The Practice Manager Issue 2 2014

Issue 2 – 2014 www.aapm.org.au

10Managing

practice risks

8AAPM national

conference

In this issueSpotlight on conference

keynotes

14Employee

performance management

2 | Issue 2 – 2014

Innovative thinking. Traditional values.cutcher.com.au T 02 9923 1817 E [email protected]

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Your association

Our board members, contacts 3

President’s message 4

From the CEO’s desk 5

News Bites 6

Good systems the key to managing practice risks 10

Employee performance management 14

AAPM/Avant scholarship winners 16

AAPM’s newest Fellow 18

Practice management – A pathway to success 20

IT virtualization 22

PMAANZ/AAPM education symposium 26Leadership and the Practice Manager 28

Member benefits 30

contents

President Carolyn Ingram P 0411 725 899 E [email protected]

Vice-president Linda Osman P 0405 516 331 E [email protected]

Secretary Fiona Wong P 0412 155 865 E [email protected]

Treasurer Danny Haydon P 0438 580 319 E [email protected]

Non-Executive Directors Jannine De Veau P 0409 090 385 E [email protected]

Terri-Helen Gaynor P 0409 870 022 E [email protected]

Lynne Green P 0409 514 116 E [email protected]

Gary Smith P 0408 234 944 E [email protected]

Chief Executive Officer Gillian Leach

AAPM Board

Your association

Queensland Contact Qld Secretariat (Fran de Klerk) P (07) 3103 5152 F (07) 3112 6838 E [email protected]

New South Wales/ACT Contact NSW/ACT Secretariat P 1800 196 679 F (03) 9329 2524 E [email protected]

Victoria Contact Vic Secretariat P 1300 651 334 F 1300 651 335 E [email protected]

Tasmania Contact Tas Secretariat P 1800 196 000 F (03) 9329 2524 E [email protected]

South Australia/Northern Territory Contact SA Secretariat P 1800 196 000 F (03) 9329 2524 E [email protected]

Western Australia Contact WA Secretariat P 1800 196 000 F (03) 9329 2524 E [email protected]

INTERNATIONAL

Institute of Healthcare Management 18-21 Morley Street, London SE1 7QZ P +44 20 7460 7623 F +44 20 7460 7655 E [email protected] W www.ihm.org.uk

The Medical Group Management Association in the United States has a vast range of courses ranging from one day to several months. A complete list of activities can be obtained from MGMA

P (303) 397 7875 W www.mgma.com

Practice Managers and Administrators Association of New ZealandW www.pmaanz.org.nz

Head Office Level 1, 60 Lothian Street, North Melbourne, Vic 3051 P 1800 196 000 F (03) 9329 2524 E [email protected]

Editorial/Advertising Marilyn Bitomsky P (07) 3371 3057 E [email protected]

3 | Issue 2 – 2014

AAPM Life MembersLife Membership is bestowed on members who have made an extraordinary contribution to the Association.

Jan Chaffey Desmond Higgs

Brett McPherson Gary Smith

Colleen Sullivan Louise Tindal

Anthony Walch

Contacts

Our Cover: Our conference venue, Adelaide Convention Centre, and our keynote speakers Photo courtesy of the Adelaide Convention Centre

4 | Issue 2 – 2014

Excitement is building as reports flow in from the 2014 AAPM national conference committee and in particular Ms Marion McKay. Adelaide is set to host one of the biggest healthcare management conferences in the Southern Hemisphere. I wish to invite you to this incredible opportunity to learn, experience and network with like-minded healthcare managers and those working within the healthcare sector. Thank you to the conference committee who are putting in numerous hours to ensure the high standard of education is achieved.

Human resources is a topic often discussed by practice managers and principals and often referred to with negative tag lines or trouble-shooting sessions. We often hear “but she is being paid to do a job, has a job description, agreed to the job description and still she wants to get a bonus” or “how can I run a practice when they keep wanting to take Friday afternoon off or ring in late Monday morning taking a sickie”.

These are challenges that we commonly face as practice managers. It was with interest that I read David Wenban’s article in this edition of the Practice Manager journal, and his suggested approach of constant and consistent review and communication throughout the year and not just during the lead up to the annual review or post annual review.

With this in mind I have undertaken to research the topic of human resource management for some up-to date and relevant resources to assist with the process. I have come across an abundance of information and templates. Some

of these websites providing free templates that can be adapted to fit your practice:

project-management.magt.biz/templates/06-human-resource-mgmt/ - a great resource of role and description document

If you’re not using ClockedOn or a similar program for time management of staff Adobe has a great site for access to free templates for use in this human resource area:

www.acrobat.com/formscentral/en/templates/hr-timesheet-employment.html

The Victorian Government also provides a wealth of templates for use in business and these can be found at:

www.business.vic.gov.au/hiring-and-managing-staff/staff-recruitment/workforce-planning-and-HR-templates

MGMA (Medical Group Management Association) based in the US has a wealth of knowledge on their website and a subscription to their e-newsletter can sometimes give you good ideas on HR topics.

www.mgma.com/

Lastly, I wish you all the very best leading up to the end of financial year and remember to take time for yourself and your own health as well as the health of your practice.

Carolyn Ingram FAAPM National President

A message from the president

5 | Issue 2 – 2014

From the desk of the CEOThe 2014 AAPM national conference, “The Art of Performance”, will be one of the best conferences yet for those involved in healthcare practice management. The exciting program will be led some of Australia’s key thought- leaders including Dr Norman Swan, host of the Health Report on ABC Radio National, Bernard Salt, one of Australia’s leading social commentators and columnist for the Australian, and Fortune 500 motivation strategy and design expert Dr Jason Fox. You will be stimulated by a range of inspirational leaders, hands-on workshops and interactive sessions. More details are available later in the journal and also on the website www.aapmconference.com.au. This is a conference that you can’t afford to miss.

Adelaide is a wonderful city to host a conference in. The Convention Centre is close to a wide range of accommodation and top-class restaurants. Extend your stay and visit any of several world-class wine regions within an hour or two of the city, see the only pandas in the Southern Hemisphere, take the historic tram to Glenelg beach, or enjoy the scenic beauty of the Adelaide Hills or the southern coast.

The national conference will again host the presentation of the National Practice Manager of the Year. Members can nominate themselves or be nominated by the practice principal. This is wonderful way to recognise the significant work done by the practice manager in developing their healthcare practice and ensuring that good healthcare is accessible to their community. It not only rewards the individual but also increases awareness of the value of the role of the practice manager.

At the last conference, we launched the Avant/AAPM scholarships for the University of New England Certificate 1V and Diploma in Practice Management. We are very appreciative of Avant’s support of this program and their recognition of the importance of continued education for practice managers. In this issue we showcase the winners of the six scholarships. This is an ongoing program and we look forward to opening applications for

the next round of scholarships at the national conference.

Our first joint education symposium with PMAANZ (Practice Managers and Administrators Association of NZ) was held in Wellington, NZ, in March earlier this year. This was a most enjoyable event with over 120 attending. Australian attendees numbered 24, including several who made the long trip from the Northern Territory and Western Australia. The symposium was very rewarding with a program well balanced between improving business skills and personal development. As always, we were overwhelmed by the hospitality of our New Zealand colleagues and it helped that Wellington turned on some perfect weather.

AAPM has had trade stands at a number of other health conferences in the last few months. We are keen to raise awareness that AAPM provides information, education, networking opportunities for anyone engaged in healthcare management in all the healthcare sectors. Members include those from specialist, dental, allied health and general practices. They include practice managers, business managers, operations managers, chief executive officers and practice owners from small private practices, corporate practices, hospital clinics, and community health, to name a few. All are clearly focussed on improving the efficiency and effectiveness of their practices with the ultimate aim of improving patient care an find that membership of AAPM can help them achieve this.

