Murphy (the author of Murphy's Law) was by some accounts an optimist. He said “when something can go wrong, it will go wrong.” That is so optimistic. The reality is that when something can go wrong, it will wait until the worst possible moment to go wrong. Here's proof.
An air conditioner that is about 10 years old can break at any time. So why wouldn't an old air conditioner in Florida break on a Monday morning in November or December? The reason is, that is not at the worst possible moment. The worst possible moment is on Saturday night at 10 p.m. in August. That way the house will become a large steam room for days.
When that reality settled on my air conditioner, I noticed my little wine refrigerator that is set to keep my wine at 53 degrees couldn't do better than 60 degrees. The humidity caused our photographs to wrinkle in their frames and a paperback book's cover to curl into a tube. A woman I met told me she had to replace her refrigerator after two weeks without the AC because it was overworked in the hot environment.
There are some parallels to our businesses in that experience. The first is that, like our homes, our HME companies are dependent on the simultaneous and proper function of different mechanisms. Mechanisms in the house make food cold, keep wine cool, reduce humidity and so on. The mechanisms in our businesses are referred to as processes, and they cause referrals to be sent, customer information to be collected, medical necessity to be documented, goods to be delivered, etc.
The second is that when one part of our business has malfunctioned, it will cause stress on the other parts. The domino effect in the HME business is not a possibility, it is an absolute certainty. There is not one process in a home care company that does not affect at least one other process and, likewise, every process is dependent on at least one other process.
I hadn't thought about which mechanisms in my house were dependent on others until it became apparent. In business, a lesson that can be drawn from this is that managers should identify and document those dependencies and keep the information readily available. One way to do this is with flow charts. That way, when something goes wrong, there won't be a loss of valuable time while uncovering all of the dependencies.
Third is that problems may be latent. No problem is more overt than a crashed air conditioner in August in Florida. But, if it were the furnace, it would be unknown until one of those five mornings in January and February when there is a chill.
It is rare that a process in a home care company is unused for a period of time, but it is common to experience seasonality of processes. Managers need to be mindful of the pending loads on a department. When loads increase, the chance of experiencing a problem or weakness is greatest. Being proactive will minimize the adversity.
Fourth, the problem is not necessarily what appears to be wrong. The thermometer on the little wine refrigerator says it is not as cold as it is supposed to be, and that is true. Should it be repaired or discarded? Of course not; the problem is clearly the fault of another mechanism.
Unfortunately, business processes are usually somewhat obscure. Therefore, managers must be deliberate in diagnosing a problem. There is always a good chance that the problem could be just the last domino to fall. So, to carry the analogy on, when there is a problem with a business process, think of the domino effect and follow the trail back until you find the finger that flicked the first domino. We must fix the source first.
When the mechanisms in our homes are working properly, we usually don't think about making them work better. Businesses cannot be treated the same way. Even if every process is functioning well, managers must be intent on finding ways to make them work more efficiently.
Because the HME environment will, for the rest of our careers, see challenges with reimbursement schedules, the only hope of maintaining profitability is business process reengineering.
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Wallace Weeks is founder and president of Weeks Group Inc., a Melbourne, Fla.-based strategy consulting firm. You can reach him at 321/752-4514 or wweeks@weeksgroup.com.
