A Checklist for Doing More With Less

Surviving and thriving in health care today means you need to achieve higher and higher levels of quality while somehow using fewer resources. As one executive said to me, “We’re doing a lot more work with fewer people than before, and I don’t expect it to change. Realistically, it’s going to get even more challenging than it is right now.”

The sources of all this change are mostly external (health care reform, federal budget cuts, consumerism) but they affect every employee in an organization. No one will be untouched, from caregivers at the bedside to ancillary and support staff members to leaders. One way to survive: focus on coordinating efforts – aka teamwork.

I believe health care workers understand the importance of good coordination of effort within a work unit. They know that teamwork directly affects quality of care/service, efficiency, patient safety and patient satisfaction. Employee survey data for the question that addresses coordination of effort shows that employees’ perception improved significantly for two consecutive years (from 2008 to 2010) and now is stabilizing at that higher level. In spite of the increases, for employees, this question remains a national priority for improvement.

Here are some ways to address/improve coordination and teamwork. Consider these and add to them, or offer additional ideas of your own:

• Identify inefficient and/or unnecessary processes and fix/eliminate them. To be successful at doing more with less, this is a “must do” activity. Nothing zaps energy from a team like working tremendously hard within a process that’s broken or, worse, doesn’t matter.
• Unsure of how to identify the inefficient/unnecessary processes? Just ask your staff members! You’ll be amazed at the number of possible opportunities they can cite.
• With the help of your team, prioritize the opportunities. You’re all working harder with fewer resources, so choose opportunities that provide the greatest return on your investment of time and energy.
• Invite team members to help with the improvement. They work within these broken processes on a daily basis and will have ideas on how to make things more efficient and safe, as well as satisfy customers (both internal and external).
• Venture outside your department/work unit when lack of coordination is inhibiting high quality care or service. This gets a little stickier because you’re not in total control and compromise is inevitable. But, the resulting coordination will be worth it in terms of reduced frustration and dissatisfaction.
• The responsibility for coordination of effort within any work unit is ultimately the manager’s (or senior leaders’). Leaders support a system that either fosters effectiveness and cooperation or a dysfunctional system that produces inefficiencies, non-cooperative behavior and dissatisfaction. Ignoring issues that impact coordination of effort will be frustrating to employees and cause dissatisfaction.

Health care workers recognize and have a high appreciation for teamwork and coordination of effort. They know that in the health care environment unfolding before us, coordination of effort will be essential to providing safe, high quality, high value care.