AAPM warmly welcomes a number of new staff in our head office. Congratulations to Danielle Hanson who has a son, William, who arrived a little earlier than expected. Danielle has been with AAPM for five years and will take 12 months leave to care for William. Meet all our staff on page 6 of the journal.

I look forward to seeing you at the national conference in Adelaide.

Gillian Leach Chief Executive Officer

6 | Issue 2 – 2014

news bites

Check patient bank account detailsBefore processing patients’ electronic claims, Medicare advises that you ask them if their bank account details are current.

Many patients don’t receive their Medicare benefits because the bank account details used for the claim are no longer current.

Ask your patients for their current bank account details each time they visit to make sure their benefits are paid into the right back account.

2014 seasonal flu vaccinations programThe 2014 seasonal influenza vaccination program started on 15 March 2014.

Under the National Immunisation Program, you can give free vaccinations to:

• all individuals aged 65 years and over

• all Aboriginal and Torres Strait Islander people aged 15 years and over

• pregnant women, and

• individuals aged six months and over with medical conditions that increase the likelihood of severe influenza.

There are two new strains to the 2014 trivalent influenza vaccine so it’s important those at risk are vaccinated.

Immunisation providers are reminded that you must not give bioCSL Fluvax® to children under five years old.

Letters to the editorDo you have something to say? Like to comment on something in the Practice Manager? Have a suggestion?

Email [email protected].

What’s in a name? A question we hear so often in our profession. Is it who we are or is it what we do? The role of the practice manager has changed considerably over the past two decades. What is the main function of our role as managers? Is it management?

The question being asked, not only by our members but also by external stakeholders, is whether the Association should be renamed

to reflect what the practice manager does, that is, a change to the Australian Association of Practice Management (AAPM).

This question will be up for discussion at the Association’s Convocation and the AGM at the annual conference in Adelaide in October of this year. Further discussion forums will take place for you to comment on prior to this time.

If you have any comments, send them to [email protected].

AAPM head office staff

(back row L to R):

Malini Haran (Marketing & Communications Officer), Helen Kenny (Membership Coordinator), Lisa Harrington (Executive Assistant);

(front row L to R)

Eugenie Howard (State Liaison Officer), Gillian Leach (Chief Executive Officer), Ilona Millar (Finance & Business Officer)

AAPM’s name

7 | Issue 2 – 2014

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REMINDERS & PROMPTS

Easy-to-setup reminders, prompts and expiry dates make remembering licence renewals, compliance and registrations and other events easy to manage.

1

2

3

4

8 | Issue 2 – 2014

Bernard Salt is a high-profile Melbourne-based partner with the global advisory firm KPMG where he founded the specialist advisory business, KPMG Demographics. Bernard writes regularly for the Australian on social, generational and demographic matters.

Vinh Giang, 2013 South Australian Entrepreneur of

the Year, is fascinated with the psychology behind the

mysterious art of magic. He has devoted himself to

understanding the ways in which people are fooled

not only by illusions, but by the tricks that life plays on us and that we play on ourselves.

Dr Jason Fox, a motivation strategy and design expert, is author of The Game Changer, a new book published by Wiley that unpacks the science of motivation, gamification, and agile management to drive change within organisations, teams, and work.

Daniel Lock is the principal of Daniel Lock Consulting, a

firm specialising in helping organisations unlock hidden

value through to achieve new heights of success

through process and change management.

Dr Norman Swan hosts “The Health Report” on ABC Radio National, and “Tonic” on ABC

News24. “The Health Report” is the world’s longest running

health show. He trained in paediatrics before joining the ABC. He has also been the

medical host on Channel Ten’s “Biggest Loser” for the past three seasons.

Khoa Do, a film director, screenwriter, and teacher, came

to Australia as a refugee on a tiny fishing boat. He has had

extensive experience working with the most disadvantaged

in our community. In 2004, he was the youngest film

director in Australian history to be nominated for an AFI

Award for Best Director, and in 2005 he was

appointed Young Australian of the Year.

Gill Hicks, former publishing director of an architecture, design, and

contemporary culture magazine, lost both legs from below the knee in the London bombings of 7 July,

2005. She recently founded M.A.D. for Peace, a not-for-profit organisation which communicates the importance of our individual responsibility in creating a world in which extreme conflict is ended.

Australian Association of Practice Managers

The Art of Performance

The AAPM SA/NT Committee wish to invite you to ‘come on down’ in October for AAPM’s 2014 National Conference. Join us in celebrating ‘The Art of Performance.’ Over the last nine months of planning we have collectively embraced the opportunity to meet, talk and listen to many Practice Managers from di�ering healthcare specialties who all enjoy various areas and levels of expertise. Passions for practice management and healthcare service delivery run high for so many of us and our committee have been pivotal to the planning of this now annual event, this year being held in Adelaide! So many great thoughts, ideas and suggestions – we’re up for the challenge to o�er the best program possible to support Practice Managers in all healthcare specialties – no pressure!!

Our vision and ultimate goal is to provide you with the very best speakers along with a program to support and inspire

all who are lucky enough to attend. Our quest in bringing to Adelaide the very best learning experience on o�er for our profession doesn’t ‘happen’ without a great deal of hard work, organisation, cost and sleep deprivation! Our sensational sponsors and exhibitors are fundamental to our success in assisting the conference team to provide us with the very best learning ‘money can buy.’ Our gratitude to them all.

Benjamin Franklin wrote what I believe describes us as Practice Managers!

“Tell me and I forget, teach me and I may remember, involve me and I learn.”

See you in October!

Marion McKay 2014 AAPM Conference Convenor

2 0 1 4 N A T I O N A L C O N F E R E N C E I A D E L A I D E C O N V E N T I O N C E N T R E I 2 1 – 2 4 O C T O B E R 2 0 1 4

Visit the website to view the provisional program and list of invited speakers

www.AAPMconference.com.au

Adelaide – October 21 – 24 October 2014 – Please Consider

‘AAPM are delighted to be supported by the following sponsors and exhibitors - we couldn’t do it without you!’

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incorporating

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Top-notch speakers a real drawcardMake sure AAPM’s national conference in Adelaide October 21-24 is on your calendar to ensure you don’t miss these informative, entertaining, and enlightening keynote speakers.

Photo courtesy of the Adelaide Convention Centre

9 | Issue 2 – 2014

Australian Association of Practice Managers

The Art of Performance

The AAPM SA/NT Committee wish to invite you to ‘come on down’ in October for AAPM’s 2014 National Conference. Join us in celebrating ‘The Art of Performance.’ Over the last nine months of planning we have collectively embraced the opportunity to meet, talk and listen to many Practice Managers from di�ering healthcare specialties who all enjoy various areas and levels of expertise. Passions for practice management and healthcare service delivery run high for so many of us and our committee have been pivotal to the planning of this now annual event, this year being held in Adelaide! So many great thoughts, ideas and suggestions – we’re up for the challenge to o�er the best program possible to support Practice Managers in all healthcare specialties – no pressure!!

Our vision and ultimate goal is to provide you with the very best speakers along with a program to support and inspire

all who are lucky enough to attend. Our quest in bringing to Adelaide the very best learning experience on o�er for our profession doesn’t ‘happen’ without a great deal of hard work, organisation, cost and sleep deprivation! Our sensational sponsors and exhibitors are fundamental to our success in assisting the conference team to provide us with the very best learning ‘money can buy.’ Our gratitude to them all.

Benjamin Franklin wrote what I believe describes us as Practice Managers!

“Tell me and I forget, teach me and I may remember, involve me and I learn.”

See you in October!

