emPOWER your Medical Staff Office with Critical Thinking Skills

emPOWER your Medical Staff Office with Critical Thinking Skills

May 11, 2021

Author: Lisa Rothmuller, CPCS; Associate Vice President Consulting Services; VerityStream


Critical thinking is one of those skills where it feels like either someone has it - or doesn’t. I use critical thinking skills almost every day but, do I really think about them when I am using them or does it just happen? Throughout the week I make decisions or react to questions without much thinking. Over time I have learned to think and respond quickly which are aspects of critical thinking using my experience and knowledge and skills.


Philosophers such as Socrates, Aristotle, Plato and others may be the origin of critical thinking but more recently the National Council for Excellence in Critical Thinking advocates for the teaching of critical thinking in elementary school, in higher education, in business and professions. Schools start teaching these skills at a young age with opportunity to learn and grow into them as we get older and add more complexity.


Michael Scriven and Richard Paul define critical thinking as: the intellectually disciplined process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and/or evaluating information gathered from, or generated by, observation, experience, reflection, reasoning, or communication, as a guide to believe and action.


But WHY is this skill so important to us personally and professionally?


Critical thinking is essential if we are to get to the root of a problem and develop reasonable solutions. So let’s take time to consider what are critical thinking skills, how do they play a role in the Credentialing and Enrollment industry and what techniques can we put into place to boost this skill.


The basics are a variety of techniques used to improve critical thinking in our lives. At the foundation they include:

  • Understanding the question or issue – what are we trying to answer or solve for?
  • Gathering information – relevant information gathering whether it is from internal or external sources to provide knowledge towards the question or issue. Perspective from our experience
  • Analyzing or creating conclusions or solutions – using standards or criteria evaluating the information gathered to work towards an answer or solution working towards achieving the best possible outcome including reducing negative impacts.
  • Assessing or evaluating – critically critiquing the proposed solutions for implications and consequences and reducing those which have negative consequences.
  • Communicating and implementing – after making a decision, communicating the answer or solution that best fits or helps solve the question or issue.

Over time and with experience our thinking and decisions incorporate our perceptions, knowledge, education to make decisions. With new credentialing staff we teach and train them on the credentialing processes using documented policies and procedures. We monitor them and educate them on the art and skill of processing applicants to ensure they meet the standards, quality and competence to work at the organization. While the policies and procedures outline what to do and how to manage a file, complexity of the file can require critical thinking skills to process appropriately.


Pam Butler, Director of VerityStream CVO and I recently discussed Critical Thinking Skills.


As a director within a CVO she looks at the different elements that influence the business on a regular basis; internal operations, client facing activities, organization integration and aligning with the company’s mission and goals. Streamlining processes, ensuring quality, meeting regulatory and contractual standards, ensuring client satisfaction and growing a client base all require critical thinking skills not only on her part but from her team members and colleagues.


Pam believes critical thinking skills can be cultivated and developed through all levels of her team. It starts at the top with leadership and creating a culture of empowerment, sharing and knowledge. It is a developed skill that the team continually works on. Whether they realize it or not the team has grown in the practice of critical thinking and are much more open to sharing ideas and talking about issues.


The operational resources within the team meet periodically throughout the month where they review policies and processes. As a new policy or process is implemented, she enlists their input and feedback before final implementation, which encourages them to thinking critically about what they are doing and how the change will affect them.


The Credentialing Specialists participate in regular meetings where, amongst other topics, they discuss problem files, complex issues and files which can be used as learning opportunities. It is through the meetings where components of the critical thinking process occur. Presenting an issue or challenge, ingesting knowledge, experience and information from others help to make an informed recommendation on a solution.


Regardless of the experience or level of the team resources, Pam encourages them to identify the problem and come to the meeting with a possible solution. The discussion may provide additional information, analysis and experience to influence the ultimate solution, however, the individual who identified the problem did perform some critical thinking in advance of bringing it to the team.

The CVO completed a process change where the critical thinking process crossed teams. As we review the Critical Thinking Process we can see where Pam and her team worked through the process to come up with a solution and implement.


Question or Issue – The Credentialing Specialists were spending time following up on verifications not received (No Response Verifications) slowing down the close process. Were there opportunities in the process to improve the responses?


Understanding – The business analyst reviewed how often the No Response Verifications occurred. The Credentialing Specialist provided insight into their experience on how they were following up and what techniques they were using to obtain the verifications. The Operations Team shared observations they found during the initial processing of files.


Analyzing – The team members reviewed the information obtained through the understanding step to put together evidence confirming there were process improvement opportunities that could be made to reduce the number of No Response Verifications.


Evaluating – Based on the analysis, the team evaluated the options to change the process. These included asking the applicant for additional information, completing validation of received information earlier in the process, assigning a more specific individual to continue to monitor verification responses.


Implement or Create – The solution put into place was multi-step. The applicant was asked to submit their CV as part of the application process. By doing this the Operations team was able to validate the information submitted electronically to the CV and request and correct earlier in the process. This reduced the No Response Verifications the Credentialing Specialists were following up on in addition to boosting client satisfaction and file quality.


Through this process, Pam and her teams used their critical thinking skills (along with many other emPOWER skills) to improve business processes, quality and client satisfaction.


We hope that through this conversation with Pam, you and your teams feel emPOWERed to use the important critical thinking skills to enhance your processes, grow your team and provide value throughout your organization.

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