OUT OF THE BOX

Thought-provoking Quotes, Ideas or Publications

Q: What is one of the most common findings in an initial operations review? A: THE MISMATCH OF WORK VOLUME AND AVAILABLE STAFF

During consultations, Efficient Health Care Operations routinely assesses this equilibrium, and often finds it out of balance, leading to staff frustration and customer dissatisfaction.

Nearly every operation experiences peaks and valleys in demand or volume. Incoming telephone calls and arriving clients/patients are the two most immediate system demands, and each can be controlled only to some extent. What can be controlled? One can allocate and flex staff to meet the demands, or move the demand to create a more efficient, less frustrating and more customer-centric environment.

How do we quantify the problem? In order to better match staffing and workload, the first step is to retrieve and analyze the known information about the system or process. In this age of computer measurement, we can obtain data regarding exactly when demands rise and fall. Telephone call systems are rich in statistics such as call volume by time of day, call length, wait times, operator activity and abandonment rates. Staff and patient scheduling templates and/or historical data show patient or client arrival rates versus staff on hand by time of day and day of week. Side-by-side graphing will immediately show mismatches.

What can be done? Move the demand by modifying the visit template and/or hours of operation to smooth flow. Move the resources by flexing provider and support staff schedules to match demand. Simply changing a patient-scheduling template can work wonders in leveling workload. Various part time, cross-training or staff re-assignment options can also be used to target resources and focus more staff during known increased demand times. One seldom has the luxury of staffing phone systems to meet peaks. However, using technology, one can set up a leveraged response to high demand, as more ‘operators’ are pulled in when the system records higher incoming volume, or during known peak times such as the noon hours. Some clients have also had success in allowing callers the option of leaving a message with a guaranteed call back within 4 hours.

In summary, one can often create a less frenzied process by better matching staffing to workload. Not all elements of the equation are internally controllable, but many are. The solutions involve objective data and creative system and job design.

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ARCHIVES

January 2006: Welcome to the new EHCO website from Rebecca Brooks, President. On this page, I will periodically post a toothsome thought, an interesting article, an anecdote, or a 'war story' based on operational problem solving in health care, that readers can immediately use in their own settings I urge visitors to return now and then to find a thought-provoking gem.

Performance improvement requires people to change what they do and/or how they do it. Successful change management is driven by the WIIFM factor . . .

Change, even 'good' change, can be disruptive and fear-producing to those caught in the midst of it. Despite what concerns are actually voiced by those affected by change, their bottom line worry is "What's In It For Me?" (WIIFM-- say "whiff-em") When implementing change, each person affected must understand what will happen to his or her job duties, performance expectations, and reporting relationships. Will there be training involved? What will happen to peers? When will major change milestones happen? Can I believe my manager, or do I need to hear it from someone further up the reporting ladder? When each person is clear about WIIFM, rumors will be quickly thwarted, change can proceed more smoothly, and valuable employees will be retained.

"Change has considerable psychological impact on the human mind. To the fearful it is threatening because it means that things may get worse. To the hopeful it is encouraging because things may get better. To the confident it is inspiring because the challenge exists to make things better. Obviously, then, one's character and frame of mind determine how readily he brings about change and how he reacts to change that is imposed on him." -King Whitney, Jr., President, Personnel Laboratory, Inc. 1967.