In home care companies, the cost of employees completing tasks averages 53 percent of the expenses incurred. (The other 47 percent is for products.) Employee tasks are prescribed in a company's business processes. Providers may not always choose what they do, i.e. collecting CMNs, but they do choose the way employees do things.
Doing things takes time, and buying people's time takes money. In an environment that has (and for years to come will have) declining reimbursement rates, it is imperative that businesses reduce the time it takes to perform each business process.
Think of business processes as a group of activities that produce a specific result aimed at meeting the obligations of a company's stakeholders, especially customers. It is common for home care companies to have 10 to 15 processes — intake, billing and collecting, delivery, purchasing, etc.
Accredited providers describe their processes in a Policy & Procedure manual. Companies that don't have a written manual should prepare one for the sake of efficiency, if not accreditation. A detailed description of processes is the first step in improving them.
The act of improving processes is often referred to as “business process re-engineering.” BPR is not rocket science; it is artful management. The requirements are a detailed knowledge of the process, a collaborative effort in identifying speed bumps, creative solutions in removing those speed bumps and accountability in executing the changes.
Detailed knowledge of the process is best derived from the people who are closest to the process. They routinely see the documents, hear the comments on the phone, interface with the customers in their homes, use the computers and know how it feels to work on the company's front line. Collaboration with these employees will reveal what slows them down, as well as changes that need to be made for better efficiency.
Once solutions have been identified, accountability for their implementation must be clear. Managers who develop improvement plans through collaborative efforts and don't hold themselves and their reports accountable for executing changes will see conditions deteriorate.
There are two types of metrics that should be used to measure each business process. One is throughput and the other is quality. “Throughput” describes output per time, i.e. deliveries per day. “Quality” describes the portion of the work that meets the customers' expectations. (Keep in mind that customers may be internal as well as external.) Each process should have its own set of metrics. For most cases, companies should target concurrent improvement in each metric.
There are some common, specific ways to re-engineer processes, including eliminating redundancy. For example, writing an order on a paper form and then keying it to the computer is a redundancy. The process should be re-engineered to eliminate the paper form. Eliminate keystrokes by utilizing the auto-populate and auto-complete capabilities of computer applications. This sometimes requires updating applications or even buying new applications to facilitate the efficiency.
Most activities can't be eliminated, but providers should try to find a way. If there isn't a practical way, they should reduce the number of times activities are performed. Working denials is a good place to look. That activity can't be eliminated, but the number of times it is performed may be reduced by better intake and billing practices.
Reduce footsteps by using technology that allows people to stay at their desks. Document imaging facilitates document usage without a trip to the file room. Desktop fax solutions allow scanned documents to be faxed without a trip to the fax machine.
There are few, if any, industry norms related to business processes. However, the performance of a person or team can be benchmarked to their previous throughput and quality. Implement those benchmarks and get the team to beat its best.
Don't just look outside the company — look outside the industry. Study the way other industries manage logistics, order entry, accountability, information and other parts of business. Find the practices that produce the best results, and create ways to adopt them.
Wallace Weeks is founder and president of Weeks Group Inc., a Melbourne, Fla.-based strategy consulting firm. He can be reached at 321/752-4514 or by e-mail at wweeks@weeksgroup.com.
