Too many unexpected staff changes Managing flexible scheduling
Improve access Satellite clinics Improve access without shuffling
people Reduce waste
2. Too many schedule changes A number of them have been out of
our control. One physician left the group and 5 providers our
onsick leave. But how can we improve the current system 3. Things
to consider whensubmitting your request BE AS SPECIFIC AS POSSIBLE
If you need a day off request a VACATION on theschedule Order of
preference SICK LEAVE>VACATION>EDUCATTIONAL LEAVE 6/10,
8/10/9/10 comp off days are flexible If requesting Friday or Monday
vacation then let meknow what you would like for the weekend. Dont
be as one of the extremes 4. Things to consider whensubmitting your
request Dont use symbols such as X or O or blank space since
theylead to mistakes and misunderstandings. Use the following
terminology VACATION NO CALL CALL SICK LEAVE 6/10, 8/10, 9/10 OFF
(These requests are flexible) AT or IW with committee meeting
detailMore detailed you are easier it is 5. Steps we are
implementing When the schedule is completed It will be submittedfor
your review and you can request changes at thattime. When the
schedule is published then changes will bedone only on case by case
Will start the self scheduling module on AMION.COM 6. Do more with
much less 7. What is the fiscal cliff During dept ceiling
negotiations congress set up abipartisan committee, the
supercommittee, to addressthe budget deficit and cut the deficit by
1.2 trillion in10 years. If they did not agree on a compromised
plan thennother part of the Budget Control Act directsautomatic
across-the-board cuts (known as"sequestrations") 8. Why should I
care? Mandatory 300 billion dollar cut from the medicareand
medicaid fund More taxes40 K/year$ 3000100$ 8000200$ 12000300$
16000 9. Very inefficient system One area of waste in our
department has beenscheduled cesarean sections. We perform 50-60
scheduled cesarean sections permonth 5-10 deliver at other
facilities and the patient deliversprior to the scheduled cesarean
section and theschedule is not modified and goes to waste. 10. we
are witnessing history as it happens. 11. Current system We devote
W per cesarean section and one hour oftraveling time if provider
travels from the satelliteclinic 30% of the cases are bumped and do
not go on time Great source of frustration on providers and
patients Problem with the lack of providers and access issue. 12.
Solution Arrange the call schedule around the schedulecesarean
section que. The primary surgeon will do the surgery It is a
patient satisfier Eliminates the need for other providers to
perform thecesarean section Potentially can add 30 W of clinic
access per month tothe schedule 13. Rational against it We are busy
Not true: 2 years ago we used to deliver about 350babies per month
and now we are down to 240 permonth Due to shortfall of deliveries
we might lose our CNM 2spot and by scheduling Cesareans on call we
canprotect the above. 14. What to expect? 1-2 scheduled cesarean
section per call day. If more than 2 per provider then will arrange
a perdiem physician to cover the labor and delivery for thatperiod.
15. What to do? try to do the cesareans with the CNM staff on call
thatday Delay the case as needed depending on the volume onthe
labor and delivery
