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Creating a staff plan for integrating practices

By Rebecca Anwar, Ph.D.

In cases of buyouts and mergers, creating a detailed staff plan is the road less traveled. But it’s the one that can make all the difference.

In this busy world of mergers and acquisitions, developing a staff plan for integrating practices is a familiar, but often undervalued task. Ignore this need, though, and you’ll soon regret it.

Just as a competent and dedicated staff is critical to the success of any new practice structure, a well-thought out staff plan is key to staff acceptance. The following checklist will help you address this fundamental area of integration.

Know your players. First, you’ll need to examine the major players of the various independent practices that plan to merge into one entity. Who are the key players, what role do they play and what significance does this have for merging into a larger group? Finding this out will clue you into the power plays and insecurities among staff, and will help you to bridge the gap with existing loyalties.

Also find out who the leaders are, who the plodders are and whether any sloughs or instigators are among the bunch. Can you identify the people who can provide you with various technical skills and personality traits you will need—the self-starters, the analytical and data-driven people, the independent workers and the team players? This will help you assess how current employees fit into the new organization—what roles suit them and the organization best.

It’s also essential to interview individuals to find out what’s on their mind, offer reassurance, flush out insecurities and keep them abreast of changes to expect. This requires someone skilled in human resources and transition planning, and it may even be in your best interest to hire someone with no prior affiliation with any of the practices. Such a person will come free of bias (real or perceived), and will bring expertise to the table, since he or she will have worked through similar situations.

Define your needs. Before you examine the old system’s work functions and prepare a transition plan, you’ll need to define the new organization’s staffing needs. Base this on the size of the organization, competitive factors, managed care penetration and both growth and service objectives. If this is new territory for you, try to solicit the assistance of advisors who have experience in developing and implementing staff plans in the managed care environment. The foundation you create at this point will be the blueprint for your future success.

Examining existing job functions. It will take a critical and objective eye to complete this assessment. The objective is to compare the existing functions with those you will need in the future. Think about the skills and functions that will transfer to the new system, coupled with the best use of existing resources. Look with a discerning eye for wastes in the current system, such as duplicated efforts and redundancy. If you find them, eliminate them when you transition to the new system

Developing new roles. A cookbook approach to developing job descriptions will crumble like a burnt cake. Each organization is different and you must customize your approach to meet specific needs. You’ll also need to look to the future: What will the new organization look like in 12 months? In 24 months? Develop preliminary functions and create the staff positions essential to get the job done and run the new organization as efficiently as possible.

Beyond this, determine the economic value of each new position based on the projected salary budget, existing job market and the requirements of each position, such as educational background required, job skill and levels of experience. Don’t make the mistake of developing salary standards from a hospital environment or the existing private practice sector. It won’t work and you’ll run into problems attempting to equalize the plan and balance your human resource budget.

The next step. Before you can implement the staff plan, you’ll also need to develop training monitors for each position, set and measure performance standards, and monitor performance. Then you will be ready for the final element to implementing a successful staff plan: developing an effective feedback tool. Your employees will need counseling and reassurance. They will need special attention, such as a procedure that invites them to come forward and share concerns that emerge during the transition. This could be a combination of informal weekly huddles (brief group meetings) and individual sessions, or an open-door policy for employees to come forward during a pre-established transition period (perhaps 30-60 days) to be confident and secure in their new environment.

At the same time, they need to be held accountable for their performance. They should be expected to support the change and meet the performance standards for the position. For example, if someone is reassigned to handle incoming phone calls, communicate the volume they are expected to manage without bumping into voicemail. Then conduct a random audit (review) to confirm that they are not avoiding incoming calls by ignoring the ring and allowing the caller to drop into voicemail.

Motivating staff, from the receptionist to the chief technologist, from the file clerk to the management team, will be a challenge. Likewise, garnering a strong allegiance to the new organization will not be easy. While you may be greeted with unrelenting skepticism, it is vitally important to get employee buy-in and support. Without this, your new organization will struggle to survive, and you could suffer a substantial financial impact.

Overall, opportunity exists for new, expanded practices to capture a lucrative market, since a larger group can often acquire a higher level of management expertise and offer more services than a smaller group. In addition, a stronger market presence not only allows for better bargaining power with contract negotiations, it improves your competitive position, allowing you to take charge of your future. While the behind-the-scenes work of integrating staff may not be easy, the end result is worth the effort.

Rebecca Anwar, Ph.D., is based in Philadelphia and is president of The Sage Group, Inc.

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