Hiring The Right Clinical Manager: Its Much More Than Just Promoting Your Best Staff Nurse.

shelly • July 3, 2021

I remember vividly being told one day, "You take all the best clinicians out of the field". At this time, the statement struck me. It is something I had not really considered. It was just what made sense. Your best clinical staff fill positions of management as they become open. Why wouldn't you want the responsible, hard-working, reliable people in these positions? Right? Well, you have to consider if this is the right decision for your agency and your patients. Let's look at some things to consider when hiring or promoting a clinical manager.

Choosing A Clinical Manager:

The best clinicians don't always hit the mark of a good clinical manager in today's home health climate. It is not to say that your best clinicians can't be great clinical managers. It is more about not assuming they will be. Here are our top 4 considerations for setting yourself up for success:

How well does the clinician communicate during the plan of care? A huge part of clinical management is truly managing the care plan. You need to make sure that the best clinical person is also able to coordinate the care plan effectively. Changes to visit frequencies and visit plans are something that will need to be discussed by the clinical manager with the clinical disciplines providing the hands-on care on a routine basis. Gone are the times of this process just being about a one-sided report from the clinician to the manager.
How well does the clinician understand the money? Clinicians don't like talking about clinical care and money together, but the reality is that some of your nurses and therapists are really good at understanding the finance end of things. Yes, you can afford to lose money on certain cases, but some of the best clinical staff are better in the field as opposed worrying about the dollars behind the cases they manage.
What do your clinician candidate's care plans look like? This is also key as we live in a PDGM world. If you don't see how frequencies are based upon the most effective way to provide care to the patient in a cost-effective manner, then there are probably other things missing. Are care plans really long? If you pull 5 patients with the same diagnosis, does that clinician create the exact same care plan each time? Is the aide always added throughout the entire length of the care plan? Does it show forethought of progression of the patient to independence as the agency prepares for DC? Are the care plans updated along the way? These are all things to consider about your potential candidate. It will show you if the care plans are patient centered. It will show if the clinician clearly stays in their own swim lane and doesn't attempt to integrate a care plan. You need a clinician who promotes all disciplines working within full scope of practice for patients where they are the primary nurse. Rehab goals should be addressed with all disciplines every visit. Nursing goals can be achieved with the help of the home health aide and the rehab staff. Does your nurse have the have the aide or therapist report if there are days in the medi-box where the patient didn't take meds? Or, is this something potentially just held to assess once the nurse goes back into the home? These are simple examples of where our disciplines should overlap in advancing the care plan goals.
How are they with confrontation? Your best clinicians may not be the ones who can address issues with other clinicians as they arise. The fact is that there absolutely will be times when your clinical manager will have to provide coaching or initiate a performance improvement plan. I recall once a manager who could not look clinical staff in the eye for these types of issues. It was a problem and the staff never took any type of performance improvement plan seriously because of it.

These are important things to consider for such an important position within your agency. It holds both clinical and financial ramifications as well potential compliance landmines if the wrong person is in charge of your clinical program. If you see good clinical staff who may not fit the role of clinical manager, then consider other ways to reward the clinician for being so good in homes with your patients.

At Kenyon Homecare Consulting , we focus on high quality care while helping agencies to do it in a cost-effective way that promotes financial success as well. Call us today at 206-721-5091 or contact us online if you need assistance with clinical care, operations management, education, policy and procedure manuals, ICD 10-coding, interim management, or more.

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