POA: Patients Come First

To build a strong, united team everyone must have the same focus and the same agenda, said Sander Nassan, CPO, FAAOP, owner of POA-Prosthetic Orthotic Associates, Scottsdale, Arizona. "Our focus is taking care of patients, not making our jobs easier," he pointed out. "Our goal is not to use the cheapest way, but to solve problems and get positive outcomes."

This focus on the patient remains the same for administrative employees as well as the clinical staff. For instance, the billing department treats people with integrity and courtesy in collecting payments. Everyone's role in the business is considered vital. "The front desk plays as valuable a role as our clinicians," Nassan said. "Their role is unbelievably important: how they treat the phone caller and how they welcome the person who walks in the door affects how the patient feels he will be treated throughout his whole experience."

Everything in the facility's environment is geared toward making patients feel comfortable and welcome, he added. The front desk is open, rather than having a sliding glass window. The entry ramp is four inches high and 18 feet long, making it an easy rise for walkers and wheelchair users. Doors open automatically.

Technicians have the same focus. "They realize they are touching people, not just materials such as polypropylene, plaster, and resin. They think of the patient behind the work."

Nassan moved to Scottsdale from Manhattan in 1985. Although he interviewed for a position with three companies, they all wanted him to sign a noncompete agreement, which he refused. Starting his own business seemed the better option. At the time, Scottsdale had a Level 1 trauma hospital which used O&P services from Phoenix. "I was available here and could provide orthoses and prostheses overnight. A 24-hour turnaround was not part of the medical scene when I arrived. It is now."

Since DRG codes provide flat reimbursement rates, the hospital loses money if patients are kept beyond a certain number of days. "I didn't want to be the reason for a longer hospital stay," Nassan said. "Also, patients want their device as fast as possible. It's win-win for everyone to provide rapid service."

High-Quality Work Many attributes are found in the best teams, but not all these attributes are found in all teams, said Steve Hill, OTS Corporation, Barnardsville, North Carolina. "Teamwork is a many-headed Hydra," Hill added. "The most important part, of course, is the top.

"If the leader is not able to organize, support, and rally his or her employees, the organization is doomed from the start," Hill continued. A democratic system of management is not efficient, Hill said. "Letting those folks doing the actual hands-on labor express opinions is a good way of venting and relieving stress, but the boss should understand that managing a company is essentially autocratic."

Real teamwork begins after the company owner has assembled his core team of supervisors. "As each new hire is added, every other team member must take responsibility for his training," Hill said. "The examples and talents of the boss are instilled into every employee." Employees then are expected to act as peer group, boosting morale and attendance, thus resulting in higher productivity and profits.

The key, however, is the company's leader, Hill emphasized. "This person must have drive and vision. Without clear leadership, the company and its employees have no direction. Employees need to feel that the person in charge of their livelihoods is trustworthy and has his act together."

Hill continued, "Only when everyone is striving toward a common goal-whether it is the next raise, the next sales barrier, or even retirement-that real teamwork takes place."

The key to building an excellent reputation and making a profit is "being good at what you do," Nassan stressed, citing careful evaluations, measurements, impressions, fabrication, and modification. Materials are important. "Practitioners sometimes make the mistake of trying to use something quick and cheap. It may not break, but it doesn't sufficiently control the limb," he said, noting that the patient may feel insecure in the device or have pressure in the wrong places." Not everything can be made out of plastic, he added. For cases requiring stronger control, he laminates devices with heavy-duty carbon graphite.

Attracting Employees Considering the current practitioner shortage, how does Nassan attract sufficient-or even surplus-job candidates? As he works in the hospital, various employees, such as physical therapy aides and radiology transporters, ask him about prosthetics and orthotics. Some have quit their jobs, obtained an O&P education, sat for their exams, and later returned to work with Nassan as certified practitioners. For others, it was word of mouth: for instance, a friend of a physical therapist would say he was looking for a career. The therapist would suggest talking to Nassan about how some of these interested people would visit the lab for a day or more or even be hired as technicians. Later they would return as board-eligible practitioners. Nassan recalled seven who came to POA via that route, plus three who went to work elsewhere.

Nassan also serves as an adjunct instructor at the Arizona State University Department of Bioengineering. After obtaining their bachelor's degree, some of his students have taken postgraduate O&P courses, later coming to work at POA or other facilities.

Good Communication Effective communication is another team-building tool. Weekly meetings keep everyone on the same page. Clinical, technical, and administrative staff discuss delivery schedules, L-Code changes, Medicare rules, and other important items. Relevant 15-minute presentations with handouts are sometimes given.

As in any facility, personality clashes or problems sometimes arise. Nassan believes in letting people work out differences among themselves whenever possible. "If you have a problem with somebody else-tell them, not me," he tells his staff. "It puts me in a 'father' position if they come to me," he said. "Of course, I'll mediate if it is needed. But if someone just comes in and whines, I tell them I don't want to hear it. I tell them, 'Am I babysitting or what?"'

New hires who are not team players and who "have an attitude" generally don't last long, Nassan noted. "They'll leave after a while, or sometimes we ask them to leave."

Nassan's company values relationships. "If someone makes a mistake, we tell them, 'It's okay. We can teach you. If you fall on your face, we'll help you up." Making a mistake is never the issue, Nassan pointed out. The issue is how to recover from the mistake. "You can recover by taking responsibility and making it right, or you recover by not taking responsibility and blaming everyone else. "It's okay to hold a person who has made a blunder accountable, but not in front of everyone else. We do need to let them know and how not to repeat that mistake."

Nassan's teaching style for graduate students fulfilling their residency requirements prior to sitting for the ABC (American Board for Certification in Orthotics and Prosthetics) is to allow them to make mistakes. "If I tell them exactly how to do something, they'll just make the mistake later on," he noted. Long-term patients have been willing to be cared for by residents as part of their training. Elderly patients have a special place in Nassan's heart. A young athlete can use a plank of wood for a prosthesis and still play sports, he said. "It's their mentality; they'll figure out a way to make anything work." Geriatric patients, though, often are dealing with problems with balance, sight, hearing, and muscle weakness. A pressure sore caused by an improperly fitting device will heal rapidly on a young athlete, but could be much more serious for an elderly person. "It's that elderly group striving to participate in life that get me out of bed in the morning," Nassan said.

He added, "Whoever comes to us-elderly person, young athlete, or anyone else-will receive our full attention. They come here to be taken care of, and that's why we're all here."

POA: Patients Come First

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Blatchford/Endolite Salutes Paralympic Winners

European Medical Equipment Group Increases Lobbying Activities

European Medical Equipment Group Increases Lobbying Activities

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