Process Improvement and Operational Design Strategy

September 19, 2019
Jessica Carpenter
Jessica Carpenter, MS, RD, LDN
Senior Director, LTSS Programs

Even at the most well-run health plans and community-based organizations (CBO), those with thoughtfully conceived and implemented processes, time has a way of pressing gaps between those processes and everyday practice. Sometimes, those gaps exist in the space between creating policies while practicing business as usual. No matter the cause, the result is often a series of workarounds or staffing inconsistencies that reduces the efficiency of resources and may threaten compliance.

A comprehensive process improvement and operational design strategy will identify and close those gaps, helping organizations deliver better results on a more consistent basis. Done right, it’s a role-up-your-sleeves proposition that requires—and deserves—support and commitment from every level of the organization. The most successful approaches to process improvement include at least three key steps.

Step One: Data Collection and Assessment

This step begins with a review of all process-related materials such as policies, training materials, protocols, and standard procedures. It may include interviewing and observing frontline staff to gain a view and understanding of where there may be differences between process and practice. Often, this phase includes interviews with senior leadership to gain insight into the organization’s deliverables and performance metrics. This information will help create a value-stream map, identifying process steps that provide little or no value to staff or the organization.

Step Two: Identification of gaps and process improvement

Following the findings and outputs of Step 1, the health plan or CBO conducts an in-depth analysis of how existing resources are deployed to achieve goals and objectives, reviewed through several distinct lenses, including:

  • Outcomes – Evaluating and, where necessary, adjusting current processes, protocols, and requirements to improve the efficiency and effectiveness of l staff members and the entire organization.
  • Administrative Framework – In this phase of work, organizations evaluate the same construct of processes, protocols, and requirements from an administrative point of view. Having a thorough understanding of the guidance provided or contractual requirements that directed process development creates a more complete and nuanced view of the process improvement initiative.
  • Target opportunities – Based on how target populations and experience or respond to current-state practice, identify opportunities to modify a process and/or implement training to improve job skills, compliance and customer satisfaction.

Step Three: Mapping the way forward

If the first two steps are diagnostic, the third step is prescriptive, where organizations create an operation and implementation plan. This next step includes workforce training and program support. For example, cultural competency training makes clinicians and staff more effective communicators, helping address the broad definition of diversity, including race and ethnicity, language, disability, age, gender, sexual orientation, religion, etc. Having a broad range of views and input will result in more robust and, ultimately, more productive work plans, trainings, and program enhancements. Pilot testing of new or revised processes should begin on a small scale, before rolling out organization-wide.

A continuous cycle

Process improvement never ends. It is an ongoing activity that deserves designated, senior-level support and ownership by teams representing every area of operations. When employees are encouraged to question current practice and empowered to suggest improvements, the result is an organizational culture that supports innovation, continuous improvement, and customer satisfaction.

Commonwealth Medicine, a division of UMass Medical School, is comprised of experts in policy, operations, practice transformation, research, and analytics. Commonwealth Medicine provides a full spectrum of health and social service program development and process improvement services, including workflow analysis and redesign. For more information about how we can help your organization please contact us.