Marion McKay 2014 AAPM Conference Convenor

2 0 1 4 N A T I O N A L C O N F E R E N C E I A D E L A I D E C O N V E N T I O N C E N T R E I 2 1 – 2 4 O C T O B E R 2 0 1 4

Visit the website to view the provisional program and list of invited speakers

www.AAPMconference.com.au

Adelaide – October 21 – 24 October 2014 – Please Consider

‘AAPM are delighted to be supported by the following sponsors and exhibitors - we couldn’t do it without you!’

smilewear

incorporating

9990_AAPM2014_Journal_ad.indd 1 28/04/14 10:58 AM

10 | Issue 2 – 2014

As Australia’s largest medical defence organisation, Avant is well placed to identify risk and develop strategies to help practitioners manage their exposure to patient-adverse outcomes, complaints and claims.

Our dedicated Member Risk Management team does this in two ways: through one-on-one practice visits and a wide variety of online education resources.

What is risk management?Risk management can be defined as the identification, investigation, analysis and evaluation of risks, and applying appropriate measures to correct or reduce identifiable risks.

Throughout the world, successful businesses have been incorporating risk management into their strategic planning and management for quite some time. It requires a drive for improved risk management procedures.

One of the primary macro-benefits of risk management is that it fosters consistent and systematic management behaviour, which historically has been lacking in healthcare.1

Risk management involves managing to achieve an appropriate balance between realising opportunities for gains while minimising losses. It is an integral part of good management practice and an essential element of good corporate governance.2

The implementation of good systems and the wider use of the Standards Australia Risk Management - Principles and Guidelines AS/NZS ISO 31000:2009 to manage these systems, should provide structured tools and guidelines to better manage our businesses in the healthcare industry.

Supported by excellent risk management processes, these systems should envelop an underlying philosophy of patient/client satisfaction by generally achieving a far better match between their needs and what the organisation offers in the provision of services.

The fundamental factor in good risk management is to develop and use good business systems. Supported by the Standards Australia approach, and accompanied by continuous processes

of monitoring, auditing, reviewing and revising, good systems are the key to:• improved quality care• increased professional satisfaction• increased business efficiency and • better risk management.

A systems approach to risk has the potential to include all members of the organisation, meaning that the responsibility is then shared by all.

The world thus appears as a complicated tissue of events in which connections of different kinds alternate or overlap or combine and thereby determine the texture of the whole.3

The complexity of an overlapping tissue of systems, however, lays the business open to more risk, for it is clear that many different technical and professional systems are involved in the healthcare of people.

Systems can be described as a collection or network of processes acting together to produce an outcome.

A system is a set of things, actions, ideas and information that interact with each other and in so doing alter other systems.4

Identifying system failuresThe risk management process identifies failures in the system (where they occur, why they occur and how we can remedy them). Such a process allows an organisation to learn from its mistakes, implement appropriate preventive measures and dramatically improve quality outcomes.

It is important that frustration with failures is directed towards the system, not people. After all, as long as people and systems combine there will be errors.

Better outcomes will be achieved by addressing the errors and correcting the system, thereby promoting improved safety, better system development and better utilisation of the systems. A risk management approach that identifies, analyses, evaluates and ultimately reduces any future risk of failure is the preferred option.

The overlapping of clinician systems and administrative or organisational

Applies to all healthcare practices

Core principles: Risk management, Business and clinical operations, Information management

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Website www.avant.org.au

Freecall 1800 128 268

Freefax 1800 228 268

[email protected]

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Good systems the key to managing practice risks by Marianna Kelly, Avant Senior Medico-Legal Risk Manager/Advisor

11 | Issue 2 – 2014

systems should be understood so that an integrated management approach can be taken.

The following points about complex systems are taken from a paper by Berwick (1998):

… Complex systems break down more often than simple ones. The statistics are quite simple. Imagine a system with 25 components, each of which functions properly (there are no errors), 99 per cent of the time. If the errors in each component occur independently of each other, the probability that the whole system will function correctly is about 78 per cent. With 50 elements, it would be 61 per cent. Many situations in health care involve more than 24 activities or decisions.

… it underlines why we need the skills and professionalism of involved health professionals, as well as the very best systems to support that skill and professionalism. It can also be seen that often very small changes to a system in multiple areas can make a big difference to the result.5

An illustration of how supportive the systems approach can be is to evaluate the use of computers in allied health practices. Such automation can significantly reduce errors, provide an excellent tool for administration as well as support for clinical management. However, if practitioners and practice managers do not fully understand how the computer software can assist in managing the risks, the opportunity for effective risk management and maintaining optimum patient care is diluted.

Effective and well-used systems can reduce risk and overall processes can be improved if:

• Systems and tasks are simplified to reduce complexity

• Equipment and procedures are standardised to reduce variation

• Reminders, protocols and checklists are used to decrease reliance on memory

• Constraints are introduced to make it harder to make a mistake

• Automation is introduced to support workers, and• Effort is put into data collection so decisions can

be based on accurate and up-to-date information.6

Good systems in health management provide good risk management processes and support at the consultation level between the practitioner and the patient, as well as at the organisational management level.

As healthcare undergoes rapid change, the need to introduce new systems can be expected. A risk management process that relies on Standards Australia Risk Management - Principles and Guidelines AS/NZS ISO 31000:2009 will assist the continuous reviewing and implementation of systems – an absolute must for excellent business management and reduction of medical litigation. The Standard also assists identification of problems and offers corrective strategies where required.

Laying blame on people and the increasing volume of litigation does not benefit the healthcare industry. The time has come to improve the systems to better support and enhance the risk management process.

Risk management must be applied to all of the systems in the healthcare industry and not be confined to medico-legal issues. It is time for the healthcare industry to adopt risk management principles across all business systems and seize the opportunity to:

• Establish a context for risk management processes/policies

• Identify the risks in all of the systems• Assess and evaluate those risks• Respond and treat the risks.

It is a process that has to embrace ongoing monitoring and assessment, continuous quality improvement, and communication and consultation with stakeholders.

Risk management must be seen as an opportunity. As Churchill said:

“Pessimists see the difficulty in every opportunity; Optimists see the opportunities in every difficulty.”

Tools to help you manage risk Avant members can access risk education fact sheets, checklists, webinars and benchmarking tools at avant.org.au/risk/iq and our Getting Started in Private Practice portal (avant.org.au/gsipp).

You can now access the Practice Manager Resource Centre, developed by Avant in conjunction with AAPM. This highly informative and practical website contains advice and tools to help you improve, grow and protect your practice. Learn more at www.avant.org.au/practicemanager.

BIBLIOGRAPHY

Alan Waring & A. Ian Glendon. (1998). Managing Risk, Thomson Learning, UK.

Berwick D.M. (1998). Taking Action to improve safety. How to increase the odds of success. Keynote address provided to the 1998 Anaheim Conference, California.

Michael E.Gerber (2001). The E-Myth Revisited, Harper Collins, NY.

Safety & Quality Council First National Report on Patient Safety (2001). Volume 1, Australian Council for Safety and Quality in Health Care.

Werner Heisenberg. Physics & Philosophy.

(AS/NZS ISO 31000-2009 Risk Management – Principles and Guidelines).

Standards Australia International & Standards New Zealand (2001). Guidelines for managing risk in healthcare.

Standards Australia International & Standards New Zealand. The Future of General Practice: A Strategy for the Nineties and Beyond.

