Tuesday, November 17, 2009

An Open Access Scheduling Model for Management

Wouldn't it be great if we could solve today's problems today?

Every day I receive over 1000 emails. A small number of those emails are complex problems that require multi-stakeholder coordination. Although I can try to solve such problems via email, my rule is that if more than 3 rounds of emails go back and forth about an issue, it's time to pick up the phone or have a meeting.

However, scheduling a meeting among senior managers in a large organization can take a month. By that time, the issue has either become a much larger problem or the opportunity to rapidly move forward has been lost. So much for nimble decisionmaking.

How can we improve this situation?

I suggest we learn from the Open Access Scheduling model used in primary care.

Patients who are sick today do not want an appointment in three weeks - they need to be seen today.

In the past, clinicians noted they were so busy that their calendars were backlogged weeks to months.

But wait - if you see 15 patients a per day, a backlogged calendar does not imply you are seeing more patients. Why not work through the backlog and then leave 50% of the calendar open each day for the patients who are sick each day - solve today's problems today.

The same thing can be applied to our administrative lives. Each day there are challenges created by customers, employees, and the external world. If we left 50% of our calendars open each day for solving today's problems today, we would reduce stress, enhance communication, and improve efficiency. We could even develop metrics for senior executives which measure "time to problem resolution" as a means to drive incentive compensation.

Today, we pay doctors for quantity of care delivered instead of quality. Healthcare reform is intended to change that. Administratively, we should be paid for the problems we solve, the chaos we eliminate, and the processes we improve.

Open Access Scheduling for Management - In December, I'll give it a try and report back how it works.


Anonymous said...

Kaiser Permanente has done a lot work to pioneer that model and I had the good fortune to hear one of their doctors give a presentation on how it works. What stunned her was the discovery that most of her nurse's spent their time juggling patient's who wanted to see the doctor. Once the patients were able to get in with minimal hassles, the nurses went back to nursing.

Anonymous said...

This is a great post for all those members who believe they are driven by the customer needs (tech support, customer care etc.) as most of us are always trying to play catchup. If we follow the Open Access Scheduling Model, I believe we'll see a difference. Truly motivating!

Lauri S said...

I like the concept and have generally operated by it, prioritizing work according to two basic factors: criticality, and how quickly it can be done. Simple and short tasks (even of low priority) shouldn't have to wait days, nor should critical and complex ones. The problem I've encountered: lower priority complex tasks tend to keep falling to the end of the to-do list and/or take many days to complete because fewer hours/day are available.