We present the seven symptoms that reveal a lurking pathology in physician enterprise operations. Can you recognize some or all of them in your own organization? If so, then it may be time for an operational transformation.
What to look for: Sudden decreases in emotional and physical energy from previously engaged providers and staff. Employees may also decline to participate in shared governance functions or express feelings of cynicism, disinterest, or apathy.
Why it’s important: If left untreated, low morale and staff burnout may progress to an advanced case of employee turnover, with providers and staff opting to leave the organization.
What to look for: Processes that require unnecessary clicks in the electronic health record; redundant data entry requirements for providers, staff, and patients; and lack of “smart” technology features that allow discrete data fields to be pulled into clinical notes.
Why it’s important: Redundancies create barriers between employees and between staff and their patients. Patients may also become frustrated with providing redundant information and may lose confidence in the organization’s ability to deliver seamless, efficient care.
What to look for: Appointment wait times over 14 days, along with a deterioration in customer service (e.g., taking longer than 30 seconds to answer patient phone calls, long hold times).
Why it’s important: In an era in which consumers demand immediate service and competition lurks in every smartphone, patients are far less tolerant of delays associated with access to care.
What to look for: Providers or staff who develop work-arounds within technology platforms or variations in technology use and adoption across the enterprise.
Why it’s important: Work-arounds and inconsistent use of technology signal that provider and staff training may need to be improved or that underlying technology-driven workflows do not mesh smoothly with practice patterns.
What to look for: Increasing days in A/R or decreasing collection percentages.
Why it’s important: Degradation of these high-level revenue cycle metrics absent any significant external events is typically a leading indicator of an issue with back-end revenue cycle processes.
What to look for: Management lacks access to timely, accurate operational and financial data streams. Leaders are not tracking the same key indicators and are defining performance differently.
Why it’s important: Trying to make operational decisions without access to timely and accurate data streams is next to impossible. Decisions uninformed by data can compound operational issues.
What to look for: Managers who lack the tools needed to hold direct reports accountable for operational policies; incentive structures that do not promote correct enterprise-wide workflows.
Why it’s important: Implementing operational policies is hard enough without incentives that actively encourage employees to deviate from prescribed workflows. Additionally, when providers and staff deviate, it is infinitely harder for leadership to initiate corrective action if it lacks standards to hold employees accountable.
The presence of the above symptoms should be viewed as a warning sign. If you can recognize the symptoms, you should be able to identify and correct the underlying operational pathology with operational transformation efforts. While operational transformation is a complex undertaking, the consequences of inaction are severe. The symptoms will only get worse over time, causing pain throughout the organization.