A lean perspective: The power of process consistency

Tuesday, December 23, 2014

Many providers struggle with implementing and maintaining consistent, well-defined processes. From front-end intake to back-end billing workflows, having well-defined and formalized processes is a key driver of operational excellence and successful revenue cycle management.   

Standard work is one critical success factor associated with well-managed and effective processes. The other two critical success factors are hardwiring of vital behaviors among team members; and having visible, effective front-line leadership. 

A key principle of lean thinking or “lean management” is the concept of standard work. Standard work means that a process is well-defined in terms of who does what, when, where and how. Without standard work, consistency becomes more elusive and nearly impossible to influence. 

All too often, processes tend to evolve over time and they are not documented and communicated to others within the business. Standard work means that we are formalizing the informal. Standard work helps to ensure that different people doing the same work approach their work in a similar manner and in a way that minimizes errors and variation in process outcomes.  

Standard work is often made visible by standard work tools, such as process flow maps, visual checklists, and other important reminders that are displayed where the work takes place. These tools serve as effective reminders or visual cues that can help guide daily actions. For example, having a basic process flow chart of the steps involved in the intake process can help clarify and communicate key process steps within the referral receipt to confirmation process. 

Identifying and “hardwiring” vital behaviors is also a critical success factor for effective process performance. For example, providers that have well-managed processes have identified and reinforced appropriate vital behaviors, such as checking same or similar, obtaining prior authorization, and gathering the required documentation, etc. These vital behaviors are hardwired or engrained into everyday practice habits—every transaction, every time. 

Well-managed and effective processes also require effective front-line leadership—these frontline leaders are often the supervisors or team leads that are closest to the work. These leaders own consistency and they ensure that we have the right people doing the right things at the right time. 

Process management is a big part of lean thinking. Lean is all about identifying and minimizing the non-value added activities that can consume our daily work. Sound process management is a function of these three critical success factors. 

Improving a process is as much about changing behavior as it is about changing the process. Having standard work in place, identifying vital behaviors, along with having front-line leadership, can help drive consistency and instill operational discipline. 

Effective leaders understand that you really can’t hold people accountable—you can only hold people accountable to “something,” and hopefully that “something” is standard work along with clearly defined performance expectations.

Chris Calderone is the founder of Lean Homecare Consulting Group. He can be reached at 734-709-5487 or chrisc@leanhomecare.com.