The challenges in healthcare right now can be readily seen; workforce shortages, financial challenges, complexity in reporting and regulatory requirements, competition, and many other daunting issues for leaders to conquer. There is no shortage of potential problems for leaders to address. To address many of these challenges, there is a lot of energy being put into figuring out responsible/safe AI, leveraging technology, and on exploring new and innovative care delivery models. All these potential solutions pose important questions for the future. For example, moving patient care from the hospital to an at-home delivery model will take creativity and significant effort. It will also change the landscape for hospitals as they see acuity continually increasing and complexity growing.
Across all of the current challenges, there is a common element, time. Time to invest in new care delivery models, explore the use of technology, experiment with AI, and keep improving the coordination of care across the complexity as that is what patients need. Time, however, is one factor that seems to be in short supply these days.
Everyone in healthcare, from the frontline to the executive teams seems like they would benefit from added time. What if there was a simple way to give back the time needed to do the innovation? I’d propose there is a simple two-faceted approach that can provide time, for everyone on the team. The first facet has been shown to give time back to the team members and the second to leaders.
How to Reclaim Time for Teams
Let’s use nursing as an example since most health systems employ more nurses than any other role. As a leader, if you want a quick reality check – put on your running shoes and go follow a nurse in your organization for an hour. Take note, you’ll see them consistently clarifying things, fixing things, or searching for things; to the tune of 3-3.5 hours per shift, per nurse (that amount of time has been shown consistently across all types of healthcare systems in the US). The nurses will describe the things they are doing as their job. They see this work as their role as a safeguard in the imperfect systems that exist. They need to save the day and make sure the issues that are in the current system don’t reach the patient. However, if everyone had the same idea, that their customer should never experience an issue, then nurses wouldn’t need to fix, clarify, or search for 40% of their time. If we look at other industries, like the airlines, they see this work of clarifying/fixing/searching as the enemy and do everything in their power to avoid it. In those other industries, they want the work to be agnostic of who is doing the work and for it to be easily known if part of the work is not happening correctly. As a result, they aren’t fixing defects, clarifying things, or searching for things. They are not wasting TIME, they are able to do their work effectively and repeatedly at exceptional quality.
In healthcare, we can give back those hours each day to nurses to do the things that only they can do. If...the teams supporting nurses are consistently making sure the rooms are turned accurately and on time, the med cabinets are stocked, the meal deliveries are on time and accurate, etc. When that happens, the nurses can excel at bringing the best practice bundles to patients and ensure that the care advances. Throughout healthcare systems different teams are suppliers to internal customers (i.e. pharmacy to nursing); when everyone in a health system is meeting their internal customer’s needs every time, then everyone can be more effective at what they do. This approach is different from the common approach of convening a team to explore why the nurses are not doing the bundles that everyone is trying to complete. Focus on giving the nurses time back to do that work, and they will. That starts with the supporting teams that nursing relies on. Get that work right and the nurses, who just like their colleagues are also compassionate hard-working team members, will take exceptional care of patients getting them home without complication.
How to Reclaim Time for Leaders
I’ve coached a number of leaders who each day receive a new batch of incident reports each day. Dozens of issues that they feel they need to address and personally help solve. The reality is that there is no conceivable way for those leaders to get involved and help solve all of those problems. Their role should be to ensure there is an operating system that when functioning correctly supports resolving those issues.
An operating system, made up of 4 subsystems, with a daily focus on 3 of the subsystems:
- Strategy system – to ensure the organization is innovating the right work
- Work system – to ensure processes are successful each day at delivering what customers need
- Improvement system – to give all team members the structure they need to solve problems themselves and have a path to escalate when they need help
- Management (or leadership) system – to guide part of a leader’s day to ensure that front-line teams can deliver what customers need and that improvement is happening when needed.
Instead of leaders reviewing those incident reports and taking action themselves, the systems kick in and guide all team members’ behaviors. Connecting back to the teams delivering the work, let’s explore an example. An important customer for the pharmacy in any hospital is the nursing team. The pharmacy work is multi-fold, but one specific work process that is vital is ensuring med cabinets are stocked. If not, nurses spend hours searching for meds daily. The pharmacy should have standards for doing this work and be able to know when it is not done correctly (the work system). When there is a defect noted, then they can take action, respond to the incident that happened, investigate to understand the cause, and design a solution (the improvement system). The leaders’ role in this case is not to respond to the incident report calling out the harm that happened the day before because of a medication issue, it is to go and understand if the pharmacy was positioned to be able to meet its customer need (the nurse) the day prior, and if not, are they using the improvement system to solve the issue? This is the management system that aims the executive time to see the efficacy of the work system and the capabilities of the front-line teams to solve problems to ensure the ultimate customer (the patient) receives what they need.
By developing the operating system, the frontline teams’ work is well understood and consistently executed. Improvement, by those closest to the work, is initiated. When this combination is effectively happening, teams invest minimal time clarifying, fixing, or searching for things and leaders can focus their time on ensuring that the systems are working instead of going to solve individual problems.
The challenges of today do call for innovative solutions, and technology and AI certainly will have their place. What AI and technology won’t do, is replace the need for all team members in the complex healthcare environment to consistently meet the needs of all the customers across the organization (each other) and ultimately the patient. When processes are stable and everyone has what they need every time, in the way they need it, in the quantity they need, when they need it; then…freeing up time will no longer be the common challenge; it will be the advantage!
Written by Bill Boyd
Bill Boyd serves as Value Capture's Chief Operating Officer, and is responsible for business operations and overseeing all support functions. He is a seasoned healthcare professional with over a decade of practice integrating process improvement methodologies into how he leads. He is passionate about collaborating with healthcare teams to create better care experiences and outcomes for patients and families. Full Bio
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