A little teamwork goes a long way

Team solutions may ease reorganization struggles

It's not often that a worker is asked to build a system that may replace his or her job. But that's essentially what has happened in the medical records department of Port Huron (MI) Hospital, where staff are being asked to help develop and implement a new computer system that will eliminate some clerical jobs and other positions.

The department, which handles coding and reimbursement data from the hospital's inpatient and five outpatient facilities, has been proactive in dealing with this reorganization, says Robbyn Lessig, RRA, director of medical records for the 188-bed hospital. Lessig spoke about how to implement teams effectively at a recent conference held by the Chicago-based American Health Information Management Association.

Employees, who work in teams, are a part of the process of change rather than bystanders, as sometimes happens in bureaucratic companies, Lessig says.

The result is that the department's staff and other hospital employees have tailor-made a system that will eliminate duplication and automate some clerical work. Although that means many of the department's 40-plus employees need to learn new skills and work at new jobs, they have accepted the change, Lessig says.

Teams of employees, including representatives from data processing, coding, financial records, and transcription, are working on a team that is helping to design the computer system implementation, Lessig explains.

"We told the team, `The sky is the limit. If you could have anything you wanted with this computer system, what would that be?"

Here's how the team process works:

1. Team members assess the current situation.

When the team's task was to help implement a new computer system, they approached it as an opportunity to help the computer software professionals with designing a system that would make their own work more efficient and cost-effective.

The first thing they needed to do was to describe their current jobs through a work flow design. Representatives from each area wrote down their jobs in a step-by-step, flowchart fashion. For example, the transcriptionist described the steps involved in transcribing reports, and the utilization review person showed what is done for each case, Lessig says.

"The next step was to look at where we could gain efficiency, to see where we have processes that are not automated but maybe could be automated through use of the computer system Lessig says."

2. They create a flowchart for analysis and comparison.

Using a flip chart and having one team member take notes, the team members compared each work flow design. They looked for duplications and manual processes that could be eliminated.

"Maybe we have two people who do record analysis, and now we only need one," Lessig says as an example. "We may have a total reshaping of where everybody is going to be."

The team might examine the work flow design for a clerical job, for instance. At Port Huron, the system for handling transcriptions required one employee to take the reports off the printer, find the physician who made the report, and then physically take the report to the correct person. This process took about 1.5 hours, four times each day, Lessig explains.

However, under the new computer system, the reports will automatically be sent to the correct people, so that function of a clerical job is eliminated.

3. Team members collectively make decisions, and staff members are encouraged to learn new skills.

"As you work together more as a team, you realize that everybody has a common goal," Lessig says.

Teamwork promotes buy-in to changes

When the medical department was faced with job cutbacks, particularly in the outpatient area where the first cuts often are made, they readily accepted the change, Lessig says.

"They may not be happy with it, but they understand why they have to do it," she adds.

The staff may have new positions after the reorganization is complete.

"We will need more highly trained people, and we have been encouraging people to go back to school," Lessig says.

The staff was told that jobs could be found for them in that department or in other parts of the hospital, but they should do their part by learning new skills.

4. Management gives performance incentives and reinforcement to employees.

All employees at Port Huron receive bonuses when the hospital has a good financial performance, and in all but one of seven years, they have received this money, Lessig says.

"Everybody is very aware from month to month where we are on the budget, and if we have to cut back on supplies, they're willing to do that," she says.

Employees also are given positive feedback in the form of "applause" cards after a job well done. And there are numerous potlucks, parties, holiday gatherings, and other celebrations, Lessig notes.

"Employee satisfaction is a big deal here," she adds.