NTERNET SOURCES

avant.org.auhttp://www.safetyandquality.orghttp://www.clinicalrisk.com/relationship.htmlhttp://www.medicalproducts.au.com/research/articles/ade.htmhttp://www.aihw.gov.au/publications/workingpapers/hwp03.pdfhttp://www.mja.com.au/public/issues/may3/vincent/vincent.htmlhttp://www.mja.com.au/public/issues/174_12_180601/wolff/wolff.htmlhttp://www.medicalproducts.au.com/research/articles/ade.htmhttp://www.medfac.usyd.edu.au/divisions/units/ncirs.htmlhttp://www.informationr.net/ir/7-1/paper113.html

REFERENCES

1. Standards Australia International and Standards New Zealand (2001, page iii). Guidelines for managing risk in healthcare

2. (AS/NZS ISO 31000-2009 Risk Management – Principles and Guidelines)

3. Werner Heisenberg. Physics & Philosophy

4. Michael E. Gerber (2001). The E-Myth Revisited, Harper Collins, NY, page 234.

5. Berwick D.M. (1998). Taking Action to improve safety. How to increase the odds of success. Keynote address provided to the 1998 Anaheim Conference, California.

6. Safety & Quality Council First National Report on Patient Safety. Volume 1, Australian Council for Safety and Quality in Health Care, (2001). P22.

Disclaimer: This article is not comprehensive and does not constitute legal advice. You should seek legal or other professional advice before relying on any content, and practice proper clinical decision making with regard to the individual circumstances. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published.

12 | Issue 2 – 2014

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13 | Issue 2 – 2014

To �nd out more, call 1800 128 268 or visit avant.org.au/practices

Is the practice you manage at risk?Your practice could be at risk if you don’t have an Avant Practice Medical Indemnity Policy, protected by Australia’s leading Medical Defence Organisation with the largest specialist medico-legal team.

A practice policy with Avant means you can rest assured that the practice, partners, directors, and employees are all covered against claims, including cover for privacy breaches and errors made by staff.

Avant’s Practice Medical Indemnity Policy now also includes improved policy features such as Employee disputes cover,

statutory liability cover and Optional Avant Public Liability Insurance to cover your practice against personal injury or property damage claims.

Being a mutual, everything Avant does is for your benefit. As an Avant member, you have direct access to our claims managers and dedicated corporate underwriting team, who are specialists in Practice Medical Insurance.

So don’t leave your practice exposed to medico-legal risks.

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IMPORTANT: The Practice Medical Indemnity Policy is issued by Avant Insurance Limited, ABN 82 003 707 471, AFSL 238 765. This policy is available at avant.org.au or by contacting us on 1800 128 268. Practices need to consider other forms of insurance including director’s and officer’s liability, public and products liability, property and business interruption insurance, and workers compensation. 2732/04-14

Cecily IgglesdenPractice Manager

J2186 AAPM Ad v4.indd 1 17/04/14 4:26 PM

14 | Issue 2 – 2014


Managers are aware that it is critical for organisations not only to manage their employees in an efficient manner, but for them to be able to communicate the company strategy to the workforce and ensure they execute that in an effective manner.

An essential component is the use of the employee performance management (EPM) process to ensure that they get the most out of their employees and consequently the organisation achieves its goals.

While most people have a negative perception of the value of EPM, based on the view that it is a “once a year process” rather than a continuous cycle, this article suggests that through the use of some relatively simple and pragmatic techniques you can add value to the organisation and the individual as part of a continuous EPM model.

Performance managementThe history of performance management is one that is relatively new, and often misunderstood. At the outset we need to understand that the performance appraisal properly describes a process of judging past performance and not measuring that performance against clear and agreed objectives. Performance management shifts the focus away from just an annual event to an ongoing process.

In planning, implementing and maintaining your performance management processes the most important facet is the promotion of it as a continuous or ongoing activity between the manager and the employee, not some annual process to be scheduled and avoided.

The leaders of the business, including managers, should set the expectation that all performance-related activities and conversations lead to the annual appraisal, not from it.

As a continuous and ongoing activity managers can truly measure employee performance and enhance the productivity of the individual and the team, through:• Linking the individual employee

objectives to the businesses operating and aspirational strategies;

• Providing the individual with a clear concept on how they contribute to the achievement of the overall business objective,

• Highlighting and articulating the importance of employee development, whether that be skills or knowledge based;

• Aligning individual periodic tasks to employee objectives or goals and making them accountable for achieving them;

• Developing and implementing clear and concise performance expectations that can be measured objectively;

• Conducting regular discussions throughout the performance cycle, which include things such as coaching, mentoring, feedback and assessment;

• Documenting evidence of individual performance;

• Adopting an employee reward system that involves recognition, motivation and remuneration, rather than relying upon money as the sole motivator.

For small- to medium-sized businesses there needs to be a performance management cycle consisting of the following important stages in staff performance management

• Performance planning – this is a process that ensures that, right from the very beginning, your employee has a clear understanding of the scope of their job and that you have explained what is expected of them. It also includes a process that ensures they have received proper training necessary for using systems or complying with procedures associated with performance of the duties in their job. It is a critical stage often neglected.

• Performance monitoring involves the supervision phase to monitor the progress and performance of the employee, to ensure that they are undertaking their duties as intended. It involves monitoring and occasionally observing, yet without being neither intrusive nor seen as too distrusting. With a new employee we will need to be checking on the quality and timeliness of their work more frequently than a more experienced staff member, who has already demonstrated competence in their performance.

• Mentoring and feedback on performance – provides the employee with recognition of good work and demonstrates that their efforts are being noticed. This is the time in which it may be necessary to provide constructive feedback where job requirements are not quite being met. This might be a reminder that they need to take care with a particular procedure, or a reminder about what time they need to be back from lunch, or a reminder to take more care when filling out a form. We need this feature to ensure that we enable the employee to learn from mistakes, and avoid the behaviour in the future.

• The formal performance review is the final stage of our cycle undertaken at agreed intervals to discuss their performance – what’s been going well and

Employee performance management

Core principles: Human resource management, Governance and organisational dynamics

by David Wenban,

Principal – HF Legal Services Pty Ltd

Managing Director – Health Financial Pty Ltd

Managing Director – Salary Options Pty Ltd

Tel: (03) 9280 8061

15 | Issue 2 – 2014

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whether there may be areas that could be improved. The review is documented and focuses upon the individual’s performance in respect of each of their key responsibilities and identifies whether these have been performed to a competent or acceptable standard. The annual review can also include a conversation about the employee’s longer-term career development aspirations, and how these may be beneficial both to the individual and the business.

Whilst the most recent research suggests that both managers and employees generally perceive annual staff reviews alone as a difficult and painful process the benefits of a continuous n EPM include: • Communication improves as the employee and

manager communicate more frequently and agrees on changed objectives to suit continuing changes in conditions and priorities. It becomes an inclusive and collaborative process, where the employee works towards specific objectives that are relevant.

• Everyone knows the rules – the EPM provides a process where the manager and the employee can have a level of confidence that the “rules” of the process clearly stipulate what is being assessed and how. Employees are assessed on achievement of objectives that have been clearly identified and agreed to. Managers have a better framework to assess an employee’s performance, as they are familiar with the criteria to assess the employee. The outcome is that both individuals have an informed discussion and focus on achievement of both personal and business objectives, not on issues that are irrelevant.

• Frequent communication reduces stress – the process allows the discussion to focus on performance of objectives rather than being dominated by the employee’s needs. The needs of the business

are discussed more frequently to achieve specific performance outcomes. This means both the employee and manager communicate more effectively and achieve better outcomes. Emotionally charged discussions tend to be displaced by business-focused discussions on achievement of objective outcomes.

• Appraisals become relevant for everyone – the discussions and objectives can be varied or modified to suit changing business conditions. This dramatically increases the probability that the objectives are relevant and are able to be acted upon during the performance period.

