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Seventh reflection

Seventh internship reflection (done at 105 hour mark)

Seventh Week Reflection: Practice Interview (This assignment remains unchanged from my previous submission last quarter, because it doesn’t directly involve my internship). In this assignment we were asked to prepare interview questions for a position we were interested in, and then have someone we know ask us them. INTERVIEW QUESTIONS: 1. From everything you’ve observed in management and the optical field, what problems can you cite regarding working in this field? 2. As an optical manager, what kind of problems will you deal with? 3. As an optical manager, what systems are in place for dealing with conflict? 4. As an LDO and someone in management, what projects have you worked on that have been particularly interesting? 5. How did your college experience prepare you for this job? 6. What obstacles do you see getting in the way of the company’s profitability and growth?

7. How are teams and groups organized in relation to optical management work?

LEARNING EXPERIENCE:

1. What did you learn from your interview experience?

I decided to interview with my brother. Personally, I feel that I learned that it’s important to be specific. People typically know what a good manager or leader looks like. Being able to describe certain steps and an approach is much more impactful. Secondly, interviewing is quite different from different forms of communication that don’t require a face to face reaction. There’s a lot of improvisation involved, so I can’t expect my answers to be perfect. I just need to show I’m a good candidate and I know my stuff.

2. What kinds of feedback did you get back from the interviewer?

My interviewer commented that towards the beginning of the interview my answers seemed more stilted and scripted. I did better towards the interview once I got comfortable. He also commented that I had good word choice, overall. Additionally, he told me that I seemed a bit rushed because I was trying to deliver a lot of information at once. He recommended that I pace myself a bit more and avoid filler words.

3. Explain how you plan to apply the feedback you've received to future interview opportunities and what if any tips.

In the future, I’ll try to slow down my pace and making sure the other person is following along. What I’m saying isn’t new information to me, but my interviewer will be hearing it all for the first time. In addition, it’s okay if I take a minute to think about what I’m being asked. Reviewing Pluralsight’s article on interviews, I’ll also make sure to shake the hand of my interviewer with friendliness and confidence. In addition, it’s important to remember to avoid speaking poorly of myself, even if asked to highlight my weaker areas by an interviewer. I should also listen fully to the question my interviewer is asking --- it’s very tempting to formulate a response halfway through. Lastly, I should make sure to ensure where and how they will follow up with me, if they choose to do so (Kaiser, 2012).

4. Relate what you have learned to this week’s readings, articles or your past experience.

In order to assess progress, feedback is an important component of the process. Feedback can help you recognize areas of improvement and strengths that self-assessment cannot. This idea is applicable to all practice interviews. Practice interviews to solicit feedback are a great tool to help students become more comfortable with being evaluated. Real interviews don’t provide a lot of opportunity for feedback because often all you will receive is either a rejection or a job offer. You can’t help but wonder about your performance in these cases. Our textbook acknowledges the fact that learning how to take both negative and positive feedback in a graceful manner can be difficult. For example, it would be easy for me to defend myself and say I was nervous, and that’s why I spoke so fast during my interview. However, it would be more fruitful to take the advice, regardless of whatever excuse I come up with. Overall, enduring evaluation and scrutiny can be painful and hard on one’s self esteem. Sweitzer and King also remind interns that questioning feedback is important because it’s very difficult to learn from something you don’t understand (Sweitzer and King, 2013, pg. 223).

References:

Kaiser, Abhinav (2012, Dec. 7). 15 Tips on How to Nail a Face-to-Face Inteview. Pluralsight. Retrieved from https://www.pluralsight.com/blog/career/15-tips-on-how-to-nail-a-face- to-face-interview

Sweitzer, H. F., & King, M. A. (2013). The successful internship: Personal, professional, and civic development in experiential learning (4th ed). Cole Cengage Learning, Belmont.

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rachelstaylor2 · 5 years ago

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Sixth reflection

Sixth internship reflection (at 90 hour mark)

Sixth Week Reflection: Checking In

Think back to the first week of the internship:

1. What thoughts and feelings did you have at the time about the placement?

At the beginning of my internship I had some anxiety that I wouldn’t be able to complete all my hours by the end of the quarter. We still hadn’t confirmed a schedule at that time. I also worried about writing task objectives that were realistic and plausible for me. 2. What hopes did you carry with you?

I hoped to do a better job than I did during my last internship. I wanted to do well on my evaluations and avoid a situation where I was unable to accomplish all the goals I set for myself. With these hopes in mind, I was able to write a better learning contract. I knew I would be with MultiCare very temporarily. Our textbook talks about how a learning contract in important for defining the roles and responsibilities of an intern. By centering my learning contract around specific daily tasks (rather than a very large long-term project), it was easier to see my value as an intern on a daily basis (Sweitzer & King, 2013, pg. 144). 3. With what role did you identify at the time...that of student? As an intern? In your family role? As an employee? Perhaps in another capacity?

At the time of beginning my internship, I was thinking of my experiences as a prior intern. This mindset helped me navigate MultiCare as someone who was there to assist the staff of MultiCare and make their lives easier.

Think about where you are today, 5-6 weeks later:

1. What kind of new skills have you learned since beginning to work at this site? I’ve learned new skills in planning, preparedness, and communicating more regularly. In terms of planning, I had to put extra effort to coordinate with Theresa because she was unfamiliar with my internship requirements. In terms of communication, I also needed to check my email very often; Theresa was very busy so sometimes she would have to move around meeting dates. Lastly, since my shift started so early, I needed to make sure all my cart supplies were ready and stocked the day before. If I left my post to get more supplies, I would likely miss people entering the building.

2. How have your thoughts and feelings about the internship changed? I’ve become more confident in my ability to adjust and adapt to new situations. At this point, I’ve worked with a lot of organizations in my career! I always find change difficult. I’ve also grown more comfortable working within a hospital setting.

My internship at MultiCare made me realize that I work better in a structured environment. I like when expectations are clear. Having now worked in both settings as an intern, I can see the advantages and disadvantages to both structured/unstructured environments.

3. What has changed about you? At my last internship, I overestimated my own capabilities and expected too much of others. This time around, I tried to be more considerate of my limitations and those of my supervisor.

4. Do you like the changes? If not, why not? I think the changes were necessary in order for me to do well. In my final evaluation review, Theresa said that I should be more confident in myself and work harder to “toot my own horn”. However, she wasn’t aware how poorly my last internship went; I had a lot of reasons to be unsure of myself.

5. What hasn't changed and needs to? I think I have difficulty recognizing my own abilities and either expect too little or too much of myself. I think I need to find a healthier balance.

6. What is your plan to address this and how will you know that you have improved? In the future, I want to be more realistic in my expectation for myself and others. I want to be able to gauge what is within my abilities and what is outside those abilities. In order to address this, I should try to set goals that are challenging but not too much for me to handle. I will know I’ve improved when I can maximize my productivity to the fullest while still predicting my outcomes reliably.

Your challenges:

1. What specific difficulties or problems have you faced so far? These may be with the supervisor, field studies instructor, co-workers, peers.

When uncertain in my role during the first two weeks, I often deferred to someone with more experience. This uncertainty often involved exceptional situations (like when someone had poor English). However, after some time, I would find myself being the most knowledgeable screener on site. Many of the volunteers only did a single 4-hour shift each week. I had to draw on previous instruction and experiences to make my own decisions.

