Emergency Department Directors Academy Phase I Spring 2020 Conducting Effective Meetings DESCRIPTION The effective ED leader must understand cost appropriate care and efficient utilization of critical resources. Financial realities place pressure on all participants in the healthcare environment and frequently necessitate a critical review of utilization. Too many CTs, admitting patients eventually denied by third party payors, unnecessary laboratory tests, staff cutbacks, etc., are all areas of frequent ED review. Critical review, peer comparisons (locally and nationally), and effective communication all play a role in defining appropriate utilization. The presenter will describe methods of encouraging practitioner (utilization) behavior change, when appropriate. OBJECTIVES

• Define resource utilization and cost containment. • Identify the major types of over-utilized resources in the delivery of ED services (imaging studies, staff,

inpatient services, laboratory studies, etc.) • Describe several tools available to the ED director and management team to assist with demand

forecasting and cost management. • List institutional leaders traditionally most concerned about over-utilization. • Describe the potential risk of under-utilization. • Describe successful methods of demonstrating findings and creating behavior change. • Conducting Effective Meetings

2/6/2020, 11:15 AM - 12:15 PM FACULTY: Robert W. Strauss, Jr., MD, FACEP DISCLOSURE: (+) No significant financial relationships to disclose

Robert W. Strauss, M.D., FACEP Emergency Department Dir. Acad.

ACEP, Dallas

“80% of success is showing up.”

Woody Allen

How would you answer the ?

Ø If I didn’t have to go to meetings, would I like my jobmore?

Ø Are meetings are the low point of my day!

Ø Are meetings are the high point of my day!

Ø 32 hours x

Ø $180 per hour x

Ø 120 participants =

Ø Conference expense à

Monetary value of meeting time“opportunity cost”

Monetary value of meeting time“opportunity cost”

Ø 10 hours / week

Ø 46 weeks

Ø $180 per hour

Ø 120 participants

x

x

=

à

78 % said:“Meetings are a

waste of time!”Communispond Poll of

471 Management Leaders

Learning to lead meetings: How did you get your training?

Ø You’ve observed how not to…Ø OTJ, by trial and errorØ You’ve gone to a course

(AAPL, EDDA)

Ø You’ve got an MBA, MMM,MHA…

Ø You haven’t learned…or…

Characteristics Of Bad Meetings

Characteristics Of Good MeetingsA dynamic, passionate focused, engaging

process that extracts the collective wisdom of a team . It must be:

Well Conducted Time Efficient Meaningful Focused

OBJECTIVESØ To have or not to have a meeting

Ø How to prepare in advance

Ø How to conduct a meeting

Ø Avoiding traps and terrorists

Ø What to do after the meeting ends

To have or not to have…

Is it necessary?or

Can it be avoided?

Ø Nothing of significance to discussØ No decisions to be madeØ The leadership doesn’t

want/need permissionØ No “buy-in” requiredØ More input only confuses the

issue.

Reasons to avoid a meeting…

Ø Problem SolvingØ Input = “Buy-in”

Ø If you don’t need the group for input (“buy-in”), then it is unnecessary to have a problem solving meeting.

Ø Information Exchange

Two reasons for meetings…

First: Determine the purposeThen: Write the minutes (before the

meeting)Create an “essential agenda”

- Specific and action oriented- Both a map and a promotional tool- Circulate in advance

Preparation in advance

BEDSIDE REGISTRATIONØ Discuss GoalsØ Describe existing programs

Ø List equipmentØ Define IT supportØ Describe roll-out and education

Ø Describe “roadblocks” to success

“ROADBLOCKS” TO SUCCESS

Putting “Roadblocks” to success

Ø Creates earlier success by allowing“suspension of disbelief”

Ø Gives “Naysayers” their opportunity

Ø An organized roadmapØ Sequential – Easy issues earlyØ Accomplishable – Don’t

squeeze too much into the allotted time

Effective agendas eliminate pandemonium

Prepare by

Setting the setting

↑ ↑ ↑ ↑ ↑ ↑ ↑↑ ↑ ↑ ↑ ↑ ↑ ↑

Seating configuration discourages participation

↓

Seating configuration empowers participants

Unless the affected participants are part of the plan,

they will not support the solution. (Its slower, but the solution lasts.)

Input = “buy-in”

X X XX X

A B C D E

FYou

“Most business managers have no formal training in running meetings.”

Meeting with SuccessNorman Sigband

A poorly run meeting frustrates the participants, who will feel like things should have gone better.

Running th meeting

Leadership…is the ability to help the group recognize and accomplish its

goals, (not the chair’s).

“We must climb to the hilltop.”JFK

Ø Create a positive first impressionØ Clarify relevance of the discussionØ Provide the big pictureØ Describe the roadmap

Set the tone early

Ø Is not to accomplish his/her goals, but to accomplish the group’s goals.

Ø If convinced of a particular solutionand the issue is controversial, thenknow the outcome in advance…

The Chair’s Role

Similar to the lawyer’s adage

Take a stand only when you know the outcome.

If it’s really important to you, employ pre-meeting

“jaw-boning”

Ø No clear agendaØ Too longØ Wandering

Blanchard’sOne Minute Manager

Ø Participants tend to believe that itis:“Not my job.”

Ø Leaders may be afraid to be controlling andoverbearing

Drifting Discussion

Ø Affirm the speaker’s point of view (Theory of YES)Ø Consider “Parking Lot”Ø Agree to deal with issue off-lineØ Recognize issue as beyond scope

of meetingØ Refocus on original agenda

Refocusing theDrifting Discussion

How can I ensure that we continue to move toward a conclusion?

The Chair’s Mantra

THE THEORY OF YES

Appreciating input, almost no matter what it is

Just say, “YES”

Ø Identify ProblemØ Generate SolutionsØ Establish CriteriaØ Reach ConsensusØ Get Commitment

Problem Solving - Brainstorming

Ø This is going to be easy – No prepneeded

Ø The chair is totally responsible for the meeting’s success

Ø Consensus is necessary and everyone must express his / her opinion

Ø Emotion and conflict are loss of control

Common Misconceptions

Saccharine is

SWEET

But…it can’t sustain life

Ø Corralling emotionØ Acting as a “stage director”Ø Distilling discussionØ Redirecting digressionsØ Redirecting dominators

Handling Impasses

Ø Getting help from a collaborator

Ø Process check

Ø Take a break

Ø The “runaway horse”

Handling Impasses

Topic Issue / Plan Who When Status

Management Action Plan

Ø Review what is to be done (MAP)Ø Give each an opportunity to voice a

last critical issue / questionØ Schedule next meetingØ Intermittently assess the

effectiveness of the meeting

Concluding the Meeting

Ø Meeting efficient and productiveØ Participation was balanced among the

groupØ Individual responsibilities were fulfilled wellØ Opinions were expressed with candorØ Opinions were expressed with respectØ We focused on processes, not peopleØ Me maintained a focus on improvement

Participant EvaluationStronglyAgree Agree Disagree

Strongly Disagree