As a manager, do you ever wonder why you need to continually remind your staff what it is they are supposed to do?
You give them job descriptions, policies, desk-top procedures, detailed instructions and yet many still stray from these directives and fail to meet basic job requirements. It’s an exhausting cycle for both the manager and the employee: The employee feels he/she can’t keep up with the changes, can’t meet all the work assigned and he/she invariably misses deadlines… Or, perhaps the employee feels overwhelmed by the amount of work involved and has difficulty deciding which activity he/she will tackle first. The result can be poor quality work and a large turnover of staff.
Today, this is especially true in healthcare. Rules and regulations from CMS, Medicaid, NCQA, JCAHO etc. are continuously changing. The requirements for correct documentation increase at an alarming rate and the focus of what’s most important varies frequently. Therefore, processes for doing the work involved to stay current have to be modified regularly. These changes and the increase in documentation require examining your staff’s workflows more frequently than is usually possible.
Workflow is defined as a series of physical and mental tasks, how they are accomplished, in what order, and by whom. It can be performed on several levels: with only one person, between people, and across the whole organization. For now, let’s just talk about the processes worked by one person to get their daily work done.
As a manager of many staff, it may be impossible to consider everyone’s workflow separately. It takes more than a simple questionnaire or meeting to understand the workflow. Every team has individuals who easily succeed at their jobs, accept change, meet deadlines, and do exceptional work. From these individuals you can get a better understanding of the other staff and their workflows and where there might be a need for better workflows. You can also identify the skills and competencies needed to assist those who have deficiencies.
A good staff workflow should at least:
- Provide a chronological order for accomplishing tasks
- Identify and remove unnecessary steps, processes, and duplications
- Reduce paperwork and computer clicking and searching
- Reduce questions and decision-making
- Assign the right tasks to those with the appropriate skill set for better quality work
It is important to invest the time into looking closely at workflows and finding ways to simplify tasks, save time, possibly add resources, and thereby increase quality of work and job satisfaction of your team. A workflow analysis entails reviewing or establishing processes with the goal of identifying inefficiencies, duplication of effort, and then recommending implementation and/or improvements. Even if you feel you already have a good system in place for completing tasks and reaching goals it may still be invaluable to take a second look. For starters, you need to examine and define your team’s workflow. How can they become more efficient? Are there new processes that can be added or adapted to enhance your team’s productivity? Are there new resources needed to assist your team in getting the job done?
Unfortunately, many businesses have workflow problems at the staff level that get ignored or go unnoticed. Managers do not have the time or energy to review the workflows when an upper management decision changes a goal. However, workflows should be routinely reviewed for optimum efficiency. If there are unmet goals, time crunches, unfinished work, and/or poor-quality work, it may be a sign of poor or missing workflows. While there’s no unique solution for a proper workflow, a positive workflow will eliminate redundancies, simplify processes, minimize errors and help your staff accomplish tasks quickly and efficiently. The biggest barriers to success in workflow can, and often are, internal. Most companies don’t regularly assess their staff’s needs and workflows because they seem fine from an inside perspective.
Even when inadequate workflows are identified and acknowledged, there is usually little time available to put into mapping and redesigning and then following through with revisions. Hiring a consultant is the best way to go for reasons of time, and mostly because being external to all the processes they can be impartial and objective. A consultant can collaborate closely with staff members, facilitating teamwork and cooperation, while adding or changing workflows that will result in better quality work and more efficiency, and an increase in employee satisfaction. A health care entity, whether it be a health plan, hospital department, MD office etc. that feels they are running inefficiently or are putting a new area into production may benefit from a comprehensive work flow analysis. A consultant with experience in Work Flow Analysis, Six Sigma, and Change Management will be able to assist you. – By Debra Echelmeyer
About Debra Enchelmeyer
Debra Enchelmeyer, RN BSN CCM, has over 30 years of experience in the health care industry. She brings a great deal of expertise in implementing new programs and company start-ups. She began with over 15 years in Home Care – starting up her own Home Care Company in addition to creating a Joint Venture with a Rehab Hospital. For the past 15 years she has held increasingly responsible positions within Managed Care Operations that have operated in over 8 states. She has experience with Prior Authorization, Utilization Review, including the use of Milliman Care and Interqual Guidelines.
Debra has led Case Management and Disease Management Teams to achieve 100% on their portion of NCQA accreditation. She has worked in Case and Disease Management with Commercial Members. Started a Medicare Case Management Department in Oregon and more recently, developed a Case Management Department covering Medicare, Medicaid and DSNP members to meet all requirements of NCQA and CMS Model of Care. She has expertise in establishing policies, procedures and workflows and working directly with IT to produce needed productivity and data reports. She has a proven record of managing large teams, improving efficiency, performance, customer satisfaction and company growth.
Debra has earned her black belt certification in Six Sigma/Lean. Recently, as a consultant she has developed the Utilization Review Department of a hospital by creating policies, procedures, clinical guidelines, workflows and gathered the necessary resources to improve their insurance approval rates as well as ready them for Medicare inpatient reimbursement.
Debra obtained a Bachelor’s in Nursing from Boston University and is a Certified Case Manager, with experience in Motivational Interviewing and Change Management.
About Professional Services Network, Inc.
Professional Services Network, Inc. (PSN) works with clients nationwide in the search and recruitment of experienced healthcare professionals in managed care and clinical roles for temporary assignments and direct hire opportunities. Additionally, PSN’s consultants work with organizations and providers seeking accreditation or re-accreditation with URAC or NCQA. For additional information regarding our services contact us at 301-460-4089 or email us at [email protected].