• Employee learning and development starts to happen – because the EPM process requires managers and employees commit to a development plan, employees experience real personal development and become more engaged with the organisation. The organisation is developing the employee and the employee is working towards developing the organisation by achieving its goals.

• The majority of performance management systems are able to provide graphical compliance reports. Therefore, the setting of objectives and development plans for employees can no longer be ignored. Employees see real planning, are involved in setting meaningful objectives and have input into personal development plans, which benefit both themselves and the organisation. In all, this results in an engaged workforce committed to achieving real outcomes for the organisation.

AHIG provides comprehensive training for members on the performance management process, should you wish to inquire about this, contact our training staff on (03) 9280 8063.

16 | Issue 2 – 2014

Sponsored by prominent medical defence organisation Avant, the AAPM scholarships aim to foster and promote continuing training and professional development for practice managers.

This year’s winners are:

• Cecily Igglesden from Prospect Medical Centre in Launceston, Tasmania

• Tania Luttrell from Longford Medical Centre, a large rural practice south of Launceston, Tasmania

• Jane Wiggins from Randwick Specialists, a large paediatric medical centre in Randwick, NSW

• Nikki Broad from Gastrointestinal Associates, a specialist practice in Spring Hill, Qld

• Fabiola Bran from Inala Primary Care, a not-for-profit general practice in Inala, Qld

• Rachael Hadlow from Third Avenue Surgery, a large general practice in Mount Lawley, WA.

Cecily IgglesdenCecily, who has worked at the Prospect Medical Centre for the past 13 years, received the scholarship to study for a Diploma in Professional Practice Management at the University of New England.

She said she felt incredibly lucky to receive the scholarship to help improve her knowledge and skills to become a more effective practice manager.

Tania LuttrellTania received the scholarship for a Diploma Bridging Program in Professional Practice Management at the University of New England, which will allow her to build on the knowledge she gained after finishing a Certificate IV in Professional Practice Management and a Diploma in Management in 2011.

She applied for the scholarship on the encouragement of Kath Hinde, a practice management consultant for Health Recruitment PLUS.

Jane WigginsJane, who started working at Randwick Specialists when the practice opened last January, received the scholarship for a Diploma Bridging Program in Professional Practice Management at the University of New England.

Jane’s mentor, Fiona Kolokas, AAPM NSW vice-president and director and management consultant at Synergize, urged her to apply for the scholarship after employing her at Randwick Specialists.

Nikki BroadNikki, who recently completed a Bachelor of Nutrition and Dietetics and has been working at Gastrointestinal Associates for the past 16 months, received the scholarship for a Diploma in Professional Practice Management at the University of New England.

She said she was elated to win the AAPM scholarship after being encouraged to apply by her mentor, Jenny Roberts, practice manager at Gastrointestinal Associates.

Fabiola BranFabiola received the scholarship for a Certificate IV in Professional Practice Management at the University of New England.

She currently works as a clinical support officer at Inala Primary Care which cares for mental health, chronic disease and refugee patients, and intends to use the Certificate IV in her new role as a practice manager at the surgery’s new site.

Rachael HadlowRachael received the scholarship for a Certificate IV in Professional Practice Management at the University of New England.

She said she is looking forward to gaining a theoretical basis to back up her existing experience as a practice manager at Third Avenue Surgery, where she has worked for 12 years, starting out as a receptionist.

AAPM/Avant scholarship winners announced


17 | Issue 2 – 2014

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18 | Issue 2 – 2014


I have been the practice manager at Mount

Beauty and Falls Creek Medical Centre

for nearly 30 years. During that time the

practice has expanded from three GPs and

three receptionists to seven GPs, an intern,

a full-time student, 10 receptionists, four

nurses, two specialists and four allied health

providers. We run our own “super clinic”

in the rural town of Mount Beauty, with

the closest regional hospital located over

an hour’s drive away. Managing the Falls

Creek Trauma Centre usually knee deep in

snow over winter where multiple trauma,

emergency air evacuations by helicopter,

home and lodge visits by skidoo are all

common events brings its own challenges.

I have seen general practice change from

manual Kalamazoo accounting systems and A5

card medical histories to our current practice

which is fully computerised with access

to personally controlled electronic health

records, electronic prescribing and telehealth

consultations all through a cloud environment

ensuring that the latest technology is available to

our doctors, nurses, staff and patients.

I “dabbled ” a few years as the part-time

executive assistance to the executive director

as he set up the North East Victorian Division

of General Practice which was also located in

Mount Beauty. In those days it was great to

drive around meeting all the practices in the

area, getting to know the doctors and staff and

gaining valuable friendships and great support

systems that are still strong today.

In 2006 when the practice manager at the

neighbouring town of Myrtleford unexpectantly

resigned, I filled a part-time practice manager

role at Standish Street Clinic (along with our two

practices) until a suitable full-time manager was

found. I spent five years at this clinic and I am

sure that the benefits I received from working

with a different group of health providers and

staff helped me gain better knowledge and

understanding of what communities want, need

and value in a medical service.

I am a keen advocate for further education and training and started my journey through AAPM and the University of New England, completing the Certificate in Practice Management in 1996 and Diploma in Practice Management in 1998. I also completed a certificate in health economics with Monash University in 1998 and this certificate formed a good basis for understanding the financial side of managing a small business. I was awarded the AAPM Certified Practice Manager in January 2002.

Being a member of AAPM for nearly 20 years, I have attended most of the AAPM national conferences, many of the AAPM e-seminars and enjoy receiving the newsletters and the more recent AAPM money matters document. The information that is available to AAPM members through these programs as well as the AAPM website certainly keeps me abreast of what’s happening, how it will affect my practice and assistance in dealing with the never ending changes to general practice.

I was privileged to have been nominated by my GP partners for the 2013 AAPM Victorian practice manager of the year and being runner up was just an absolute thrill and honour for me. The practice went on to nominate me for the 2013 Practice Management Award for Excellence in Chronic Disease Management, and being presented with this award at the AAPM national conference in Sydney was again an absolute thrill particularly in front of so many of my peers.

I am very lucky to have two very approachable and supportive GP owners, Dr Mark Zagorski and Dr Jeff Robinson. They are both visionaries who are always keen to look at new ways of doing things, willing to try new methods and systems and totally supportive to all our staff. Our intern and medical students and their thirst for knowledge keep us all on our toes and they have become an integral part of our team.

In October 2011, I wrote an artlcle for the local Division called “A day in the life of a practice manager – we are being ‘paperised’” which

AAPM’s newest Fellow describes her journey

Core principles: Human resource management, Professional responsibility

by Pat Ryder, CPM FAAPM,

Practice Manager

Mount Beauty & Falls Creek Medical Centre

19 | Issue 2 – 2014

resulted from a practice managers meeting where discussion centred on the amount of paperwork that comes across our desk every day. The volume of forms, documents, applications, attendances , rules and regulations, reports, entitlements and emails to name a few is still relevant in 2014 and requires knowledge and capacity to deal with the ever-changing and complex role of the practice manager .

I am a great believer in providing and participating in regular professional development and using a variety of methods and opportunities. Being located in a rural area we all rely heavily on access to online training. Our staff have participated in e-seminars with General Practice Australia, Australian Practice Nurse Association, AAPM as well as linking in with training opportunities provided by the local hospital.

Our practice has provided in-house training sessions, including stress management and handling not only difficult customers but dealing with issues arising from working in a small environment alongside diverse staff. We have had the local physiotherapist analyse the posture of staff sitting at their computers, including the doctors in the consult rooms. We have regular staff social events that allow us the opportunity to become friends as well as work colleagues. I know that to keep good staff, they need to feel appreciated and feel confident about contributing to the efficient running of the business.

