If you were to inspect every process you do every day you would probably discover that a number of them are the result of a technology not performing ideally. Developing a process for an ineffective technology is the definition of a “workaround.” People create workarounds for a number of reasons, including:
We don’t have the ability (skills and/or knowledge) to fix the problem
The technology we need does not exist
We cannot afford or cannot access the technology we need
Workarounds, over time, become standard practice. When new people are onboarded they are trained in the workaround, and it becomes, “The way we do it/The way it’s always been done.”
In healthcare, this workaround phenomenon is the source of unimaginable waste in dollars, resources, and time. It can also be the source of incredible frustration. Many of us have been shot down or chastised with “This is the way we do it,” when we’ve attempted to change what we saw as an unnecessary or cumbersome process.
Smart Square, our healthcare scheduling software, came about in large part because we no longer saw the point in creating workarounds for scheduling software that didn’t perform ideally for healthcare. At the time, we were using what is today a competitor’s software to manage the 24/7/365 staffing operations for what is now CHI Health. To compensate for the software’s limitations we created dozens of ad hoc reports and employed a team of database engineers to develop custom solutions to give our client the data they needed to effectively manage their labor resources.
Essentially, we were in the business of developing innovative workarounds.
In 2007 we made a pivot. That was when we committed ourselves to developing innovative solutions.
In many instances, paper is a workaround. The printing of schedules, trade and PTO requests, picking up open shifts, tracking licensures and certifications, and tracking float profiles, last cancel/last float and seniority dates are all things many hospitals still do on paper.
Paper is a workaround for a healthcare scheduling system that does not track or display information effectively.
In 2008 the Intensive Care Unit at Bergan Mercy Medical Center, a 400-bed hospital, used Smart Square healthcare scheduling software to take their staff scheduling communications paperless.
Describing the state prior to going paperless, Ali Bruckner, the unit’s Operations Director said, “It was a nightmare. To have my Clinical Leads bogged down with so much paperwork, in addition to their responsibilities to the staff and to our patients was a real waste of their time and talents.”
Since going paperless, the unit’s mangers “get several hours back each week that they can devote to their real jobs, caring for patients and mentoring staff.”
Workarounds, whether they are in the form of paper-based processes or processes with too many steps, are a drain on the “time and talents” of caregivers and those outside the clinical setting trying to provide leadership and stability.
At Avantas we value curiosity. I frequently remind my team to not let what they know limit what they can imagine. I encourage them to bring their experience to a project, not their past, and to challenge the mentality of, “this is the way we do it.”
The changes healthcare must make to survive and thrive in a post-reform world are as dependent on transforming the culture of each organization as they are on implementing the strategies and technology to set the changes in motion.
For the next hour examine everything you do and ask yourself, “Am I working on something, or am I doing something that is a workaround?”
I’d be interested to hear what you discover. You can email me directly at jackie.larson@avantas.com.