Once a quarter I have an opportunity to self-reflect on how well I am serving my patients. It's been a lot of years since I've received a "grade" for my efforts. When I was practicing in a hospital based system, my "performance reviews" were limited to the lowest level of performance. I'd even go as far as stating, the level of expectation was not industry specific: arrived to work on time, achieved a particular productivity level, work completed in a timely manner. Those days felt so... so... kindergartenish. At no point in time was my actual performance rated. It's a refreshing change having a system in place to provide objective information about my real performance: the FOTO scorecard. Each quarter I spend time analyzing my FOTO scorecard.
Expert clinicians are known to be different than average clinicians. The one category missing from this research is that of self-reflecting. One cannot improve if one does not have consistent, objective feedback. One cannot improve if time is not spent reflecting on one's professional experience.
I appreciate the opportunity to reflect about my current clinical experience. First quarter 2015 is under my belt and it's time to review my clinical performance. For those of you who do not know me, I practice clinically 3 days/week. From a data perspective, it is difficult to analyze quarterly data because my n numbers are always low. One patient who has additional needs outside of the indicated impairment really messes with my scorecard in a negative way. I wrestle with whether I want to look good on paper or focus on the needs of each patient.
The way I reflect while looking at my scorecard may or may not be the same as other clinicians. My first tendency is to see how many red boxes I have. This quarter I'm doing better than some quarters: no red. Yippee! Next, I check out to see how many yellow boxes I have. Again... no yellow. (I'm feeling happy at the moment.)
So, what now? It doesn't do me any good to just pat myself on the back and log out of the portal.
In the utilization area, green only means that the high percentage has basically surpassed the low percentage. I learned from Jim Hoyme at Therapy Partners of a new challenge: What is my percentage of high + low? He'd suggest attempting to have that figure be 80%. Although I come close, by no means have I consistently reached that level of performance.
I tend to have quite a bit of blue. I glance at the information for the blue situation, but I don't put much weight into it because the n value is too small. I look for trends or explanations if the numbers are looking to be horrendously bad or good. For example, I know my neuro appears horrible. Well, I had a lady who had multiple sclerosis. She fell into a category where my heart ruled my data. Although my data looks horrible, I am excited to say she can safely ascend and descend stairs... and she was able to take a trip to the Carribean and had more issues due to heat affecting her than her strength, balance and coordination.
When I think back to who received services for quite a bit of time for a hip problem, that was a situation of poor execution. Physical therapy services were not the answer for one gentleman. He was in denial over his situation. The combination of dementia and denial created an obstacle for me with gaining agreement from him to accept the need for an orthopaedic consult. I need to work on communicating better or persuading better or telling the right story better.
How many of you use your scorecard to self-reflect?