Member Spotlight: Tips to overcoming staffing uncertainty

This Member Spotlight episode of the podcast features Veronica Villarreal, MHA/MBA, chief ambulatory officer at DHR Health. DHR oversees 75 multi-specialty clinics in Texas’ Rio Grande Valley and Villarreal is responsible for 1,200 employees that work alongside 200 providers.

Editor's note: The following Q&A has been edited for length and clarity. 

Q: What does a day in the life look like?

A: Our health system started as an ambulatory surgery center, and it just grew. It's physician owned, so it's not a corporate health system. So all decision makers are in the valley and from the community. … And I'm proud to always say that I'm homegrown here - I started as an intern in 2013 and just moved my way up fairly quickly. …

Why I call myself a mini-CEO, is I'm responsible for our own HR team, I have our own compliance team, our own education team, different support systems, our own professional billing – (they) really all report to me because we are very different from the hospital. Our workforce is not primarily nursing, its primarily medical assistants, frontline staff, and physicians and mid-level providers. So day-to-day, I pretty much meet with my core team - which are my clinic directors - then I have operations meetings, and then I have support meetings, and little fires in between.

Q: You are a certified medical coder, certified medical office manager, certified medical insurance specialist, and a certified Maxwell leadership coach - why is lifelong learning so important to you?

A: That is my passion because I feel like if I don't understand something, how can I help others? So I really have a collaborative approach where I know I don't know it all. … So that's my passion is really to be able to keep serving others. And if I am not keeping up to date with new trends, new generational needs, how to be able to look at different innovation techniques or projects or ‘who is doing this, how can we implement this to be more efficient than that?’. I don't think I'd feel like I would be benefiting my team and leading them because I would not bring be bringing any value to them if I don't keep learning.
 
Q: You are leading a session at MGMA's Medical Practice Excellence: Financial and Operations Conference Monday, March 20, in Orlando. The session is titled Living in and Overcoming Staffing Uncertainty. Give us some main points.

A: I would actually love for peers or colleagues that are dealing with the same issues from an ambulatory clinic setting to come to my session, and just hear the things that we've done to be able to keep our doors open. I’ll be talking about pay scales - how to be competitive in that by data analytics. I'll be talking about retention and different tools that we've been able to implement. I'll be talking about surveys and how we implemented more, even though there's now a survey fatigue, we're still not there yet thankfully.
 
I'll be giving out some handouts on what we noticed in our workforce is that we were having people leave (within) 90 days on the job. … So we implemented 7-, 45-, and 90-day surveys. So people are scared to speak up when they feel like they should know the job. But did we actually give them the tools to know the job? … I will also be talking about a virtual workforce. 
 
Q: What are some of the KPIs you look at in regards to staffing?

A: When I first started, we had this, ‘every specialty, every doctor gets X amount of staff’. That's not reality. Some providers work like they’re three providers. We have some providers that work like they're two. And then we have ones that focus on, ‘I'm going to take my time because quality is more important to me than quantity’. And I respect all points of view, we just have to be strategic and fair with who needs what. So that's really how analytics has helped me. … Next available appointment by provider, that's a huge one for me to see. Okay, are we needing to add more specialists? We know that specialists are very hard to recruit. So what could we do? Could we add an advanced provider to help with that next available appointment? Do we need to add a scribe to help the doctor see more patients but not be working on notes till 11 o'clock? Timely completion of notes, I look at that weekly. Sometimes it's really physicians not thinking that they can ask for more staff. So I think that (was) a big eye opener when I took this role. I need to be proactive in helping (providers) because my role is for them to not worry about all the administrative burden, (but) for them to focus on patient care.

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The MGMA Insights podcasts are produced by Daniel Williams, Camille Burch, and Rob Ketcham. 

Sponsor:
Humana: The latest Value-Based Care Report from Humana outlines many interesting findings and highlights how some physician practices found creative paths to success. Check it out now at Humana.com/VBC. Humana is working closely with physician practices on their value-based journeys.

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