2. Describe the actions you have taken to deal with them? I’ve stepped up to help train and guide others. Leading has its own rewards, even though it can be a little more stressful. Due to the fast pace of the internship, I went from being totally new to the job, to an expert, to a teacher in a truly short amount of time! Luckily, the role itself isn’t too complex to learn or teach. I’ve been assigned to help train a new volunteer on Wednesday.

3. What are your thoughts about your need for acceptance versus the need to be liked?

While I would prefer to be liked and accepted in the workplace, if I had to pick between them, I would prefer to be accepted. If I follow my morals and values, it doesn’t matter if I’m liked. The right people will like me! Dye speaks about how a leader’s personal values shape their behaviors (Dye, 2017, pg. 60-63). Naturally, people with different values than my own may not like me. As long as they accept my values, I feel that’s sufficient for teamwork. In addition, in the workplace it’s very important for others to accept your work – even if they don’t accept your personality. Work speaks for itself.

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References:

Dye, Carson. (2017). Leadership in healthcare: Essential Values and Skills. 3rd Ed. Chicago: Health Administration Press.

Sweitzer, H. F., & King, M. A. (2013). The successful internship: Personal, professional, and civic development in experiential learning (4th ed). Cole Cengage Learning, Belmont.

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rachelstaylor2 · 5 years ago

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Third Reflection

Third internship reflection (done at 45 hours)

NOTE: Done at 56 hours, 8/3/2020 My answers for this reflection haven’t changed much from the last time I took this class. This reflection mostly deals with patterns I’ve learned over the years. I added some new commentary on the bottom for this assignment. __________________________________________ Third Week Reflection: Self Understanding FAMILY PATTERNS 1. Unwritten rules that I learned growing up with my family: a) You should never give excuses. b) Don’t refer to anything negative. c) Certain things must be kept a secret from everyone outside the family. 2. These rules still influence me. In some ways, positive. For example, by avoiding excuses I have learned to take responsibility for my actions. However, more negatively, it has taught me to minimize issues I come across. By avoiding negativity, I have learned to be a more positive person. However, by avoiding talk of anything negative, it makes it tough to tackle problems because they’re not brought out into the open. Similarly, by keeping certain facts within the family, I have learned to be selective with who I share with. I believe this can be both positive and negative --- not everyone needs to know everyone’s business, and discretion is important (Sweitzer and King, 2013, pg. 95).

REACTION PATTERNS

1) Initially I used to withdraw from conflict, as I don’t always feel comfortable expressing my needs and wants. I still do this to an extent. I’m working towards being more compromising. I feel that this is the best route to establish teamwork and make everyone feel that their opinion matters (Sweitzer and King, 2013, pg. 98). These concepts ties into ideas we’ve learned in my organizational behavioral theory classes. Everyone has a different way to process situations and attribute their causes. I tend to blame myself rather than environmental issues. Essentially, I view things in a pessimistic style. If I had a more optimistic viewpoint for issues I might be less prone to considering my needs as negative (Borkowski, 2016). 2) Generally, when handling conflict I try to give equal weight to the problem and the people I am working with. For example, if someone feels I am not respecting them enough, I would try to compromise. I would reflect on my own actions and change my behaviors with the understanding that they will do the same and respect me in return. However, if I don’t see the other person making an effort to meet me halfway, I tend to withdraw. I also think it’s important to seek a middle ground by stepping forward first. When you show a good example, others are more motivated to return the gesture. Even if they don’t respond likewise, most of the time I get some effort in return which ultimately helps towards a solution on both sides.

DIS-FUNCTIONAL PATTERNS

1) See if you can identify any dysfunctional patterns in your life by using the format suggested by Weinstein (1981):

Whenever I'm in a situation where someone is rude or sharp with me, I usually experience feelings of shock. The things I tell myself are that I did my best, and what I typically do is try to be calm and patient. Afterward I feel sad. What I wish I could do instead is help them be kinder to others.

2. I get so shocked when people are rude because I don’t see a good reason for their behavior! I think I have difficulty talking about negative things, and in response I tend to brush them aside and ignore them. Thus, it gets to the point where people feel they have no other choice but to act rudely in order because I miss more subtle signs of dissatisfaction being communicated. I would like to better understand how people perceive me, so that we don’t get to the point where they feel they must be rude with me in order to resolve our conflicts. I would like to gain more self-awareness and situational understanding. Perhaps I should try checking in with people more often rather than allowing things to progress in this fashion.

New Commentary as of 8/3/2020: Reading over my initial submission for this assignment makes me realize that I still hold most of these dysfunctional patterns in my behavior. I can see more clearly now that I was minimizing the issues at my last internship because I didn’t want to feel bad or negatively about how I was doing. Acknowledging conflict is the first step to solving conflicts. However, it’s difficult to unlearn patterns we’ve learned over a lifetime. I’m still doing my best to improve my communication skills and pay closer attention to situations so I don’t encounter surprises down the road. I need to anticipate problems before they occur, and then spot them while they occur. References:

Borkowski, Nancy (2016). Organizational Behavior, Theory and Design in Health Care (2nd ed.). Burlington, MA: Jones and Bartlett Learning LLC.

Sweitzer, H. F., & King, M. A. (2013). The successful internship: Personal, professional, and civic development in experiential learning (4th ed). Cole Cengage Learning, Belmont.

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rachelstaylor2 · 5 years ago

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Second Reflection

Second internship reflection (at 30 hours)

Second Week Reflection: Getting the Most from Supervision 7/29/20 (At this point in the internship, I have reached 40 hours.) 1. Rank the roles of a supervisor in priority order:

1) Role Model

2) Advocate

3) Supporter

4) Consultant

5) Mentor

6) Teacher

2. Four strengths I bring to the supervisory relationship: 1) Honesty 2) Work Ethic 3) Team Player 4) Passion and Kindness

3. If you were "shopping" for a supervisor, for whom and what would you be looking?

In our textbook, it is stated that the engaged intern embodies several attitudes and values. These values include being open-minded, flexible, receptive, and open to diversity. Additionally, other desirable traits include reflection skills, communication skills, knowledge, personal resources and empowerment are considered valuable. (Sweitzer and King, 2013, pg. 52). In my opinion, a successful supervisor, in many ways, acts similarly to the ideal intern. While their professional context and work history may be different from mine, I would want my supervisor to be just as willing to give and receive feedback and knowledge.

4. In what ways is your supervisor's style well matched to yours? MultiCare lists their core values to be respect, integrity, stewardship, excellence and collaboration. When Theresa was speaking to me on whether she could take me on as an intern, she mentioned that in order to act with integrity, she would have to make sure she could follow through on all my supervision requirements. Since she framed the situation based on her values, Theresa’s style appears to align with an expressive approach rather than an instrumental style (Sweitzer and King, 2013, pg. 166). It would reflect poorly on MultiCare if she agreed to take me on, only to apologize at a later point for being unable to meet my needs. Thus, it’s important to act with integrity, and a major lesson I learned at my last internship was to, “say what you mean, mean what you say, and do what you say you’ll do”. Essentially, in this situation, Theresa is able to build trust by ensuring she can deliver on her promises (Dennis, 2010). I feel that in this aspect, Theresa is a good match as a role model, and I can learn from her supervision style.

