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Optimizing Front-end Operations

Posted on in Growth Strategies

Written by: Chris Calderone, Lean Healthcare Consultant, Altarum Institute 

This article is featured within theAnalyzing Business Operations Playbook – a free resource for VGM members.

Chris Calderone PortraitHME providers can leverage lean strategies to transform office operations by reducing wasteful practices. Using lean techniques to address common office workflow problems can lead to a decrease in associated hidden costs.

Lean is rooted in a process of continuous improvement for customer satisfaction and workflow efficiency in any industry. Despite the application of lean, office operations are sometimes overlooked. This may be due to a lack of tangible or visible product involved in an office setting. Information is the main product in an office setting. Waste is difficult to see because it does not litter the floor like wasted material in a warehouse. A typical HME frontend operation is rife with waste and workflow problems: reworking loops to correct errors, hand-offs, missing or incomplete information and excessive waiting.

There are many staffing factors that can contribute to waste and office overload: too few employees, the wrong mix of staff, lack of training or the wrong allocation of responsibilities. The result? Costly errors, staff turnover and dissatisfied customers.

Five Solutions to Front-nd Process Issues

These are five solutions to process-related issues that can contribute to poor workflow and excess waste in an office operation.

  1. Create Standard Work Practices

    Standard work is the foundation of lean. Standard work is defined as the one best way to perform a process or task most effectively and efficiently. That way everyone approaches similar work in a similar manner, which reduces errors and improves the process. You may have detailed procedures and policies that have become buried in operations manuals seldom referred to beyond an initial training period. Over time processes evolve into a set of tasks, workarounds and exceptions to get the work done. There is usually little documentation to guide staff in this evolving process. An effective standard work technique involves creating a standard work document and displaying it in the area where the work takes place. Include a diagram or process flow map and a visual checklist. Keep it simple: the main steps and important information in a one-page, easy-to-read and visible document. List main process steps in sequence, including key information such as timing requirements.

  2. Manage Interruptions

    Waste is created every time there is a non-essential interruption, such as questions, phone calls and e-mails. This uneven flow increases the potential for errors as employees abruptly stop what they are doing with each interrupt. In lean lingo, interrupts are known as “random arrivals” because people often react to interrupts in a random, unplanned manner. To gain better control over interrupts, monitor and track all interrupts for a short period to identify trends and patterns. Then, redesign workflow to address and minimize specific types of interrupts. Share knowledge and expertise through cross-training to allow more employees to answer common questions. In an HME, interrupts can include phone calls about order status and product information or availability. Making product information available online can help to reduce product information calls. So, too, can proactively informing patients about delayed orders, back orders and expected delivery times.

  3. Excessive Batching and Queuing 

 To achieve lean flow, you must minimize uneven workflow. Many larger HME providers organize office operations based on functions in separate departments. This can lead to excessive hand-offs, each resulting in a new queue and more wait time. Merging separate functions or combining different functions into a single area can greatly reducing waiting. Creating a smoother workflow can be accomplished by dividing work into smaller amounts waiting to be processed over a longer period. This is a lean concept known as batch size reduction and work-leveling. Crosstraining staff will provide more flexibility to maintain level workflow as people are moved to cover areas with increased activity and fluctuating workloads.

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