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To be productive, we must visualize the outcomes we want.

EDITOR’S NOTE: This is a transcript of Dr. Zelem’s segment during Talk Ten Tuesdays recently.

Marcela Sapone, an American entrepreneur and the CEO of New York-based startup Hello Alfred, has said “Ticking off tasks on our to-do lists might make us feel productive. But to truly be productive, we must visualize the outcomes we want and design everything we do around getting them.” Within the clinical revenue cycle, the task initiative seems most prominent with CDI and maybe less with the other modules. Tasks, also known as key performance indicators, KPIs, are not a bad thing as they are designed to provide some degree of accountability. Yet they should not be a sole indicator of results and success.

Success is what everyone wants to achieve but it is not an overnight accomplishment. Therefore, let’s spend more time looking at this using different terms, outcomes, and outputs and hopefully this will not get confusing for you.

Outputs typically are achieved as the result of implementing an activity or a process. Outcomes are the results of the outputs, what we would like to see. Although outcomes may not be achieved right after that implementation; it’s what’s created at the end of that process. For example, you may have made a phenomenal dessert as your output, great job! But nobody liked it, not a great outcome. In general, and more specifically in the clinical revenue cycle, KPIs provide a result, a specific statistic, an output, but what is the outcome. Are KPIs an accurate indicator of the success that your organization desires? They may be different for every department, every organization.

How does one set themselves up for success? Here are simplified steps:

  1. Define and understand your goals: if you don’t know where you are going, you will never know when you get there. They must be SMART: specific, measurable, attainable, relevant, and timely. They must be both team-focused, and organization-focused. Don’t be siloed, take a holistic approach where no one part is more important than the sum of the whole.
  2. Build your team, and harness strengths and weaknesses. Every team member has both that are unique to them, and you must balance them across the team
  3. Develop your success plan and define your outputs to achieve those goals, and the outcomes, and work on this plan.
  4. Re-evaluate frequently and tweak as necessary, work it again; repeat frequently to make it an endless loop. You know the old expression: wash, rinse, repeat!
  5. Never stop because if one continues to do what they have always done, they will continue to get the outcomes that they already achieved.


John Zelem, MD, FACS

John Zelem, MD, is principal owner and chief executive officer of Streamline Solutions Consulting, Inc. providing technology-enabled, expert physician advisor services. A board-certified general surgeon with more than 26 years of clinical experience, Dr. Zelem managed quality assessment and improvement as a former executive medical director in the past. He developed expertise in compliance, contracts and regulations, utilization review, case management, client relations, physician advisor programs, and physician education. Dr. Zelem is a member of the RACmonitor editorial board.

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