5. Are there any areas of mismatch?

As Multicare’s Volunteer Coordinator, Theresa is quite busy! Part of her job duties are to schedule and coordinate all volunteers. In this sense, rather than being my teacher, she’ll be acting as a consultant and advocate (Sweitzer and King, 2013, pg. 164). As a result, I’ll probably get less face-to-face time with her. Up to this point, most of our communication has been over email or by phone. The content of her communication has also been directional rather than supportive (Sweitzer and King, 2013, pg. 166). This may not be an optimal teacher-learner fit if I expect to learn alongside her or see her as a mentor.

6. If so, are those areas important? How do you plan to come to terms with those differences? While it’s important to have face-to-face communication, this mode of communication can be very resource intensive. As an intern, I need to learn how to be considerate of Multicare’s human resources. This internship is a good opportunity to improve my communication skills over various channels. At prior workplaces, I wasn’t expected to check my email or phone very often. One thing I can do is make sure my feedback over email is concise and concrete, because answers may be slow (Sweitzer and King, 2013, pg. 63). I can also send forms well in advance, which I have already done. I already sent in a copy of my evaluation form (from the last time I took the class), and we have scheduled my mid-term evaluation to be done on Friday. I’d like to make sure my tasks and objectives submission meets Professor Shana’s approval before this appointment occurs. Due to the fast pace of my internship I also need to take initiative to call her if I have any confusion on my duties (which I did today because I needed some clarification on a shift location change I have tomorrow because I will be working at the Gynecology clinic). --- References: Dennis, Tom (Sept. 29, 2010). Say What you Mean, Mean What You Say, and Do What You Say You’ll Do! Workplace Insanity. Retrieved from http://www.workplaceinsanity.com/2010/09/say-what-you-mean-mean-what-you-say-and.html Sweitzer, H. F., & King, M. A. (2013). The successful internship: Personal, professional, and civic development in experiential learning (4th ed). Cole Cengage Learning, Belmont.

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rachelstaylor2 · 5 years ago

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First Reflection

First internship reflection (at 15 hours)

First Week Reflection 1. I’m currently a week into my internship, and I’ve accumulated a total of 16.5 hours work. So far, I’ve finished my orientation, watched a presentation and video, went over tasks and objectives with my supervisor, read the new volunteer packet, and completed my training. I’m now starting clinical screening with supervision. During my meeting with my supervisor (T*****) we went over a few additional subjects. MultiCare has closed their job shadowing opportunities for volunteers until 2021, but I was offered special projects if I needed extra work to reach my hours by the end of the quarter. She also let me know I would be acting as a trainer at some point for new volunteers. As a clinical screener, my duties include meeting and greeting visitors, providing information and directions to them, asking specific health screening questions, taking temperature readings, mask distribution, encouraging hand hygiene, and following MultiCare’s communication model. My first impression of MultiCare is that it is a much larger organization than my last internship site. The Tacoma location has 3 separate buildings. It’s easy to get lost. The facility is very nice and there are multiple departments across the site. MultiCare itself is a health system with many different locations. I can see that my site supervisor, as volunteer coordinator, is a very busy member of the staff. So far, she has been very cooperative over email and in-person. I won’t be seeing her much outside of meetings or when she’s directly observing me for evaluations. I’ve met with a few different coworkers so far. A few staff members have thanked me for my time. All the other volunteers seem comfortable with screening duties and my trainer (J*****) has been helpful in guiding me around the building. Most clients are appreciative of the work I’m doing and the extra level of safety I provide. From what I can observe, there are a lot of elderly patients visiting MultiCare. 2. At the start of the course, I didn’t have a complete picture of my duties and responsibilities. After going through the standardized orientation and filling out my learning contract, I now have a much better idea of my job. Initially, I was worried I wouldn’t be able to complete all my hours by the 13th. I’m happy to say we’ve worked out a schedule and it’s been posted on VICnet for me. Overall, I feel more confident than the last time I took my Field Studies course because I know all of my upcoming assignments. Otherwise, my feelings about the internship haven’t changed too much. The work I’ve been assigned closely matches the job description provided online. Additionally, I can easily connect how my role as clinical screener helps improve safety and health during the COVID-19 pandemic. Simply doing my work shows visitors that the organization is willing to make the extra effort. Enforcing masks is especially important when so many people at MultiCare belong to vulnerable groups. I do have some reservations with assisting wheelchair patients, but I’m sure I’ll grow more comfortable once I’ve helped a few people. 3. I’ve received a lot of new information, but it’s all information I would need to know if I was interested in working at a hospital in the future. I made sure to pay careful attention to hand-washing and hand-sanitizing instructions, as well as my screening script, since I will be using them very often. I felt the workplace violence module was mostly common sense, as well as the confidentiality agreement. MultiCare’s core principles are listed online, but the LEARN and AIDET models of communication are new to me. Since we’ve learned about value of communication in the HCML program, I feel prepared to apply them properly. Emergency codes, wheelchair escort, and injury protocols will take me longer to retain since I won’t be applying them often. 4. Aside from all the immunization requirements necessary to work on the site, the experience has been similar to my last internship. However, navigating the various buildings has made me realize that I’ve never worked at a place with over 20 employees on-site. Additionally, I’ve never needed to use a badge to enter staff rooms; my current workplace uses traditional metal keys. Since I don’t have experience working at a hospital, learning how to don a gown and identify proper cleaning supplies has been informative. I now realize that if I want to work outside the optometry field, I’ll need to earn a lot more experience before I think about managing. I think this internship will provide a good introduction to the wider health care system for me.

5. Based on our textbook, I can connect my initial experience with the “Developmental Stages of an Internship” (Sweitzer and King, 2013, pg. 32-33). Our textbook describes the developmental stages of an internship as being anticipation, exploration, competence, and culmination. Currently, I am transitioning from the anticipation stages to the exploration stages. Since my role was strictly defined during orientation, I have less exploration to do than at my last internship. I already have some familiarity with screening since most health care facilities have started to ask screening questions to visitors. Since I’ll only be at the organization a few weeks rather than several months, this prior familiarity means I can move into the competence stage more quickly. During the anticipation stage, an intern may experience concerns about their internship. Our textbook separates these concerns into “interest” and “worry”. I’m interested in applying concepts I’ve learned in effective communication to my internship. As a clinical screener I’ll be interacting with a large number of people. While these interactions are short, they set the tone for the rest of the patient’s visit. For managers, interpersonal skills are very important to achieving organizational goals (Celluci & Wiggins, 2010, pg. 19).

With this in mind, I do worry about interacting with uncooperative visitors. People, in general, are frustrated with the COVID-19 pandemic and many will see my questions as intrusive and excessive. These sorts of challenges are common when enforcing safety. I also worry that I might get sick or pass it onto others because I’ll be greeting so many people (especially if I’m not sanitizing properly for any reason).

At the anticipation stage, I can also expect to develop my initial relationships with my supervisor and co-workers. Many members of the staff will not be aware of who I am beyond the fact I have a volunteer badge. My closest relationships will likely be with my coworkers on the same assignment as me. We’ll be working closely together to cover the three entrances to building C.

