Kenneth Maddock: Pushing the Limits for Greater Efficiencies

At this point, everyone in healthcare technology management (HTM) is aware of the need to drive efficiencies in healthcare, and specifically within their own departments. I’m confident that a high percentage of HTM teams are actively and aggressively pursuing additional efficiencies. From participating in discussions online and in person, I’ve learned that this pursuit focuses primarily on minimizing or eliminating vendor service agreements, utilizing third-party parts or services rather than the original equipment manufacturer (OEM), and looking for additional equipment to support outside of the normal purview of the HTM department, which could lead to cost savings. Some more forward-thinking departments also focus on equipment utilization—making suggestions for removal of under-utilized equipment, saving both support and operational dollars.

However, many departments seem to avoid looking at reducing staffing dollars unless forced. How many managers haven’t lived in fear of being told they have to cut staff when more and more work seems to be piled on their department? One challenge is that there is no accepted formula for staffing ratios. It is an inexact science. So while most managers fear losing staff, few could state definitively that they know they are staffed properly. There may not be an easy answer to this challenge, but I have suggestion that may help with staffing costs and show your leadership that you are actively addressing this issue.

Over the many years that I have worked in the field, I have seen departments, within and outside of HTM, utilizing pay raises and promotions as a retention tool. Whether that tactic helps with retention is open to debate, but it definitely drives inefficiencies. When you use pay and promotion as a retention tool, you typically end up with a top-heavy department with too many expensive employees.

As a manager, assuming that the total number of staff is correct, you have data that can help you to identify how many positions you need at each level. The reality is that if you look at the data objectively, a fairly high percentage of the work is not complicated. It can be completed by lower-paid staff members with little experience but strong technical acumen, specific training for simple, repetitive tasks, and excellent customer relation skills. The problem is that we don’t usually have enough of those people. We also tend to assign our staff to specific areas, doing all of the work for that area, including simple tasks. Even if the highly-paid staff members are willing to do simple work, it costs too much to have them do it. I would suggest that you look closely at your data, stratify your work by complexity, and identify exactly how many staff members you need for each level. If, as I would expect, you find out that you have too many senior staff members, through attrition you can shift your workforce to a more efficient model. This would allow you to save money by keeping the same number of staff with a higher percentage of lower-paid staff, or maintain your staffing dollars at a constant level while adding staff to handle a larger equipment load.

Another often overlooked area to consider is collaborating with other departments. Have you ever thought about how often your staff and another department’s staff are in the same area at the same time? Are there opportunities to have one staff member go to the area instead of two? This goes back to my earlier comment about much of the work being of low complexity. There is no question that there is a need for highly skilled workers in HTM, information technology, and other departments. The goal should be to make sure that those workers can focus only on the complex work that requires their expertise. If you work closely with another department to identify simpler work that could be completed or at least triaged by a hybrid team, you can save payroll dollars by having a higher percentage of lower-paid employees, reduce employees by combining trips, drive additional efficiencies through a combined service dispatch model, and increase customer satisfaction by giving them a single number to call for service, and through more rapid response and quicker resolution of simple problems. A bonus is that the hybrid team can be taught to triage calls effectively if it is unable to resolve the problem, allowing you to send the right person with the right tools the first time.

I’m sure that there are departments that are already looking into these two areas as well as many others I haven’t mentioned. My goal is to get more of you to think of areas for savings that you may not have considered. Above all, I want you to push the limits when thinking of ideas for efficiencies. Everyone is familiar with the phrase, “Think outside the box.” My suggestion is to forget the idea of a box completely. There is no box and there are few boundaries for a free thinker!

Kenneth Maddock is a business development consultant specializing in healthcare technology management. His executive experience includes positions at Baylor Health Care System, Advocate Health Care, and BJC Healthcare. He is a member of the AAMI Board of Directors.

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