Workplace Variation in Healthcare

The work place frequently consists of individuals who demonstrate strong survivor capabilities as they frequently adapt to a wide range of demanding and conflicting work requirements saturated with variation and waste that provide no value, rather endanger profitability, product/service quality and/or customer satisfaction. Some individuals are also able to generate significant output under these conditions. Though the tenacity of the worker (employee, support staff, provider) and/or the work environment may keep the organization operational, the organization will not achieve it’s potential, optimize safety, minimize the risk of error in complex environments nor meet customer requirements on an on-going basis. In addition, waste contributes to excess costs associated with the consequences of workforce (employee, support staff, provider) performance problems.

The following are examples of waste in the working environment. To what extent are these situations evident in your organization? Where is change the most important to you?

  • Patients frequently wait more than ten minutes for the registration and/or pre-visit prep work to begin.
  • Patients frequently wait more than ten minutes for the provider to begin his/her portion of the visit.
  • Providers frequently wait to begin the visit with the patient due to incomplete registration and/or pre-visit prep work.
  • Multiple no-shows/same day cancelled appointments, which sometimes are left open, other times filled with a same-day appointment.
  • Work pace is hectic most of the time.
  • Routinely experience feast or famine work moments.
  • Expected to utilize reactive (vs stable) work processes to meet consumer needs.
  • Work interruptions are the routine.
  • A specified % of total work time is allocated for correcting errors (omissions, data entry).
  • Work with an inappropriate level of detail (too little, too much).

As a Service Industry Healthcare is Different

Healthcare services are different from other types of service industries. When the service a consumer is seeking involves an individual’s performance (i.e. physician, financial planner, lawyer) as opposed to an organizational service (auto repair, restaurant, entertainment, hotel) it tends to be more difficult for the producer of the service to modify the service in a manner most optimal for the consumer. This is primarily due to the availability and access of the individual service. Historically, providers in health care have set office hours around the provider’s schedule which is influenced by numerous factors (hospital rounds, surgery schedule, personal needs/preferences) making minimal changes that accommodate the consumer (extended early or late office hours one or two times a week; weekend hours once a month). Other key factors contributing to the differences with healthcare delivering a consumer centered service are determining what type of service the consumer needs, predictability of when the service will be needed and who is paying for the cost of the service.

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