Lastly, I look forward to soon increasing my capabilities and dealing with challenges I may encounter within the exploration stage. It can be difficult to use good judgement and discretion when you receive pushback from clients. Multicare has provided a list of scripted responses for these scenarios. At this point, Johnathan has already stepped in to help me with a few of these situations, but I hope to manage them on my own soon. _________________

References: Cellucci, L. W., & Wiggins, C. (2010). Essential techniques for healthcare managers. Chicago:

Health Administration Press.

Sweitzer, H. F., & King, M. A. (2013). The successful internship: Personal, professional, and civic development in experiential learning (4th ed). Cole Cengage Learning, Belmont.

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rachelstaylor2 · 5 years ago

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Week 8 Internship Reflection

Week 8 Internship Reflection The Civic Minded Student

Mission and Values: 1. Research, and copy here the mission or values of your organization.

The mission and values of PMB are listed on their website as being: “ At Prestige we are committed to providing top quality medical services to our providers. We have a simple understanding that Medical Billing is not easy… it can be very frustrating at times. With the experience and tenacity of our knowledgeable account managers and their compassion for helping patients, you will never have to worry about your Accounts Receivable again.” (Our Promise, n.d.). Essentially, the organization’s mission is to provide top quality medical services by ensuring that providers can make a living, and by proxy help their patients. PMB values serving patients and providers with compassion and tenacity. 2. Does it mention their role with their clients or community?

Their website makes it clear that by helping providers with their finances, they allow the provider to focus on treatment and care. Prestige believes in representing the provider and patient against insurances and fight for their claims. Prestige supports the mental health community through the services they provide as a mental health billing organization. 3. Does the printed mission or values match the reality of how this organization truly serves their clients or community? Yes. It’s clear to me that most of the staff could have earned higher salaries working at larger corporations – but the staff believe in PMB’s mission so strongly that compensation is secondary to living their values. For example, each biller customizes their workflow depending on the preferences of the provider they’re working for. There’s a lot of flexibility and room to make providers happy at PMB. Management also takes lengths to match providers to an account manager that they like and can communicate well with. From what I’ve seen, PMB’s account managers always do their best to treat providers like family. I can see that this is reciprocated because a provider going on maternity leave wanted to share pictures of her new baby with PMB staff.

Human Resources:

1. What are the unwritten rules for your organization? Examples would be going to or not going to lunch, gossip, in or out crowds, working late, leaving early and cliques.

The employee manual doesn’t have a dress code specified, but from observation, I can assume that the unwritten rule is to wear business casual clothes. Coffee and snacks appear to be allowed in workspaces, but employees should continue to be productive during work hours and avoid bringing meals to their desks. Music, if played during work hours, should be quiet and not distract peers. If employees arrive late for work, it is expected that you stay longer to make up for it. Employees are free to come in on weekends if they feel they are behind on work. Although managers have an open-door policy, associates should try to solve issues on their own or among their peers before approaching a manager. Lunch appears to be taken either at 12:00 or 12:30 and lasts approximately half an hour.

2. Do you observe “politics” as described in chapter 10? Describe your perceptions of it in this organization.

By engaging in politics, you are engaging in the context of your employment. In terms of context, due to the smaller size of PMB’s organization, some hires are friends and family of the owner. Poor performance would probably put a strain on these relationships. In addition, there aren’t enough employees to form the typical cliques you will see between departments. Employees are more concerned with the company’s profits and the future. Management staff has really invested a lot in the company. There’s not much motive to “climb the ladder” because the CEO doesn’t make much more money than the receptionist (relatively speaking, when compared to most CEOs, but I’m making some assumptions based on the size of the business). In addition, there is less hierarchy and organizational structure – meaning some roles and functions can be ambiguous (Sweitzer and King, 2013, pp. 298-301). 3. Which of the sources of power identified in chapter 10 can you see being used in your agency? Describe how it is used.

The CEO has a lot of personal power since she’s taken the time to network and keep in contact with old employers. For example, she knows how to get in connection with funders for non-profits. Her involvement in the mental health community provides her a lot of power. Billers hold a lot of power and influence (“insider knowledge”) because they provide the bread and butter for the company --- they have the strongest control over a provider’s account and thus revenue. As mentioned earlier, informal networks ( ex: family members at PMB) can provide opportunities for better collaboration as well as more interpersonal conflict. For example, if the CEO buys a staff member dinner, it could be interpreted as either a business reward or as a familial gesture to a cousin. It’s not necessarily easy to differentiate. (Sweitzer and King, 2013, pp. 301-302).

---

References:

Our Promise (n.d.). Prestige Medical Billing Co. Retrieved from https://www.prestigemedicalbilling.com/#aboutus

Sweitzer, H. F., & King, M. A. (2013). The successful internship: Personal, professional, and civic development in experiential learning (4th ed). Cole Cengage Learning, Belmont.

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rachelstaylor2 · 5 years ago

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Week 6 Internship Reflection

Mid-term Reflection

Think back to the first week of the internship: 1. What thoughts and feelings did you have at the time about the placement?

At the beginning of my internship I was sure to be open-minded and not have so many expectations. However, now that I look back, I had a lot of expectations on my internship. I expected to be part of a structured, corporate internship program. 2. What hopes did you carry with you?

Primarily, I wanted to help PMB succeed and feel like a member of the team. However, I have come to realize most of them only expect me to be around for a few days a month. I should just try to help and learn where I can. 3. With what role did you identify at the time...that of student? As an intern? In your family role? As an employee? Perhaps in another capacity?

At the time of beginning my internship, I was thinking of the experience as an employee. I believed I would have a few days orientation and then I’d dive into the grind. Being an intern, I’m not actually going to be touching work that often.

Think about where you are today, 5-6 weeks later:

1. What kind of new skills have you learned since beginning to work at this site? I have learned to be more firm about my schedule and obligations with my own workplace. At the beginning of the internship I could not secure specific days off for my internship. This made coordination very difficult. PMB made it clear to me that they needed a set schedule for me for me to continue my internship and maximize my learning. I have since had a discussion with my manager and made my priorities clear.

2. How have your thoughts and feelings about the internship changed?

While my internship was always a priority in my mind, by making it a priority in my schedule I know my actions and thoughts reflect each other. It’s a small step, but I now feel more dedicated to my time there. Our textbook discusses interns should seriously think about how their internship fits into their schedule (especially when employed) and consider the demands of their placement --- a concept I have had to reflect on this month (Sweitzer & King, 2013, pg. 67).

3. What has changed about you?

Honestly, 60 hours of interning isn’t enough time for me to see any huge personal changes in myself. Most of what I’ve learned has been technical in nature (ex: job tasks, software, etc.). Overall, I believe I have learned to be more accountable and not let setbacks discourage me too much.

4. Do you like the changes? If not, why not?

The whole experience has been a little humbling. I like the changes because they’ve taught me not to be too comfortable or arrogant. Just because I can manage optical work doesn’t mean I can manage medical billing.

5. What hasn't changed and needs to?

I feel like I haven’t learned enough about management. Dottie has taken the time to involve me in meetings, but what is required to step into her role has flown over my head. I’m sure that as I progress and learn more about the workflow, I’ll start to pick things up more.

