When two organizations decide to merge into one, regardless of the type of transaction, it’s a great opportunity to review how some things are currently being done and how you may want them to be done differently in the future, eg, the physician scheduling process. I have heard more than once by seasoned practice administrators that when two groups are merging, one of the first things to be done is figure out how to merge the physician schedules. Once the physician schedule is complete, practices can begin to schedule patients and staff. Due to physician scheduling’s importance, it’s a great time for a process review. After all the 7 most expensive words in business are “We have always done it that way”.
Here are some tips:
Step 1: Assemble a small group that represents the “stakeholders”. In addition to the practice administrator, this would most certainly include several physicians, men, women, full-time, part-time, and both newer and more senior physicians in the practice. It also is important to include the “scheduler”, or the person who creates the schedule, along with the person who maintains the schedule. Finally, I would include someone from your answering service and or Emergency Department at the hospital. The Answering Service and ED are actual end users of some of the most important information on your schedule, the on-call portion. This should be a representative group that includes everyone’s voice.
Step 2: Now that you have the right people at the table, it’s time to decide on a goal. In many practices the goal is to have a physician schedule that is:
- Fair and balanced physician workload
- Considers the locations, assignment preferences and unique skills
- Simple for internal staff to find needed information
- Up-to-Date and accurate
- Reasonable to generate
- Reasonable to maintain
- Easy for physicians to consume on their mobile devices
You may want to review a previous blog post "Who are you buying the software for?" to be sure you're tuned into your audience.
Step 3: You have made great progress thus far, you have the right people at the table and you have a clear understanding of what the goals are for the organization, now it’s time to evaluate how some key-things are being done today to see if they meet the goals established or if they need to be re-evaluated. I would suggest that you review the following;
- How vacation and other day off requests are submitted?
- What are the policies around approving and declining day-off and vacation requests?
- What are the policies regarding swaps and changes to the schedule?
- What is the groups expectations regarding fairness of assignments and days-off?
- How far in advance are we going to create the physician schedule? Weekdays -vs- weekends?
- How are people going to consume the physician schedule information?
- Internal staff
- Answering service
- Emergency Department
- Partners, etc.
- Who’s going to create and manage the physician schedule?
- What tools, time, budget will the scheduler have to do their job?
For example, if you review your current process around “submitting time off and vacation requests”, I would consider discussing the following with the key stakeholders:
- How does that process work today?
- Is it the same for everyone?
- Does everyone follow the current method?
- What are the pros and cons of the current method?
- If you could redesign the process today, what would it look like?
- Who would be the main beneficiary?
- How would you enforce a new policy?
Step 4: Now that you have done the process review and have some recommendations that have been thoughtfully prepared and discussed by the entire stakeholder group, you should be prepared to make some decisions. Please note that your ability to succeed in step 4 is going to be predicated on the fact that your “organization” is business minded, patient centered, and makes decisions in the best interest of the collective group and its goals and objectives, as opposed to the loudest or most influential person. Hopefully some or all of your ideas will be implemented.
As previously stated above, the 7 most expensive words in business are “We have always done it that way”. Like many other things in life, timing is everything. Process review that results in transformational change can be justified during times when the organization is being forced to change due to a positive circumstance, like an acquisition.
Key takeaway: To grow, we must change.
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