Tips for implementing a truly spectacular solution!
♦ Work well with what you have → find the tactic that fits your resources.
♦ Complex problems do not always require complex solutions.
♦ Though it may be a regulatory jungle out there, when you hear hoof-beats, think of horses not zebras.
♦ Consider approaching improvement from a patient driven perspective as this may actually promote an easier transition as the organization navigates though the multitude of programs and changing government initiatives.
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).
Committed, competent individuals in the workforce (employee, support staff, provider) will produce consistent results when they are:
- Able to focus on planned activities that are value added rather than reacting to unexpected situations.
- Required to adhere to specific standards and a well defined work processes when completing the planned activities.
- Provided clear and consistent expectations regarding performance and customer service.
- Expected to adapt/modify process to maintain effective workflow.
- Required to balance speed and quality of decision making with execution
- Part of a work team that shares common goals and works in a coordinated fashion.
- Encouraged to be vigilant to find and fix problems rapidly.
- Provided routine, periodic feedback pertaining to their performance.
- Encouraged to provide suggestions for work place improvement.
- Able to sense there is genuine appreciation for the work/service they perform.
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.
Consider the following consumer preferences/characteristics in relation to how your practice functions. What opportunities does this suggest for your organization? Where is change the most important to you?
Importance for Consumer:
1st – 4th Access & Convenience
5th Provider Continuity
56% Consumers consider use of retail clinics; their reasons for using:
64% More convenient hours
62% Convenient locations
53% No appointment needed
48% Lower cost
34% Have no usual source for care
How much easier can it get: mind you manners and just don’t mess-up → is that all it takes to keep a patient? Patients are more influenced by their primary care provider’s:
Manners than by their credentials.
Missteps than by the attributes of a new primary care provider.
Important for consumers:
On-line Ratings (i.e. Healthgrades, CMS).
Ability to shop for care, selecting what matches their preferences (needs, interests) when possible.
Patient satisfaction survey results are a key component of numerous third-party reimbursement programs. Wait times are such a problem for patients that it has become a standard indicator of patient service.
Consumer Expectations of Healthcare Providers:
Personalization, including bridging health and wellness.
Convenience → completely redefined to include both access of care and protection of data in office, retail and tele-health settings.
Quality, Best in Class → demonstrated use of evidence-based guidelines when available.
Transparency → price, experience, quality outcomes, real-time waiting times; social and community sharing; on-line community becoming more influential than peers, employers, insurers, providers.
Active Engagement & Partnered Health → coaching; follow-up calls at home; engaged providers who give guidance.