6. What is your plan to address this and how will you know that you have improved?

My project is directly related to management, so whether I want to or not I will have to start investigating how things are managed. I think I will have succeeded in my goal if I come up with a lot of improvement suggestions from my data and understand how the data backs up what I’m saying (ex: production reports). The skills involved go hand in hand.

Your challenges:

1. What specific difficulties or problems have you faced so far? These may be with the supervisor, field studies instructor, co-workers, peers.

I had originally on-boarded as an intern because of my interest in the change management project that PMB was planning to initiate in February. However, this project was first delayed, then canceled due to extenuating circumstances. Additionally, my supervisor has gone on vacation this week.

2. Describe the actions you have taken to deal with them? I have moved the focus on my project away from software and integrating technologies. There’s not much point in pursuing solutions that are out of the budget or take a large number of staff to mobilize. Small, realistic changes are key. Since my supervisor is gone this week, I am doing my best to save my questions for later and figure out what I may need help with when she gets back.

3. What are your thoughts about your need for acceptance versus the need to be liked?

___

References:

Dye, Carson. (2017). Leadership in healthcare: Essential Values and Skills. 3rd Ed. Chicago: Health Administration Press.

Sweitzer, H. F., & King, M. A. (2013). The successful internship: Personal, professional, and civic development in experiential learning (4th ed). Cole Cengage Learning, Belmont.

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rachelstaylor2 · 5 years ago

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Week 5 Internship Reflection

Week 5 Internship Reflection Checking In

1. What was the best thing that happened this week at your site? How did it make you feel? The best thing that happened this week at my site was getting feedback on my project progress. On Wednesday I presented a rough draft PowerPoint presentation to my supervisor (approx.: 30 minutes), and was able to share my current understanding of the medical billing cycle and the employee roles at PMB.

I felt that I was able to integrate a lot of my schoolwork into what I was learning in my internship. This experience made me feel that the information I have learned is valuable and applicable to actual business practices.

2. What thing(s) did you like least this week about your site? What I liked least this week was that I was late on Wednesday due to traffic. I’m embarrassed, but all I can do is ensure it doesn’t happen again. Another thing I didn’t enjoy was feeling out-of-place. At my workplace, I am very familiar with everyone’s roles and necessary skillsets. Dye states that many leaders are “out of touch” with what frontline staff are doing every day. To me, it is very important that leaders know about the work done and how to improve it (Dye, 2017, pg.145-146). However, while interning at PMB I am made very aware that medical billing is not my specialty and I don’t know many of the skills involved. It’s clear to me each employee has a specific skillset that allows them to perform their job roles efficiently --- as in any organization. Healthcare management is a very broad field, so I honestly need to learn to be more comfortable working with others even if I don’t know the full scope of their job.

3. How does working at this site make you feel? Happy, proud, bored? Why?

Working on the site makes me feel a little insecure. This week was very busy for PMB and I felt that I was taking away valuable time from the staff. I had to wonder if I was asking too many questions or interrupting too much. I’m looking forward to taking on small projects in order to alleviate workload from the team and be more useful to the business.

4. If you were in charge of the site, what changes would you make? If I were on the site, I would ensure that everyone knew my task objectives for my project. It doesn’t feel like everyone is on the same page on what they should be teaching me. This week I was shown how to do seemingly random tasks in Medisoft, but I didn’t really know where it fit into the larger picture.

5. How do the people you work with treat you? How does it make you feel?

Most of the people I have been working with have been very friendly and understanding. They have really taken lengths to make me feel comfortable despite the fact I will only be interning for a few months. However, I have felt at times that some of the employees are a little exasperated with how little I know about Medisoft. I try not to take this personally – I know what I know.

6. What was the most critical moment of learning during the past week?

I believe the most critical moment of learning this past week has been realizing how much more information I will need in order to fulfill my project’s goal successfully. The number of steps that go into workflow, frankly, is a little daunting to tackle. In principle it sounds easy to suggest waste improvements, but many additional steps are there to ensure quality checking is being done.

7. What have you done this week that makes you proud? Why?

On Wednesday night I went home, went over my notes, and put together a rough draft of how workflow coordinates together on the client-side, biller-side, insurance-side, provider-side, through Epay (payments processor platform) and the clearinghouse. Putting together this chart really made me feel proud that I understood how Epay changed the typical flow of cash at PMB compared to other offices.

8. What insights did you develop about yourself in your role of intern?

As an intern, I have developed insight on how I should take more control over my learning. Our textbook discusses the value of an “Engaged Learner” and taking charge of the pace, direction, and shape of what they learn (Sweitzer and King, 2013, pg. 50). Taking this advice, I brought up the idea of presenting a PowerPoint before my mid-term evaluation. My supervisor probably appreciated the initiative. I am not a passive player on the team nor should I expect to act like a student in a classroom seat.

----

References:

Dye, Carson. (2017). Leadership in healthcare: Essential Values and Skills. 3rd Ed. Chicago: Health Administration Press.

Sweitzer, H. F., & King, M. A. (2013). The successful internship: Personal, professional, and civic development in experiential learning (4th ed). Cole Cengage Learning, Belmont.

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rachelstaylor2 · 5 years ago

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Week 3 Internship Reflection

Week 3 Internship Reflection Self Understanding

FAMILY PATTERNS 1. Unwritten rules that I learned growing up with my family: a) You should never give excuses. b) Don’t refer to anything negative. c) Certain things must be kept a secret from everyone outside the family. 2. These rules still influence me. In some ways, positive. For example, by avoiding excuses I have learned to take responsibility for my actions. However, more negatively, it has taught me to minimize issues I come across. By avoiding negativity, I have learned to be a more positive person. However, by avoiding talk of anything negative, it makes it tough to tackle problems because they’re not brought out into the open. Similarly, by keeping certain facts within the family, I have learned to be selective with who I share with. I believe this can be both positive and negative --- not everyone needs to know everyone’s business, and discretion is important (Sweitzer and King, 2013, pg. 95).

REACTION PATTERNS

1) Initially, I used to withdraw from conflict, as I don’t always feel comfortable expressing my needs and wants. However, I have learned in the workplace to be more compromising. I feel that this is the best route to establish teamwork and make everyone feel that their opinion matters (Sweitzer and King, 2013, pg. 98). These concepts ties into ideas we’ve learned in my organizational behavioral theory classes. Everyone has a different way to process situations and attribute their causes. I tend to blame myself rather than environmental issues. Essentially, I view things in a pessimistic style. If I had a more optimistic viewpoint for issues I might be less prone to considering my needs as negative (Borkowski, 2016). 2) Generally, when handling conflict I try to give equal weight to the problem and the people I am working with. For example, if someone feels I am not respecting them enough, I would try to compromise. I would reflect on my own actions and change my behaviors with the understanding that they will do the same and respect me in return. I also think it’s important to seek a middle ground by stepping forward first. When you show a good example, others are more motivated to return the gesture. Even if they don’t respond likewise, most of the time I get some effort in return which ultimately helps towards a solution on both sides.

DIS-FUNCTIONAL PATTERNS

1. See if you can identify any dysfunctional patterns in your life by using the format suggested by Weinstein (1981):

___

References:

Borkowski, Nancy (2016). Organizational Behavior, Theory and Design in Health Care (2nd ed.). Burlington, MA: Jones and Bartlett Learning LLC.