The local Medicare Local provides practice managers with other learning opportunities and the benefits that we get from the discussion after the formal presentations are quite just as

useful as the presentations. The practices involved are similar in that they are usually located in small rural towns and as we are all trying to deal with ongoing changes in rural practice, we have the opportunity to discuss how we are dealing with these issues. We visit each others practices and I can honestly say that I have never left a practice without picking up or learning something useful.

I had been considering applying for the AAPM Fellowship for a few years. Once I received the two awards last year, I thought it was time to stop procrastinating and submit my application. A telephone interview with Colleen Sullivan finalised the application and her nomination to the Board of AAPM completed the process. I was honoured to be awarded my AAPM Fellowship because it is judged by my peers on my knowledge, education and capabilities as a practice manager. Being accepted by one’s peers must rate high on everyone’s list.

When I informed my GP partners that I had achieved my Fellowship, they were extremely proud and even suggested a pay rise – something I couldn’t knock back.

So if you are considering what to do with your spare time and want something that will give you the opportunity to gain standing with your GPs and peers, consider the AAPM Fellowship pathway. I have proved that you can teach an old dog new tricks. Thanks to AAPM for all their support and assistance throughout the years and I look forward to more involvement over the years to come.

Workshops open for enrolment in:Sydney • Brisbane • Canberra • Melbourne • Adelaide

Call to discuss funding & study options1800 066 128 • www.practicemanagement.edu.au

AAPM MagazineSize: 200mm x 140mmDeadline: 15/4/13

• CertificateIIIinBusinessAdministration(Medical)

• CertificateIVinProfessionalPracticeManagement

• Diploma of Professional Practice Management

• Distance programs also available

The Education & Training Company of the University of New England

skills for your practicediscover

Australian Association of Practice Managers Ltdexcellence in healthcare management

20 | Issue 2 – 2014


The Diploma of Professional Practice Management (9143NSW) is a fantastic way to formalise your skills in managing a practice and now it can lead you to further professional development with the introduction of the UNE Partnerships and the University of New England’s Graduate School of Business (GSB) to bridge the gap between vocational education programs at diploma and advanced diploma level and postgraduate study programs in the university sector.

The Executive Development Pathway is a short course that, combined with a Diploma, will articulate entry into UNE’s graduate program.

This unique pathway gives recognition to students who have completed an approved management qualification at diploma or advanced diploma level from the vocational education sector allowing successful candidates to gain credit into the postgraduate program of the graduate school of business at the University of New England.

The Executive Development Pathway is a 20 week “assessment only” pathway designed to augment the skills and knowledge gained from the relevant vocational award and develop critical thinking skills to support study at postgraduate level.

Pathways are available in our Business, Facilities, Practice and Project Management programs and are open to applicants holding a diploma or advanced diploma qualification in a management field issued by UNE Partnerships or another registered training organisation.

The aim of this course is for participants to demonstrate an advanced understanding of theoretical concepts, and to critically

evaluate these in relation to practices in their organisations. This evaluation may identify gaps between current practice and what the participant may consider is best practice for their organisational context. Determining best practice will come from broad reading, research and analysis.

Students who enter the executive development program with an eligible diploma qualification and successfully complete the assessment requirements may apply for one unit of credit upon enrolment into the MBA program at the University of New England. Students holding an Advanced Diploma qualification who successfully complete the program may apply for two units of credit upon enrolment into the MBA program at the University of New England.

Further information about this program can be obtained by contacting UNE Partnerships on 1800 288 622 or by visiting our website at www.unep.edu.au/executive-development-program/.

Practice management – A pathway to successA Diploma of Professional Practice Management could be your pathway to an MBA

by course advisors Linda George and Margaret Kirby

UNE Partnerships Pty Ltd

T: 1800 288 622E: [email protected]: www.practicemanagement.edu.au


Core principles: Human resource management, Professional responsibility

UNE Partnerships Pty Ltd

T: 1800 288 622E: [email protected]: www.practicemanagement.edu.au

Linda George

Margaret Kirby

21 | Issue 2 – 201421 | Issue 2 – 2014

22 | Issue 2 – 2014


With the proliferation of the term “virtual” in our media and in technology, have you ever wondered what “virtual” means? One of the best definitions I have come across is from webopedia:

“virtual - Not real. The term virtual is popular among computer scientists and is used in a wide variety of situations. In general, it distinguishes something that is merely conceptual from something that has physical reality. For example, virtual memory refers to an imaginary set of locations, or addresses, where you can store data. It is imaginary in the sense that the memory area is not the same as the real physical memory composed of transistors. The difference is a bit like the difference between an architect’s plans for a house and the actual house. A computer scientist might call the plans a virtual house. Another analogy is the difference between the brain and the mind. The mind is a virtual brain. It exists conceptually, but the actual physical matter is the brain. The opposite of virtual is real, absolute, or physical.”1

In IT terminology then, “virtualization” is the creation of a “virtual” rather than the real physical or actual version of a device or resource, such as a server, storage device, network or an operating system.2 (See other definitions of virtual, i.e., “not physically existing but made to appear by software”. 3-5)

A similar concept familiar to most PC users is dividing the storage capacity of a physical hard disk drive (HDD) into different logical partitions or drives such as C:\, D:\, etc. This “logical” division of data storage capacity on a physical HDD creates, in effect, multiple separate “logical” hard drives.

History of virtualizationComputer virtualization started in the early 1960s by IBM in research that was part of IBM’s revolutionary CP[-67]/CMS – a virtual machine/virtual memory time-sharing Operating System (OS) for the IBM System/360 Model 67 mainframe computers, and the parent of IBM’s VM (Virtual Machine) family.4 In the late 1990s a start-up company called VMware Inc. introduced VMware Virtual Platform for the INTEL x86 processor

families and virtualization technology became more affordable for smaller organisations. Prior to VMware virtualization technology was too expensive and cumbersome for PC-based applications.

Many aspects of computing have been virtualized:

Software: e.g., Operating System (both Server and Desktop), Application, etc.

Data: Separating applications and data from hard-coded retrieval instructions, physical data locations, etc.

Hardware: Memory (RAM), storage, or complete computer system or platform, hence “virtual machine” or VM, etc.

Backup: A “snapshot” is taken at a point in time of a VM and this snapshot is a complete copy of the VM which is stored for later retrieval in case of failure, data loss, corruption, etc.

Network: Virtualized networks within or across physical networks, e.g., VLAN, also virtual private network (VPN).

TerminologyHere are some more basic terms to learn:

Host: The physical machine which “hosts” the virtual machines (VM)

Guest: The virtual machine on a “host”

Hypervisor: The core virtualization software that separates the physical hardware from the OS

Virtual Machine (VM): A self-contained operating environment independent of a HOST operating system

For this article we shall concentrate on Operating System (OS) virtualization. OS virtualization is the use of software to allow a physical hardware system (i.e., a server or PC) to run multiple OS images at the same time. These multiple OS images are also called Virtual Machines as in the figure below described conceptually:

Basics of IT virtualization Core principle: Information management

Miroslav Doncevic is managing director of Digital Medical Systems, a company which has been providing ITC solutions and support to medical practice in Australia since 1990.

Figure 1 - Non Virtual Machine and VM Configurations5

23 | Issue 2 – 2014

Virtual vs dedicated serversWith every choice we make it seems that there advantages and disadvantages between the options. Here is a summary of the most common pros and cons:

Some Benefits of Virtualisation (Pros):

Some Downsides (Cons)

1) Maximize efficient utilization of server physical resource capacity, e.g., CPU, RAM, disk, etc.

1) If the HOST fails, all the GUEST VMs are shut down as well (a single point of failure.2) Greatly reduce costs by

reducing number of physical servers, also reducing electricity costs, space requirements, etc.

