Doing the Right Thing is a book about people who work in offices, why we fight, and how we can stop fighting, solve our problems, and get back to work. All materials on this site Copyright © Marianne Powers 2002. All rights reserved. Home Back Next
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Doing the Right Thing
and Achieving All Your Goals
at the Same Time
Full Book Outline:
KNOWING
LISTENING
SPEAKING
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If They Can't Get It Right in 100 Tries,
There Must Be Something Wrong with the Procedure
Standard procedures are great for almost any work you do with other people. When everyone has agreed on a way to do something, tested it, refined it, and put it in practice, the work can be done by anyone. Training and, therefore, the way the work is done, is consistent. The output is the same no matter who does the work. Everything doesn’t fall apart because the person who does that work is sick, on vacation, or leaves the group or the company. Still, one of the most important things about maintaining standard procedures is being able to adapt quickly to current conditions, and being willing to throw them out and start over when they don’t work. A sure sign that a procedure needs to be reviewed is when the procedure makes it easier to make a mistake than to do something right. You can see this most clearly when you are training new people, but you can also see it to a lesser degree with the people who are experienced in the procedure. If people make the same mistake over and over again, it could be because that is the most logical or intuitive way to do it. People can learn to do something illogically or counter-intuitively, but it is a constant struggle. The medical office software I used for years required that you put in the guarantor information first. The guarantor was the person that the statement would be addressed to and the one who was responsible for the bill. The information sheet that I used to have people fill out also had the guarantor information first, to make it easier for us to put the information in the computer. But I found out that people want to give you information about the patient first. Apparently, that is the logical thing for most people. So, I rearranged the form, because I got tired of trying to follow the arrows they drew all over the form when they realized they had filled it out incorrectly, or having to correct the information I had already entered when I realized the name they had put down as the guarantor was really a kid and must be the patient. In that situation, we had to make it a little harder for ourselves, in order to make it easier for the patients. Usually, our software makes things easier for us. It has defaults so that the usual answer is automatically filled in, required fields that you can’t skip or default, filtered fields that require one of a limited number of answers, and pop-up reminders that some action is required when you enter certain data. In the beginning, I didn’t set those up, because they weren’t necessary if everyone did everything perfectly. Now, I use them whenever I can to make it easier to do it right. I use all the tools and techniques that my team and I can think of to make it easier to do it right. Sometimes, we can think of a way to prevent mistakes in a certain procedure, such as making it a required or filtered field in the computer, but our software isn’t programmed to do that and having custom programming done would be too expensive for us. Then we have to set up checks or audits to make sure that the required information is entered correctly. We also try to help people remember what needs to be done. We do that by letting them know each and every time that it is not correct. It is not a punishment and there is no penalty except that they have to correct the error. The person who is checking or auditing the work just returns it to the person who did it every time and so does anyone who notices a mistake when they go to add the next referral or claim. Even though we know it’s just an oversight, we don’t fix it for them. We don’t wait until there are a certain number of them before we say anything. And, we don’t tell them that they “always” make that mistake sometime after the fact and not give them the examples. When our efforts to make it easier for everyone to do it right fail or there is no method that will work for everyone, we have to rely on the individual to do whatever will work for them. For them to do that, they have to know exactly what mistakes they are making, in what circumstances, and how frequently, and they need to know as soon as possible, preferably before they get into the habit of doing it incorrectly. People don’t usually enjoy being shown their mistakes (me, neither), but most people say they would rather know at the time, when it is just a small thing, when they can fix it, and when they can try to keep an eye out for it in the future, especially if someone tells them because they want them to be successful (me, too). We tell people when they have errors or omissions, every time, at the time, and let them fix them. We are willing for people to make the same mistake or ask the same question 100 times. It hardly ever takes 100 tries for someone who is doing the work (and correcting the mistakes) to get it right. So, if the same mistake keeps happening over and over again, we start thinking about what is causing it. We think about alternative ways of accomplishing the goal and things we can do to make it easier to do the task correctly and harder to make the mistake. The two most common mistakes we made in the call center/claims group were paying at the wrong level (we had four levels of payment, depending on the credentials of the provider) and paying the wrong provider location. It was easy to make mistakes in these areas. We had to choose the pay level in the second screen of the claim entry, while the provider level only displayed on the first screen, so we had to remember what it was when we got to that field. The provider address didn’t show in the claim at all. In order send the check to the right location, the person who entered the referral, days or weeks before, would have had to pick it correctly when they set it up. Since the referral didn’t always go to the same address as the claim check, this made paying the claim to the right location something you hoped for rather than knew. People got pretty good at doing what they had to do and, considering the circumstances, we did pretty well, but these mistakes were so easy to make, nobody ever really stopped making them, not even the people who had been there for years. New people really had a hard time. We figured out what would be needed to make it easier to do these tasks correctly. It was obvious that the software should have been smart enough to pick the correct provider level once you put in the provider, since that never changed and remembering is something that computers do very well. We agitated for that change with our software vendor and eventually got it in an upgrade, since we couldn’t pay for custom programming. That mistake doesn’t happen anymore. The provider pay-to address was something that could change from claim to claim, so we did need to pick that, but we requested and got an option added to our software so that the software displayed the locations in the claim, so that we could check to be sure the payment was going to the right place. Once we got used to looking at that new field, that mistake went down about 90%, but it is still a choice that a person has to make and we still get it wrong sometimes. Even though everyone in call center/claims group probably made both of these mistakes more than 100 times, we knew that it was an indication that there was a problem with the procedure, not with the people. Next Section: Teach Everyone to Do Everything Doing the Right Thing Home Page. Contains information on how to get in touch with me, since I welcome comments, corrections (of facts and typographical errors), and suggestions for new sections. You'll be able to access all 3 topic areas of this site. The URL of this site is: http://www.mariannepowers.com/proced.htm |