Revenue Cycle Management
Healthcare Blog

Work Design

When I brainstorm the attributes of good work design, I come up with the following shortlist:

1. All the work is planned and planned in advance of a start date

2. Everyone involved in the plan knows the plan
3. Work within the plan is broken down into logical parts
4. All the people doing the work have clear role assignments
5. All the people doing the work are properly trained
6. Everyone involved in the plan knows their respective accountabilities
7. Plans are documented and readily accessible
8. Revisions and changes are captured (dates, reasons), documented, and communicated
9. The plan utilizes simple metrics to comprehensively measure production
10. The plan utilizes simple metrics to comprehensively measure performance

I may have missed one, but I’d argue that my list is a pretty solid list. I’d also argue that each of my points pass “the right stuff” test (developing a plan is the right thing to do, training people is the right thing to do, so on and so on). At the end of the day, any team covering only the 10 points on my list should have a very reasonable chance of success.

As always, the real challenge isn’t in the concept of what to do. The real challenge lies within the execution of the concept. There’s a twist to this point.

Here’s the twist:

The real challenge is not executing the work, the real challenge is executing the activities necessary to design the work.

So with the real challenge in mind, here’s three executable activities teams can take to design – or redesign – a business environment:

• Design “cradle to grave” work plans – Consultants will typically start a consulting engagement by huddling up in a conference room and creating (on paper) an overview of their client’s whole operation. I’m certain what the consultants are looking for is a lot less about the technical aspects of each job, and a whole lot more about the logic – or missing logic – within workflows. Do the same thing.  Note that this is another point with a twist - here it is: the job of designing “cradle to grave” work plans is not designing the work within each area of responsibility. The job of designing “cradle to grave” work plans is designing the work that ties areas of responsibilities together so that (accounts, customers, patients, transactions…) always navigate through (departments, systems, people…) to a logical conclusion.
• Create and maintain a (central) master plan – Key concept: put the right person on the job of maintaining a master plan. The right person for the job is a Type A personality who’s a stickler for details, a drill sergeant with follow-up, and a tough customer when it comes to who can change or modify the plan. Team management (everyone maintains their part of the plan) never works and it’s not the right job for the guy or gal with nothing better to do. Integrity of the documented plan (the initial plan and any subsequent updates) is critical to the success of the plan – the job should gravitate to the candidate pool of better employees.
• Manage consistent communications (pertaining to your plan) throughout your organization – I once participated in a management exercise that involved post-merger layoffs across multiple operation centers within an organization. The goal of the exercise was to execute a onetime job that ensured a difficult and sensitive job was executed consistently (exactly the same way) in multiple sites at exactly the same time. The subject matter was difficult. However, the exercise itself stuck with me because it was so very well coordinated. Here’s some of what stuck with me:

• In the planning phase of the exercise the team frequently rehearsed scripts, conducted role playing exercises, and reviewed contingencies (expected problems, challenges).
• Materials relevant to the exercise were scrutinized for consistency and accuracy.
• Leaders within the team constantly stated and emphasized the core objectives of the exercise (reinforcement to remind team members the key elements of the job)

Execution of the plan was flawless. The job was handled professionally and to the best of my knowledge, without issue or exception. As always: planning, preparation, and practice are always winners when it comes to designing, developing, and implementing a work plan. (For more on planning and business self assessment, click here)

There’s lots more when it comes to work design. It can be a very fun and challenging process with lots of rewards (or pitfalls).

It’s a topic I enjoy, so feel free to contact me with comments or questions – rstein@varohealthcare.com or 484 459 8723. Additionally, please comment to add questions, comments, or tips.