3) Multiple operating systems can be run on one physical machine CPU, RAM, disk, etc.

2) Some reduced performance, especially on low spec. /older technology servers. Low spec. server CPUs may not support hardware virtualization.

4) Ability to separate applications to improve performance as well as isolate from individual application crash or freezing affecting other applications

5) Improved disaster recovery (DR) capability due to portability

3) Additional layer of complexity to manage/maintain/learn.

6) Faster DR recovery (it is quicker to reboot VM image than physical server)

7) Increase availability (uptime) to high availability (HA) by improved monitoring, management and troubleshooting and automatic failover capability

4) Cost of licensing can be significant, e.g., if you require HA.

8) Extend the life of older “legacy” applications (e.g., running older 32-bit applications inside a virtual 3-bit OS hosted on a 64-bit OS)

9) Portability across servers /storage devices giving independence from specific server hardware

5) Security can be a concern with some products needing more attention.

10) Independent or non-critical test environments reducing possible downtime or corruption

The main vendors: VMware and MicrosoftFor sheer number of installations and practical purposes there are two mainstream virtualization software vendors used in most small business computing or primary healthcare IT installations today: VMware with a suite of products branded as vSphere /ESX and Microsoft with Windows Hyper-V.

Differences between VMware and Windows Hyper-V.When comparing VMware with Windows Hyper-V virtualization solutions it is important to note that from a user’s experience point of view they are practically the same. The choice will most likely be the product your IT professional is most comfortable with for your installation.

The main difference between the rival products is in the virtual platform, the type of virtualization architecture they use to access the hardware. VMware uses “Monolithic Hypervisor Design” whereas Microsoft’s Windows Hyper-V uses “Microkernelized Hypervisor Design”.

VMware’s vSphere Monolithic Hypervisor Design, requires the hypervisor-aware device drivers to be hosted in and managed by the “Hypervisor Layer”. This means that VMware vSphere will run not on hardware that is unsupported. Microsoft’s Hyper-V design does not require the device drivers to be part of the Hypervisor layer — the device drivers operate independently and run in the “controlling layer”.

VMware is well suited for medium-to-large companies where efficiency and high availability (up time) is critical. On the other hand, Windows Hyper-V can be less expensive when it comes to licensing, making it more suitable for small-to-medium companies.

Windows Hyper-V also integrates seamlessly with many Windows products. For example, this hypervisor is an integral part of the new Windows 8 and Windows Server 2012 operating systems. With that integration come familiar interfaces and features that dramatically simplify the process of virtualizing Microsoft workloads and managing Windows-based virtual environments.6

As new versions of VMware and Windows Hyper-V are created, the differences between them will likely narrow, driving down any price and feature differences and thereby making the user the ultimate winner. Space does not allow us to explore the technical details including the pros and cons here. Readers who are interested in the details can start with these sites.7,8

ConclusionVirtualization technology has significantly changed for the better the way computing is delivered even for the small-to-medium sized primary healthcare IT installation with the pros outweighing the cons. Whilst the details can seem to be daunting, don’t be put off by the techno jargon. Find a skilled virtualization IT professional for the next time you are planning an IT upgrade or a new server.

References1. http://www.webopedia.com/TERM/V/virtual.html, accessed April 20142. http://en.wikipedia.org/wiki/Virtualisation, accessed April 20143. http://en.wiktionary.org/wiki/virtual, accessed April 2014 “In

effect or essence, if not in fact or reality; imitated, simulated.”4. http://www.serverwatch.com/server-tutorials/microsoft-

hyper-v-and-vmware-vsphere-architectures-advantages-and-disadvantages.html, accessed April 2014

5. https://software.intel.com/en-us/articles/the-advantages-of-using-virtualization-technology-in-the-enterprise

6. http://www.microsoft.com/en-au/search/results.aspx?q=Hyper-V, http://www.microsoft.com/en-au/search/results.aspx?q=Hyper-V, accessed April 2014.

7. http://www.serverwatch.com/server-tutorials/microsoft-hyper-v-and-vmware-vsphere-architectures-advantages-and-disadvantages.html, accessed 2014.

8. http://www.storagecraft.com/blog/virtualization-wars-vmware-vs-hyper-v-which-is-right-for-your-virtual-environment/, accessed April 2014.

24 | Issue 2 – 2014

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25 | Issue 2 – 2014

26 | Issue 2 – 2014


There is a local (NZ) saying that “You can’t beat Wellington on a good day”. On this occasion it needs rephrasing to “…on a good couple of days”. Despite the southerly storm that hit Wellington (and NZ in general) just days before our event, the city put on its glad rags for our visitors. The sun shone and the harbour sparkled. Hopefully many of you who attended from around NZ, and from Australia, had the opportunity to see some of our beautiful home. There was certainly talk of shops being visited, Lord of the Rings tours booked, and watering holes and eateries sampled.

We had 180 registrations, of which 24 were Australians. We welcomed people from as far afield as Perth and the Northern Territory, as well as from all parts of NZ. It was so great you all made the effort to attend. There were new friendships formed, existing ones deepened, and the benefits from the knowledge and experience we shared over the two days will continue with us well into the future.

The event attracted a range of high-quality presenters. Opening speaker for the symposium was Cathy O’Malley (Deputy Director General, Sector Capability and Implementation, Ministry of Health) who shared with us her career pathway from practice manager to public servant, and how the lessons she learnt in her childhood and early roles have just as much impact in her current role.

Clive Lind, Editorial Development Manager of Fairfax Media NZ, advised us to be proactive in building relationships with our local media and to see it as expanding our relationship with our community. He also counselled that nothing is truly “off the record”, and to be prepared by asking, where possible, for the questions ahead of the interview so that we can formulate specific and succinct responses. If there is something factually incorrect in the article, we do have the right to a correction or retraction, but there is no right to review the article before it is published. He also advised that those of us with practice websites have a source of unfiltered journalism

at our fingertips – use the website to get our messages out to patients.

A series of workshops were well attended during Day One, and these covered security and fraud, marketing, performance

appraisals, innovation in nurse-led clinics, management accounting, and the capitation environment.

Gary Smith, one of our Australian attendees, shared his knowledge and experience on clinical governance and many agreed we needed longer with him. His sense of humour and generosity was appreciated.

Local GP, and self-confessed IT fan, Dr Richard Medlicott took us through the IT tools used in his Wellington practice. Data backups should be done regularly throughout the day, and on a variety of media (eg, onto a portable device, to a remote storage, and even to the cloud), and one of our best tools is to ensure we know our PMS systems well so that we maximise their usefulness. Patient portals can provide flexibility for patients who do not need to be seen, and can save time on some administrative tasks, such as updating contact details, but this comes with the awareness that they will not be suitable for, or embraced by, everyone.

Iris Reuvecamp, from medical legal specialist firm Claro Law, provided valuable and down-to-earth updates on some of the latest cases to cause concern. Areas highlighted for our attention and monitoring included the process of reviewing medications when a patient joins our practice, monitoring the competency of our clinicians, and the importance of documenting concerns and actions taken. The area of vicarious liability was discussed. Practices are responsible for the actions of others. For example, a patient is not notified of test results by a locum. Can we show that the locum was orientated fully? Do we have a test results policy? Where was the clinical handover and follow up when the GP returned and the locum left? If we can’t show this via documentation, there is increased risk that the practicecan be held vicariously liable.

PMAANZ/AAPM education symposium, March 2014, Wellington

by Wendy Slight

Practice Manager, Newlands Medical Centre

E: [email protected]

27 | Issue 2 – 2014

Day One’s last session was a masterclass on Resilience. Gaynor Parkin, a psychologist from Umbrella Health and Resilience, provided insight and advice on how to improve our ability to “bounce back” from stressful situations. Improving our physical wellbeing, generating positive emotions, practicing optimistic thinking, regular meditation, and mindfulness are all tools that can increase our recovery. Gaynor led us a through a brief mindfulness exercise and the energy levels in the room were noticeably different afterwards.