Sweitzer, H. F., & King, M. A. (2013). The successful internship: Personal, professional, and civic development in experiential learning (4th ed). Cole Cengage Learning, Belmont.

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rachelstaylor2 · 5 years ago

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Week 2 Internship Reflection

Getting the Most from Supervision 1. Rank the roles of a supervisor in priority order:

1) Role Model

2) Advocate

3) Supporter

4) Consultant

5) Mentor

6) Teacher

2. Four strengths I bring to the supervisory relationship: 1) Open Communicator 2) Accountability 3) Team Player 4) Passion and Kindness

3. If you were "shopping" for a supervisor, for whom and what would you be looking?

4. In what ways is your supervisor's style well matched to yours? I can tell that my supervisor is a team player, which is incredibly important in management. She has a drive to see her employees succeed so that the business can succeed. It’s obvious to me she’s made personal sacrifices in order to run her own business and avoid many unethical corporate business practices. In this way, D--- is extending her kindness to all her clients and the patients they see. She is also very willing to answer questions which shows me that she feels accountable for my learning.

5. Are there any areas of mismatch? Mainly I feel she hasn’t had much of a chance to be my mentor or teacher. However, Me--- has largely taken on this role. Me--- tends to be very organized and meticulous in her work. In contrast, I tend to be more flexible and off-the-cuff. My background deals directly with patient care so I’m used to a hurried environment where decisions must be made quickly. It’s been interesting to occupy an environment with a new pace and focus on diligence. Medical billing is quite easy to do incorrectly, and incorrectly filed claims can delay revenue flow (Valerius, et al, 2017).

6. If so, are those areas important? How do you plan to come to terms with those differences? I believe I could learn a lot from Me--- in how to organize work for employees and make sure tasks are accomplished completely. In my own workplace we struggle to ensure everyone has completed their tasks and we don’t really have a system in place aside from checklists (that never get filled out routinely or enforced). At my workplace we tend to have a “good enough” mentality. I can tell that Prestige Medical Billing prides themselves on being more thorough than most corporate organizations. For example, I was told that there were many areas that billing was done incorrectly at larger companies, and these mistakes often lead to loss of provider revenue. It’s a small company environment with local clients. I plan to come to terms with those differences by observing the cons and pros of Me---’s personality and workstyle. I have a feeling it will make a big influence on her client relationships; small companies must work very hard to maintain their small but loyal base of customers. -------

References:

Valerius, J., Bayes, N., Newby, C., & Blochowiak, A. (2017). Medical insurance: A revenue cycle process approach. ( 7the ed.) McGraw - Hill Education, New York.

Sweitzer, H. F., & King, M. A. (2013). The successful internship: Personal, professional, and civic development in experiential learning (4th ed). Cole Cengage Learning, Belmont.

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rachelstaylor2 · 5 years ago

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Assignment #2: Practice Management Software Project

Below is a excerpt of a report completed for my HCML 310 class ( Health Information Systems for HC Managers). The goal is to review potential Practice Management software suitable for a theoretical clinic.

HCML 310: PROJECT—SECTION THREE

______________________________________________________ Rachel Taylor 6/6/2018 Bellevue College ____

Abstract

This task is about: A brief overview has been compiled of various Practice Management Software with the goal of matching software selection with a theoretical clinic’s individual needs.

Keywords: nueMD, DrChrono, Kareo Billing, prognoCIS, Carecloud, mHealth, RPM, practice management, practice management software, HIPAA, Meaningful Use, EHR, Administrative, Billing, Clinic, Hospital, clinical software, interoperability, health informatics, health information products ----

Course Outcomes Addressed: Propose Practice Management Software solutions for various types of healthcare facility needs.

Administrative, Billing, and Financial Systems software programs, apps, or devices on the market that would be appropriate for Infantastic Clinic:

OVERVIEW: Clinics, as they grow and expand, will typically turn to software to help maximize their current efficiency. Once an Electronic Health Record (EHR) system is installed in an office, practice management software is used to then manage all the information an EHR stores for each patient. According to the Advanced Data Systems Co., PM software will have 5 main features that should be included: 1. Claim Denial Manager and Electronic Claim Submission Claims can be sent electronically, rather than requiring a medical practice to mail out each claim. Additionally, software will alert you when there are errors in a claim, fix them, and re-submit them. This increases the accuracy of claims. 2. Management and Financial Reporting PM software allows a clinic to generate documents that help measure financial activity. Essentially, a clinic can track their activities better by recording and comparing raw data. More advanced software will provide analytics for the clinic. 3. Scheduler

A good scheduler will be specific to practice needs, and the layout will be customized based on the activities of the clinic. A good scheduler will organize workflow for patients and staff. 4. ICD-10 Coding Converter This function goes hand-in-hand with billing properly. ICD-10 codes, or the International Classification of Diseases code base, are used when submitting claims. Software with built-in coding assistance help speed up efficiency. 5. Insurance Eligibility Verification Insurance eligibility can be checked using PM software, rather than calling the third parties directly on the phone. Some software will also allow management to send inquiries in bulk. This is generally a time saver (O’Connor, 2017).

The software I will discuss in the following sections will include most if not all these capacities.

______

NueMD or Practice Management Software Product 1: NueMD is a practice management software owned by Nuesoft Technologies Inc. The website advertises their product as, “affordable, simple, flexible and accessible from anywhere” (Medical Practice Management Software, 2015).

EHR compatibility is desirable because it saves time so that you don’t have to manually input data twice. In terms of EHR interoperability, I believe the silver edition pricing variant does not carry EHR interoperability, but the gold and platinum do. This software is linked the NueMd’s own EHR program, so it is recommended to match between the two for best functionality. If you use your own EHR you will have to manually input the data. The difference between the pricing options is that the gold version includes advanced analysis, electronic chart management, and an inventory manager over the silver. For a smaller clinic, the silver version may be more desirable if you are not looking for advanced functionality in data analysis and financial management.

This product is HIPAA compliant. In terms of privacy, the software uses TLS and SSL encryption on emails, uses specific file sharing protocols and a minimum of 128-bit encryption. Secure text messaging and not storing information. NueMD also includes firewall and virus protection for security. Pricing for this product is $163 for silver, $193 for gold, $213 for platinum. One of the appealing traits of this software is that the prices to use their billing service are scaled based on usage. Pricing is per provider, most likely per month. Software in this price range are most likely targeted towards small-scale operations. Additional feature considerations are patient registration, reimbursement management, patient collections, reports and analysis, and claim scrubbing. Patient registration centralize patient information from the first encounter. All patient details updated in real-time. Patient collections is the collecting of payment from patients, and this has up-to-date payment audits, and easy to understand patient statements. Analysis is improved with this product by using many standard reports that lets you analyze years worth of financial data in minutes. Claim scrubbing is part of the claim denial management process, and NueMD checks all claims against a constantly updated list of more then 10 million claims edits. Essentially, this feature of NueMD allows you to minimize management of the financial side of things. This seems to be targeted towards small and medium sized clinics, so I believe with the Infantastic Clinic’s current size it should be a good fit. It would reduce the workload without breaking the budget. This is great product to use if your focus is time management and bulk processing. This application accomplishes this with streamlining and simplification. NueMD streamlines operations with fast scheduling, quick appointment reminders, and flexibility for claim processing. For example, you only pay for the number of claims paid, making it ideal for smaller clinics that would rather not pay a fixed rate to their clearinghouse. As discussed in the overview, the PM software does support the five main features of PM software, including medical billing, patient registration, medical scheduling, collections, reports, etc (NueMD Review, n.d.).

