April 17, 2017

Coder Burnout: The Leadership Opportunity

By
I am fortunate to work for a company that begins each of its meetings with the reading of its corporate mission statement, setting the tone for the ensuing discussion. In our tradition of aligning principle and practice, I would like to share the Novant mission statement that will guide this article: “Novant Health exists to improve the health of communities, one person at a time.” This mission frames my leadership practice and creates the vision for my entire team. 

It is an honor to represent a diverse and inclusive team that treats every account as someone’s life that we can positively impact even though we don’t engage in direct patient care. While our team is considered non-clinical and works in fully remote settings across four states, the coders are responsible for strict accuracy in their work, which includes translating the provider’s documentation into diagnosis and procedure code assignments. The integrity of coded data has always impacted the lives of our patients, our physicians, and our communities. It is important that front-line coders can explain this impact as clearly as their managers.

For various reasons, some leaders are so stressed and distracted that they do not clearly communicate how their team’s work impacts the company’s mission and its bottom line. Due to this lack of communication, coders may become frustrated and leave one company for another—not because of the work itself but because of the leadership. Failing to educate and inform front-line team members about industry topics and risks limits their potential for change readiness. With education and information, this diverse group will be able to handle risk mitigation and be fully committed to the outcome.  Building an environment in which personal excellence is one of the team’s strongest values will lead to a large, diverse team who works together to solve problems and assist with change management. The net result will be a high-performing team and decreased coder burnout.

If knowledge is power, then education is one of the most critical elements for a team’s success and its ability to maintain the accuracy required in the coding world. Promoting transparent conversations with the front-line coding team about upcoming challenges and then brainstorming ways to mitigate risks leads to the ultimate solution, which is a team that is engaged and change-resilient. Change without such education is difficult, because team members will not understand the reasons for the change.  

During the educational process, it is important for leaders to demonstrate compassion when they communicate with their team members and to listen to them to understand, not just to respond. This type of communication is one way that leadership skills can improve “the health of communities, one person at a time” (Novant Health’s mission statement).

With coders receiving frequent education to stay current on coding topics, risks, changes, and challenges, leaders can then use their team’s size as another organizational strength.

At Novant Health, we have yearly strategic initiatives where the implementation groups include both front-line coders and coding leaders. This dynamic team examines the details that lead to effective decisions. Respecting the wisdom of our entire generational team allows for increased project scope, bandwidth, and personal excellence from each individual.

We are strong in our size, rather than encumbered by it. We are brave in implementing change, not paralyzed by fear nor distracted from the necessary details. Teaching our team how to accurately perform risk-mitigation through strategic initiative planning is an invaluable way to develop future leadership, because it strengthens an already change-ready and resilient remote team. We clearly explain how a productivity metric allows for patient affordability of services and develop a consistent and accurate staffing model. Overall, it becomes more of a conversation about how to teach this required leadership skill rather than an argument over the numbers. Imagine how much easier the complex and oftentimes more difficult conversations, outside of coder productivity, could be handled with compassionate communication when everyone understands the risks associated with the topic.

This type of open-door leadership, even in a remote environment, requires intentional and frequent communication. This task can be accomplished easily through weekly emails to ensure that team members understand how their work connects to the big picture. For team members to support change, they need to understand “why” change is necessary.

Who better to ensure the message is clear than their leaders? Consistently communicating clear expectations can dramatically reduce unexpected and sometimes destructive emotions.

I also am a strong advocate for personal, hand-written thank-you notes for team members, peers, and, yes, especially the bosses. In the fast-paced, stress-inducing work environment, it is easy to forget the importance of one universal human truth: We should treat others, whether colleagues or direct reports, just as we want to be treated.

Take time to start a new habit of writing thank-you notes, expressing concern for team members as individuals, and offering written words of praise when it is well-deserved. You will be amazed by the positive impact that is created by such a simple leadership tactic.

Finding time for these thoughtful ways of communicating is essential.  Using education and positive, informative communication, instead of treating team members like “numbers,” will result in greater worker satisfaction, engagement, and ultimately retention. Remember: We thought they could become great when we selected them for our teams. It is up to us as leaders to provide them with the education and encouragement they need, through compassionate communication, to realize their greatness and retain them in our company.

Remarkable leaders prevent coder burnout, one team member at a time.
Sarah Laird, RHIA, CCS

Sarah Laird has more than 10 years of experience in health information management (HIM) within revenue cycle services at Novant Health. Prior to joining Novant Health in 2011, Sarah worked at Cone Health. While at Cone Health, Sarah helped increase efficiencies for paper workflows in medical records departments, trained on appropriate charging/coding for chemotherapy, and was the company’s first Recovery Audit Contractor (RAC) coordinator. Sarah was responsible for the development of the RAC program and managed all RAC activities at Cone Health. Since joining Novant Health, Sarah has participated in several key initiatives for the system, including developing a remote coding environment, transitioning from a decentralized coding structure into a corporate department for the coding team, increasing coding accuracy, developing a coding career ladder, and creating a Coding Academy to help new coding graduates become successful coders at Novant Health.

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