Improve productivity with work-flow analysis
Improve productivity with work-flow analysis
Bring staff together to create work-flow description
By Patrice Spath, ART, BA
Consultant in Health Care Quality and
Resource Management
Forest Grove, OR
Pressure to provide more services with fewer staff has become inescapable in most hospitals. One way to deal with that pressure is to conduct a work-flow analysis an organized view of a work process that forces the case manager and staff to ask the right questions of the process so improvements can be made. This sort of analysis can give you the information you need to improve services and ultimately eliminate unproductive time.
Work-flow analysis begins with the development of a work-flow description of the current process. This can be a narrative depiction of the case management process, or an illustration. For example, the chart on p. 109 illustrates the utilization review process with a flowchart model. The work-flow description you create will be a working document a means for getting to other valuable improvement activities.
Although the final work-flow description is a great tool, the real value of this step of work-flow analysis is that the discussions required to create the work-flow map will help improve staff relationships and increase everyone’s understanding of each other’s role. So don’t rush. Keep your eye on the final output, but don’t shortchange what the exercise itself can do for you.
Once the work flow has been described, the manager and staff should evaluate their current activities. Can they:
• Reduce the cost of the operation?
• Eliminate nonessential activities that waste time?
• Increase effectiveness of each necessary activity?
• Eliminate duplication of effort?
• Make work less fatiguing?
• Remove bottlenecks or delays?
• Improve service?
• Reduce complex motions and procedures?
• Remove "red tape" procedures?
• Eliminate idle time?
• Avoid backtracking in work flow?
• Minimize rework?
• Reduce excessive paper handling?
The people who do the work should be involved in the work-flow analysis. As productivity improvements are identified, staff will be much more willing to make changes if they acknowledge the problems exist.
In the analysis of work flow for each activity, the manager and staff can use the following questions as a guide for identifying potential improvements:
What opportunities exist?
• Where is the most attractive opportunity for making a change for the better?
• What are the possible technological improvements (i.e., computerization, facsimile equipment, etc.) and how would they affect our procedures?
• Where can the department’s services and abilities be more closely aligned to the customers they serve?
What personnel issues exist?
• Who are the marginal or submarginal personnel who are draining the resources of the department? What can be done about it?
• Who is impeding improvements, and what can be done to help them better their performance?
• Who are those who have ideas but have not been able to implement them?
• Who would double their performance if they were shifted to a new set of challenges?
• Who is overqualified for their job? Could a less-skilled individual perform some of the tasks?
Are scheduling changes needed?
• When can existing commitments be moved up for completion?
• When can a new schedule be adopted for implementing a new idea?
• When can additional manpower be added to complete commitments early?
• Will seven-day-a-week coverage improve productivity?
Are method changes desirable?
• How can we regroup or alter the sequence of work assignments to reduce costs and improve efficiency?
• How can we revise our departmental layout for improved coordination and shorter distances?
• Will a rearrangement improve morale, satisfaction, and results?
• How can tasks be modified, changed, or redesigned to incorporate the functions of another activity?
• How can a major procedure be improved to eliminate or modify a suboperation?
How will changes affect the department?
• What productivity problems can be expected within three months? Six months?
• What changes can be made in job requirements to enlarge responsibilities and effectiveness?
• What are the present and future barriers that may prevent the department from reducing cost and being more efficient?
• What are the projected data needs of the department’s customers? How can these be incorporated into the department’s responsibilities?
The most important component of work flow analysis is the question "Why?" To provide better service, at lesser cost, faster, with fewer errors, and with less paper you must ask: "Why are we doing what we do?" If the answer is, "Because we’ve always done it that way," or "Because we think it is required," then a comprehensive, honest work-flow analysis could greatly improve your case management program’s productivity.
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