mHealth or RPM Product 2:

DrChrono is a practice management software owned by DrChrono Inc It focuses on delivering on the unique challenges that a clinic may face with scalable features and a high level of customization, “like no other management system”. Like other PM software, this software can manage administrative tasks, schedule, patients, medical billing. It is also cloud-based (DrChrono Review, n.d.). I would recommend this software to those looking to increase patient engagement and improve overall experience with specialized care software. To compare, this software shows strengths in patient engagement and data analytics. For example, DrChrono offers Business Intelligence Tools that track coding, collections, payment, denials, provider utilization and average payment analysis. This PM software is uniquely suited to clinics focusing on quality of care. As for the specs, this product is cloud-based. It provides an integrated software, DrChrono EHR. Most likely, other EHR cannot be linked easily and information would need to be manually inputted. In terms of usability, this means if you want to use this product you would have most likely decided on using their EHR software as a bundle deal as well.

This product is HIPAA compliant. All information is stored in HIPAA compliant SSAE 16 SOC 1 and 2, in a secured data center. This product offers a free trial, and afterwards EHR and Practice management starts at $200 per month. For increased functionality such as “advanced scheduling to clinical functionality, lab integrations, e-prescribing” the software is $279 per month.

Additional features to consider are streamlined workflow, quick automation, integrated Medical Billing and Good Mobile EHR. In fact, it has been voted the #1 Mobile EHR access platform, including iPads, iPhones and more. This makes DrChrono a great tool for convenient access. The streamlined workflow allows for consistent workflow between providers and staff with extensive scheduling, business operations, and medical billing tools. Quick Automation: Reduce administrative tasks by automatically sending out reminders and reducing paperwork.

DrChrono seems to be targeted towards a similar audience to NueMed, considering the price range is very similar. . This is a great tool to use if your clinic’s focus is customization and in-depth analysis. This is supported by their website’s statement that “no two practices are alike.” This solution seems to be strongly tied together as a package deal, which may lower costs when purchased together. Essentially, bundling the features keeps any programming conflicts to a minimum (Smart Practice Management with DrChrono, n.d.).

mHealth or RPM Product 3:

Kareo Billing is a practice management software owned by Kareo Inc. This product’s function is to primarily manage claims and patients statements, so that the healthcare providers can focus on their patients. This conclusion was drawn from the website’s feature slogan, “You care for your patients, we care for your practice.” This software helps to manage claims by tracking and monitoring claims by filters such as provider, location and date. You can also view outstanding claims. What makes this software unique is the specialty focused billing experts you can contact, as well as integrated cloud-based technology (Kareo Managed Billing, n.d.).

This product is contains EHR interoperability and is integrated with EHR. Their data can be exported as .CSVs or .XLS’s which means you can import it elsewhere or store a backup copy or take it with you if you decide to cancel your subscription. This product is HIPAA compliant. Data is secured, stored and backed up in the cloud. Compliant with all HIPAA Privacy rules.

Pricing for this product is unavailable. Contact Kareo Billing to see how much it’ll cost. Due to this, it is difficult to gauge how this software compares in terms of affordability. Additional feature considerations are claim tracking and charge capture. Charge capture collects useful information for use in a claim document, catches billing errors before it’s a problem, reduce denials, and facilitates faster payments. Again, these features emphasize the focus of Kareo’s software in billing. Other features, such as analytics, help to understand billing performance and avoid surprises in costs. Kareo Billing can analyze revenue cycle and keep track of how much you billed as well as collected. You can also eliminate duplicate data entry. Kareo Billing seems to be targeted towards clinics looking for billing assistance. This is a great tool to use if your clinic’s focus is claim management. This is supported by their website’s statement that “no two practices are alike.” This solution seems to be strongly tied together as a package deal, which may lower costs when purchased together. Essentially, bundling the features keeps any programming conflicts to a minimum (Smart Practice Management with DrChrono, n.d.). Additionally, there’s an OB Flowsheet specifically for ob-gyn, as well as an Electric Antepartum Record for these clinics.

mHealth or RPM Product 4:

PrognoCIS is a practice management software owned by Prognosis Inc. It focuses on delivering on the quick and easy billing management. Enables practice to identify insurance eligibility, manage accounting books, online patient payments, and customized statements. It may provide a good alternative to Kareo Billing, which carries similar functionality. This product carries HER interoperability and integrates with PrognoCIS EHR. Like other software that has been reviewed, it may not fully support other EHR. compatible with other HER. This product is fully compliant with HIPAA’s compliancy group. They have the “HIPAA seal of compliance” which means that they have conformed with all compliancy standards. Due to this program’s focus on billing, it will contain features that support ICD-10 code matching, but may not have much focus on ease-of-use on the patient end. The pricing for this product is not available. Additional features to consider are electronic remits, PaperResolve, Statements/BillFlash, Eligibility Checks, Denial Management, and Auto-Claim Creation. Electronic remit allows user to set up connection between payer, Trizetto (A claim clearinghouse), and PrognoCis. PaperResolve deals with paper checks and paper remits. Scans papers and put in folder to convert to electronical remit. Statements using BillFlash are scheduled tp automatically download all statements on a schedule. BillFlash lets users have client portal to access all statements that was transmitted from software for approval, cancellation, reviews, and reporting purposes.

PrognoCIS seems to be targeted towards clinics looking for billing assistance. This is a great tool to use if your clinic’s focus is claim management. Again, it would be recommended to use this company’s packaged HER. It could be useful for the clinic due to having integrated EHR, as well as its ease of use and accounting abilities. I would choose this software for similar reasons as KareoBilling (Medical Biiling and Practice Management, n.d.).

mHealth or RPM Product 5: CareCloud is a practice management software owned by CareCloud Inc. This product’s function is primarily to track, manage, and optimize financial and administrative processes. Boosts productivity by automating day-to-day tasks that can slow an office manager down.

This product only integrates with CareCloud EHR. This means that if we were to choose another EHR, we would have to manually extract/import data. CareCloud cloud based software is HIPAA compliant. They use Physical Data storage, and client side security. They also use role-based security which also prevents employees from changing or seeing information that does not pertain to their specific function. They use password complexity requirements, session lockouts, verification questions, and more.

The pricing for this product is not available. One additional feature to consider is comprehensive scheduling, which helps to easily manage practice’s schedule with multi-view calender and drag-and-drop online patient appointment scheduling. It also features Modern Front Desk Experience which allows for easy booking and confirming appointments, check-in and checkout patients. You can view past, present, and future schedules, and verify insurance eligibility with CareCloud Central where you can quickly check a patient’s insurance details such as deductibles, co-payment and co-insurance. It also offers foolproof billing with innovations like CollectiveIQ, which is a collection of automated billing rules, which helps avoid costly errors, minimize re-work, and get paid faster. Additionally, CareCloud has real time reporting to get “robust, real-time, operational, financial, and clinical reports.” Customizable charts and graphs display data are in easy to interpret formats. Another feature is insightful analytics where you can view staff productivity levels, days in accounts receivable or how you’re performing against Meaningful Use objectives anywhere. The user interface looks clean and easy to use, as well as the analytics being great for ob-gyn so that we can tell when something is doing well or is not doing well. This is a great tool to use if your clinic’s focus is workflow and time management. Essentially, most of the tools advertised allow for better productivity day-to-day and keeping track of scheduling (Central Management Control Center, n.d.).

