Follow these three simple steps to improve
by Miriam Lieber

As I travel to HME companies nationwide, it is clear that everyone is concerned with maximizing efficiencies. Some have embraced the need for improvement and are looking for creative ways to make changes. Others have removed manual functions in favor of automated features. And yet others have determined that their leadership initiatives were paramount to all other necessary changes. All three are critical elements that can make or break an HME company today.


For companies with multiple locations and a central office, or with multiple staff members performing the same task, consistency is a challenge, at best. This is a situation that manifests predominantly in branch locations where staff members are far from cohorts and must act independently. When push comes to shove, they will often make decisions based on a predecessor's tutelage or how they taught themselves to perform a certain task. This means that important changes will not happen without corporate instructions or constant communication with all employees and management. So how do you rectify the "we've always done it this way," syndrome? The first step is to have staff engaged in establishing the way a task should be performed. Then document the revised policy and invite anyone required to know the policy to attend training, either via teleconference or in person, led by an individual with a keen understanding of how the task should be performed and why. Once the training is complete, conduct a test and set an expected accuracy percentage based on input from staff and management. Grade employees accordingly and begin to hold people accountable thereafter. To do so, you might have to engage in a regular and random audit procedure. Perform this same exercise on those inconsistencies that are the most prevalent throughout the organization and those with the most profound bottom line impact.


Despite your best efforts, many of your employees still prefer to use manual interventions when they find a problem. They are often leery of the software, imagining that it won't know how to fix the problem. So instead, they resort to their trustworthy manual form, checklist and 1-31 file to keep track of all completed and missing forms. Companies must find ways to automate processes and ensure employees are actually using them. Finally, once you have determined how to use an automated method to perform and measure the task, audit against it and post results. Set goals accordingly and take action by reviewing results and helping to remediate those who perform subpar.


When faced with the decision of whether to hire a technically skilled veteran without leadership qualities or an industry novice with widespread leadership skills and experience, most key HME stakeholders would select the non-industry leader. The ability to lead, coach and motivate staff to reach the next goal is sorely lacking in HME business. A real leader who can tap into the capabilities of employees can also inspire them toward new goals. The combination of a respected and motivating leader coupled with a skilled and honed staff creates a best-case scenario. Over time, the leader learns the industry and the experienced staff gleans leadership skills from the leader. As you pursue additional talent, ensure you have the right leader to add to your technically skilled staff. All in all, with more consistency among your employees, stricter reliance on automation and a leader who is able to guide and inspire staff, you should be a certain contender for this next upward battle. You should be poised to handle competitive bidding round 2 recompete/national competitive bid pricing roll out, Affordable Care Act (ACA) demands on data and reduction in readmission rates, and the expected surge in audits. Be consistent and steadfast, stay ahead of the curve by maximizing use of software while encouraging your staff to embrace new methods and standards, and focus on core leaders who understand what it takes to forge ahead amid chaos. The result will be a sure win at the game of operational efficiency.