The Mix and Mingle function was well attended, and provided a relaxed opportunity for attendees to interact with each other and the exhibitors.

Day Two saw many administrators join the event. While managers separated off to take part in the forum upstairs, topics on the main program included a masterclass on customer service from Nikki Hommes of Potential Unleashed, Triage on Trial – what non-clinical staff need to be aware of, an introduction to the Foundation Standards by the CEO of the RNZCGPs, Helen Morgan-Banda; and workshops on staff supervision, debt management, and patient register maintenance. Their day rounded off with eye-opening facts on security and fraud, and an introduction into the newly-introduced PMAANZ Knowledge and Skills Framework that has been designed to identify a career pathway into, and through different levels of, practice management.

The managers’ Saturday morning forum was well attended and we benefited from hearing how funding, e-health, and quality are managed on both sides of the Tasman. There are challenging times ahead for both sides – in NZ it is an election year, while in Australia there is a federal budget looming that is expected to signal changes in how health services are funded. Following morning tea, we were treated to a masterclass on leadership with Marion McKay. It was an interactive, fun, and profound session. There may be a lot of managers conducting their teams from atop chairs following this session (but we won’t be playing their instruments for them!). There were too many lessons to mention, and we certainly could have done with longer with Marion.

An event like this one doesn’t happen without the input of many people. The practicalities of the event ran as smoothly as Wellington Harbour looked – all due to the care and attention paid by the functions team at the James Cook Hotel Grand Chancellor, the

AV support from Vidcom, the display and signage support from Displayworks, and a band of local Wellington managers and administrators who helped on the registration desk and chairing sessions. Overseeing all of this in her unflappable and professional way was Anna from Conference Innovators. Convening the event was so very much easier due to their efforts.

The sponsors and exhibitors merit acknowledgment and our thanks. William Buck Christmas Gouwland, Ebos, Bug Control, Deaf Aotearoa, New Zealand Office Supplies, and Umbrella Health were generous with their support. If you get the opportunity to consider taking business their way, please do so.

To the PMAANZ Executive and the AAPM members present, thank you for your help during the symposium and for your advice and counsel throughout the planning of the project. It was a great inaugural event.

To close, a few of my highlights/learnings:• meeting many new people gathered together with a

common purpose – the energy around the venue was incredible, and you were all so generous with your feedback;

• being personally challenged by both Gaynor and Marion’s sessions – lots of learning to continue with;

• the reaffirmation that we are surrounded by supportive colleagues who are only too happy to share their knowledge and experience if we only just ask;

• the personal growth that this project has given me – I can appreciate it now;

• the lesson that you really need to book if you want to go out with 12 people for dinner in Wellington on a Friday night when there is a rugby match in town (would have saved a lot of shoe leather!) – and yes, the Australian side won the rugby match!

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28 | Issue 2 – 2014


I have been reflecting on the importance

of leadership in our daily work as practice

managers. Some of us have large teams and

locations, others small. There’s specialist,

dental, general, allied, hospital based, some

are family based, others corporate. No

matter what your “type”, you are in a role

that requires leadership – and that means

work. But what sort of work? Where should

we be channelling our energy to maximise

the few moments each day that we have to

concentrate on being a great leader in our

organisations?

A number of years ago I participated in the

Governor’s Leadership Foundation Program and

one of the final speakers for that program read

a quote from Dr Lance Secretan (a recipient

of the 1999 International Caring Award, and

designated as a Top5 Speaker in Leadership)

and it resonated so much with me that I keep

this quote pinned next to my desk. It talks to me

about leadership being an art form rather than a

science.

Leadership and the Practice ManagerThis article was first published in the AAPM South Australia newsletter. Thanks to Jill for permission to use it here.

Core principle: Human resource management

by Jill Coombe,

AAPM Committee SA

“Leadership is not so much about technique and methods as it is

about opening the heart. Leadership is about inspiration – of oneself and of others. Great leadership

is about human experiences, not processes. Leadership is not a

formula or a program, it is a human activity that comes from the heart

and considers the hearts of others. It is an attitude, not a routine.

More than anything else today, followers believe that they are part of a system, a process that lacks

heart. If there is one thing a leader can do to connect with followers

at a human, or better still a spiritual level, it is to become engaged with

them fully, to share experiences and emotions, and to set aside the processes of leadership that

we have learned by rote”.

29 | Issue 2 – 2014

All too often we seek a book, a training session, a check

box or list that will tell us what to do when we are looking for

an answer or resolution to a leadership quandary. There’s a

plethora of information available in bookshops, online and,

indeed, probably on our own resource shelves, to help us

through the theory of leadership. I have several that I regularly

refer to, to remind me of best practice, latest trends and

contemporary methods.

These usually help me to identify the “standard line” that I

could take with a problem, the variety of ways that I could

deal with a conflict, an unresolved issue, or direction to take

to risk manage or develop a concept. Most often though,

these mainstream resources give me the black and white on

a topic, when really what I should be looking for is the texts

that introduce me to the colour – the colour of leadership and

the rich and rewarding world of leadership from the heart.

One text I do have that does this for me is The Power of Full

Engagement: Managing Energy, Not Time Is the Key to High

Performance and Personal Renewal by Jim Loehr and Tony

Schwartz.

When I recently interviewed AAPM SA committee member

Trudi Jones for a profile in this newsletter, she responded

that she is involved in skydiving out of hours to help with her

work/life balance.

I couldn’t help but be inspired by her courage, firstly to be

involved in this type of hair-raising activity (well it would be for

me, big time extreme sport wimp!) and secondly that she has

committed to leaving work at a reasonable hour this year.

The hours that we have in every day are a valued resource

and using your hours wisely is important for each of us to

be able to have a rewarding and enjoyable life. Both of these

undertakings take energy and require commitment.

The quote from Dr Secretan talks about human experiences,

not processes. For both sky diving and getting away at the

end of the day, Trudi will have that human experience and

example. Yes, it is a process too, but her experience is what she will feel. The process is just going about doing it.

In the Power of Full Engagement energy is identified as the most valued resource and this resource is a gift to yourself. I see this text as a great reference point for my role as a leader as it gives me permission to look at self, sort out how well equipped I am on a daily basis to perform my role as a leader and then helps me identify what I need to work on to Improve and maximise my leadership skills – things like managing my impatience, developing my listening skills, carefully balancing my positive and negative emotions and exercising humility.

Now you may be reading this wondering why I would bother to include such esoteric ideas rather than cold hard facts about being a leader. Well that’s the point. The cold hard facts are usually easily found and easily applied – do this, don’t do that, issue that piece of paper, apply that rule, instigate that policy or employ that person.

It’s the inspiration, human experience and heart that make for great leadership. Sure, issue the piece of paper, but as a leader, understand its impact, appreciate its importance, listening to the feedback from those it affects and take the time to engage with the recipient. These are the things that surpass your role as manager and allow others to see you in the role of leader.

A guy by the name of Joseph Fort Newton (American Baptist Minister in late 19th century) said

“We cannot tell what may happen to us in the strange medley of life. But we can decide what happens in us, how we take it, what we do with it – and that is what really counts in the end.”

Add this attitude to the many opportunities that we have to educate ourselves in leadership and management and we are in the business of producing great leaders and managers for the future. Take those opportunities, spend time with people who have energy and make it your goal to be a leader who inspires!

30 | Issue 2 – 2014

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31 | Issue 2 – 2014

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The Practice Manager Issue 2 2014