People—The Forgotten Secret Ingredient to Drive Successful Change

We have all heard of the people, process, and technology triangle for performance improvement. This triangle has been the proverbial three-legged stool moniker for the successful integration of all three components for achieving business transformation. When it comes to revenue cycle challenges in healthcare, being able to continuously improve the process in response to the ever-changing regulatory environment can seem daunting. I think we can all agree, we are in a period of constant change that will require the continued re-engineering of our revenue cycle business infrastructure. This shouldn’t be difficult as this is what we have done for countless years in response to all the past regulatory changes. Somewhere, through the healthcare process improvement journey, the value of our not so secret, secret ingredient—people—has become lost.

It would be naïve and irrational to think technology solutions shouldn’t be the focus for performance improvement in the future. And yet, while technology has provided the tools for the user, we have all too often seen how technology in the hands of ill-prepared users just enables the completion of poor outcomes at a faster pace. Changes to the reimbursement system will require a re-tooling of the EHR and development of new technology tools to enable users to improve performance.

But who really benefits the most from these technology tools? The super user who understands the product, how to leverage the technology to integrate it into the workflow, and who can drive efficiency and effective performance improvement. Yes, the key ingredient in this are the people with the skills, knowledge, and ability to drive the desired outcomes.

If we’re really going to go after a wide and deep solution, recognizing the dependency between the desired outcomes and the people aspect is a critical fundamental that is being under estimated. We often see performance improvement efforts concentrate on the technology aspect as the solution—completely neglecting the need for equal focus on process and people—followed by a lack of understanding as to why the initial results achieved have lost their effectiveness over time. The training phase is far too often seen as a task to accomplish on a project plan versus a true knowledge transfer to prepare the end-user. How many times have we heard through end-user feedback that the EHR training only provided them the basics and that they wish someone had showed them a more efficient way to complete a specific task.

Start with people

Performance improvement is as much about people as it is about process or technology. At the center, you need industry subject matter experts that understand not only the subject matter, but the dependency between the desired outcomes, and the people who will be reliant on it for success. People care very deeply about anything that impacts their daily work as it is personal. Try changing a physician process that results in additional administrative burden and guess what the odds are of having a long-term sustainable solution? However, put people first—in this example the physician—and see the odds of having a long-term sustainable solution increase.

We are not saying ditch the triangle, as we still need all three to be successful. But for a performance improvement initiative to be truly successful, it takes the human capital investment to be the driver. Being in the human capital solutions business, here are five critical success factors to consider for driving successful change:

  1. Involve subject matter experts, they bring the value of having a broader viewpoint of the industry.
  2. Process improvement is personal, involve the right people in the decision as they are the ones impacted by the initiative.
  3. Top down decision making has a short-term success rate, long-term success is about the adoption of change by those impacted.
  4. Listen to the voice of the customer, as they are the key to a sustainable solution.
  5. Performance improvement is hard, it is a journey that requires constant monitoring, feedback, and continued management for long term sustainability.

In the complex environment of healthcare reimbursement, coding and billing, not all experts are created equal, but all are valued resources with a specific skill set and valued contributors for driving performance improvement. The value of a process improvement specialist cannot be over-emphasized when re-designing workflow processes. Yet this is the subject matter expert resource that is often overlooked. The proverbial people, process, and technology moniker is still an archetypal for success—if the people element is as strong as the process and technology pillars.

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