1. Business Planning: Optimising Time & Resources Mary Toomey Strand Hotel, Limerick 23rd July 2011

2. Where We Are Economic crisis : greater social needs but much reduced resources Recent political turmoil : new expectations Increased legislative demands Increased patient expectations Out of date public contracts : unsuitable, abused, and dying painfully Several new (but largely uncoordinated) models of Primary Care emerging Insufficient planning, poor communication and sometimes disrespectful / undermining attitudes between government, HSE, and Primary Care Providers

3. Where You Want to Be What are your strengths? What would you love to see your Practice achieve in the future? What are your personal ambitions for the Practice? What do your patients/ community need from you?

4. Where You Want to Be What steps do you need to achieve these goals? What resources do you need? What obstacles will you need to overcome?

5. Problems Most common problems: Financial crisis, cash flow problems Stress of staying on top of daily workload Paralysis because of uncertainty / fear of risk, frustration or fatigue at challenges of change Spend less and/or earn more Take control of your workload Change... one step at a time

6. Spending Less Start by looking at bigger spends and areas which won’t affect patient care quality What are you using in a wasteful manner? What can you manage without? Get cost comparisons and samples. Look at ‘sneaky’ charges, e.g. carriage/delivery Look at your bank charges

7. Spending Less Drawings... Monthly and Profit Share Assistants and Locums – how profitable and why? Have you the right balance between Partners and other doctors? Nurses, Phlebotomists, and other HCPs Administrative / Support Staff Wages Pay cuts or freeze; unpaid leave or shortened working hours; restructuring or redeployment Redundancy

8. How to Earn More : Develop a Marketing Strategy Any marketing strategy should be based on your patients. A marketing plan is an action plan for a given period, usually one year or more, to offer and promote a range of products and services to your market. This action plan must fit in the broader and longer issues of your Practice.

9. The Hands That Feed Us How well do you know your patients? – Demographics – Social / medical histories – Their needs (physical, emotional) – Their desires and preferences...their needs / desires are your opportunities

10. The Hands That Feed Us How well do your patients know you? – Your opening hours and location – Your services – Your staff – Your best features How do your patients feel about you?

11. Looking at Your Existing Services Who availed of what service? How did they hear of it? What did they think of it? Did they think it was good value? Why? Will they come back for more? Would they recommend to a friend? Is there any other service this patient needs? Who didn’t avail and why not? Who else might need or want this service?

12. Creating New Spaces...Marketing Who are your target group of patients? What product or service do they want / need? How can you provide those services? Can you revitalise an old service? Can you find synergy with partners? How can you make those services profitable? How can you let people know you offer them?

13. “Well Woman” Transformation Well Woman : cost €290 – patients not availing of the service Most patients didn’t know what it was about Some patients felt it was too expensive Many patients were taking extended periods of time in ordinary consultations with various medical-style issues, but not enough to justify referral to Well Woman

14. “Well Woman” Transformation Well Woman broken down into different parts gave us a range of shorter, more targeted and much cheaper check ups: – Women’s Cardiovascular Check-Up (€108) – Women’s Personal Health Check (€108) – Well Woman Comprehensive (€261) – Women’s Mini-Medical (€108) – Women’s Sexual Health Medical (€72) – Sports Medical (€108)

15. “Well Woman” Transformation We also identified patients had need for diet and lifestyle advice so we linked in with the GP Exercise Referral Programme and HSE dietician-led PHEW and Expert Group services Women’s Health Evenings to be run in Autumn 2011 to encourage a healthier lifestyle and further our commitment to patient education; also promoting new Women’s Health services

16. Existing Services Possible / Developing Services GP Consult ICSP Smear Health Screen Mini Medical Chronic Disease Clinic Late night surgery hours Patient Type Private Men 46 +XXX Private Men 25 – 45XXX Private Men 18 +XX GMS Men 45+X GMS Men 25 - 45X GMS Men 18 +X Pr. Women 46 +XXXX Pr. Women 25 – 45XXXX Pr. Women 18 +XX Pts w. DiabetesXX Pts. On HeartwatchxX

17. Your 12 Month Marketing Plan Start with season-specific services e.g. flu vaccines Plan to fill up times when you may be fallow Consider pilot projects during quiet times Avoid taking on too much at busy or holiday times Manageable amounts with breaks as needed

18. Extract from Carlton Clinic’s 2011 Marketing Plan Aug Chronic Disease Clinics; 10% off health screens for summer Make arrangements for women’s health evenings (speakers, venues) Prepare fall newsletter (women’s health; back to school; flu vaccines) Sept Send newsletters Run women’s health evenings Flu vaccination clinics Oct Housebound patients flu vacc’s / pilot review form Plan Men’s Health evening. Finalise Xmas gift voucher medicals Nov Run Men’s Health Evening Prepare & send Xmas newsletter Review of activities 2011 and discuss 2012 Marketing Plan and Budget with Partners

19. Ways to Let People Know Word of mouth Practice Brochure Notice in waiting room Mail Flyer drop Newsletter Website Directories / web listings Social network sites etc Newspaper / Radio / TV

20. It’s not how I see myself...

21. ...it’s how other people see me that counts

22. How on earth did you get that impression ???

23. Creating an Impression Success comes from doing ordinary things extraordinarily well Good management (of people and processes) is essential to create the right impressions over & over

24. Manage Your Workload Micro level : Me – Accept that stress is my reaction to things and people around me, and can be controlled or eliminated – Accept that I have limitations – Prioritise the big picture: things that have serious short term or chronic long term consequences – Focus on managing others well – Say no assertively

25. Time Management Tips Understand the business position and aims Have a long term plan which is broken into several clear objectives Take a few moments to prioritise at the start of every day, ensure you have one long term “mission” for the day – and get it done! Expect the unexpected and accept the things you can’t change – but prevent repeating patterns where possible

26. Manage Your Workload Macro Level : The Whole Practice – Look at the roles required and what each team member should be doing – Focus on the people, not the processes – Engage them in their own transformation process – Believe in their ability – Reward them for changing for the better

27. Your Team Needs What you are doing really well? What needs to be improved? What needs to stop?

28. Self Fulfilling Prophecies Be aware that people will most often achieve what you expect from them... Whether that is good or bad... Be very aware of your prides and prejudices Bad performance is (almost) always the product of bad management! Your people have enormous potential... Do you believe they can achieve it? Do they?

29. Repeating Patterns Recognise them – record them (e.g. trends in sick leave, lateness, poor performance) Discuss them (informally; return-to-work interview; performance appraisal, disciplinary process investigation) Explain the effects of the behaviour on the team and the business – why this trend is a problem Ask for improvement as appropriate & follow up Have the right procedures and stick to them Stay within the law!

30. Giving Feedback Have your facts to hand (in the background) Explain why you are giving feedback – so as to help improve, and achieve better together Approach it constructively Tell the truth Agree a way forward and advise the staff member of a future date when you’ll follow up on progress Make a record of the meeting

31. Summary Spend less and/or earn more...Make a marketing plan Take control of your workload...For yourself and your practice Change, one small step at a time