____

References Central Practice Management Control Center (n.d.) Carecloud Inc. Retrieved May 27, 2018 from https://www.carecloud.com/practice-management/

DrChrono Review (n.d.) Finances Online. Retrieved June 6, 2018 from https://reviews.financesonline.com/p/drchrono/

Kareo Managed Billing (n.d.) Kareo Inc. Retrieved May 27, 2018 from https://www.kareo.com/medical-billing

Medical Billing and Practice Management (n.d.) Bizmatics Inc. Retrieved May 27, 2018 from https://prognocis.com/practice-mgmt/ Medical Practice Management Software (2015). Nuesoft Technologies Inc. Retrieved May 27, 2018 from https://www.nuemd.com/features/practice-management Practice Management Software (n.d.) Software Advice Inc. Retrieved May 27, 2018 from

https://www.softwareadvice.com/medical/practice-management-software- comparison/?deployment_id=&market_products_sort_order=DESC&market_products_sortby=nb_reviews&more=true&price_ranges=&stars=&segment_id=&platforms=&int_site_code=&size_id=

Smart Practice Management with Drchrono (n.d.) DrChrono Inc. Retrieved May 27, 2018 from https://www.drchrono.com/ehr/practice-management/ NueMD Review (n.d.) Finances Online. Retrieved June 6, 2018 from https://reviews.financesonline.com/p/nuemd/

O’Connor, Stephen (2017, Jan.3). Advanced Data Systems Corporation. Retrieved June 6, 2018 from https://www.adsc.com/blog/what-is-practice-management-software

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rachelstaylor2 · 5 years ago

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Assignment #1: Car Wash Report

Completed as part of my Strategic Operations Management in Health Care Class

Individual Assignment Car Wash Project Rachel Taylor HCML 415 5/25/2019 Bellevue College

_______________

P. 1 - INTRODUCTION: In this exercise, we were asked to collect data on two types of automated car washes: one stationary and one tunnel system. For my stationary car wash, I chose a self-service location in which tokens are used to start the wash. A hose is supplied that either shoots out water or soap. While I originally intended to find a car wash that was more fully automated, I couldn’t find any that fit the description in my area. The second car wash I chose was Brown Bear. In this system, the user pays a clerk, shifts their car into neutral and then a conveyer takes their car through a tunnel. There were three steps to their, “Beary Clean” standard carwash: a 2-step presoak, a wash, and a rinse. They had other options but I did not observe any cars that chose to purchase luxury packages. I then took data accordingly to track each step in the process. ___________ Location Addresses: #1 Self-service System: “Car Wash” 1525 W. Meeker St., Kent WA #2 Tunnel System: “Brown Bear Car Wash” 1525 W. Meeker St., Kent WA ____________

P. 2 - STEPS: Below I’ve provided graphs that analyze the average time for each step in the process:

Overall, steps ranged from 25-41 seconds each, on average. The queue took the longest, on average, while soap was the shortest step.

The stationary car wash took much longer in comparison. Overall, steps ranged from 201-324 seconds each, on average. The rinsing took the longest, on average, while the second rinse was the longest. There was no drying step, as most cars left immediately after finishing their rinse.

___________

P.3 - CYCLE, TAKT, WIP TIME: TAKT TIME: The takt time is the rate in which you need to complete an order to meet customer demand. Let’s say that 12 cars want to get their cars washed in the tunnel within 30 minutes or 1800 seconds. When we calculate the takt time, the system must be able to process each car within 150 seconds. That comes out to 2 minutes and 30 seconds per unit to meet customer demand.

CYCLE TIME: The cycle time is considered the time between each output. Cycle time = Productive Hours/Total Units Produced So, how did the locations measure up? I was at the tunnel car wash for roughly 45 minutes. There were more than 12 cars processed during this time but I probably missed every other car because I had to walk from the end of the tunnel back to the start, which caused me to miss a car queuing up. Let’s say there were 24 cars processed. Thus, the cycle time would be 1.87 minutes each. I was only at the stationary car wash about 40 minutes. There were more than 12 cars processed during this time, but I had to throw out some data. Let’s say there were actually 15 cars processed. Thus, the cycle time would be 2.66 minutes each.

From this graph, you can see that at 144 seconds, the tunnel system is much more capable of meeting this demand.

WIP TIME: Aka the work in process, it’s the inventory between the start of a process and the end of a process. On the single-file tunnel system, there were approximately 2 cars in the tunnel at once. I believe, then, the WIP time would be half the lead time, about 72 seconds. In the stationary system, there were up to 4 stations that could be filled at once. Thus, the WIP time would be a fourth of the lead time at 253 seconds. _____________ P.4 - VARIATION: The variations I observed have been summarized in the graphs below:

Essentially, between the two systems, there was very little distribution variation from the tunnel system. Variation was a matter of seconds, which ranged from 7 to 15 seconds for each step. This amount of variation could honestly just be chalked up to inaccuracy with my recording method. I used a stopwatch for this process, but it was a bit difficult to stop and start on time with such a small lead window. Overall, this process was very consistent, aside from the queue times. I believe we saw more variation here because the queue was the only part of the process that required input from the customer during payment, while all other steps were automated. I believe this is the reason that times for the queues were most variable. In comparison, the standard deviation for the stationary system really varied depending on the person washing their car. This can be seen with the very wide distribution curve in the graph above. This trend is to be expected when a majority of the timing decisions were not automated. The deviation ranged from 92-177 seconds for each step. I believe these numbers were much larger because the lead time was nearly 7 times longer than the tunnel car wash. Still, the queue had the greatest proportion of variation present. _________ P.5 - LEARNING OUTCOMES: This exercise taught me a few things: 1. When collecting data, you will need to collect more data than actually required. This is because during the collection process there was a lot of data I had to throw out because I often missed the timing for a step. 2. I’ve learned that it’s very difficult to compare data unless the steps are identical between car washes. When tracking the self-service car washes, I found that many cars went straight to the soap without rinsing. In fact, I even had a person drive off to the side of the lot in order to scrub their car with a hand sponge! I had to throw this data out. People are much more variable than machines in the amount of time they take to complete steps. 3. Additionally, I’ve learned that the self-service car wash was harder to compare to a tunnel system because the comparison wasn’t exactly apple-to-apples. There was a huge gap between the total averages even when similar steps were taken. Thus, it was more difficult to draw accurate conclusions from the data. 4. It took me a while to figure out how to input seconds into the excel sheet provided for this exercise. Without this additional accuracy, my averages didn’t represent the data I collected very well. 5. A wide variety of graphs need to be used in order to illustrate points that can be quite confusing when written out in paragraph form. Being able to visualize the data is very helpful for analyzation.

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