My career in healthcare started in the early 90s, and it was a crazy time for the industry. The Clinton version of healthcare reform had just hit and the industry was trying to react quickly to the change in reimbursement levels for inpatient and outpatient services. It was a great time for a consultant seeking job security, but a horrible time for a young professional who wanted to see his work actually come to fruition. I can’t tell you how many strategic and operational plans I had to update or abandon based on a change to the reimbursement rules.
Every time I tried to compare data from healthcare organizations with data or examples from other industries, I heard the same things: “We’re different…” “Yeah, but…” “They don’t have to…” Healthcare organizations did not accept a single case study, example, or data point I brought to the table as a valid point of comparison or example to learn from (even when I used examples from within the healthcare industry or other facilities within the same healthcare system). I left healthcare to work with other industries.
Healthcare organizations are no different than organizations in any other industry I work with. Most organizations have qualms about comparing their performance and productivity to other industries, but they tend to move past those qualms once they see other organizations successfully using cross-industry benchmarking to improve. Unfortunately, the majority of healthcare organizations still seem to resist and hold onto a “we’re different” mindset.
Yes, healthcare has to deal with patients, doctors, unions, politicians, community leaders, activists, the government, and more. But so do all organizations. Regardless of the industry, every organization contends with a different set of stakeholders. Education has students, parents, and communities. Government has the tax payers. Publicly traded corporations have shareholders, Wall Street, and unions. A multitude of factors impact businesses of all kinds, in every industry. The industries and organizations that move forward successfully simply recognize those factors and use them to drive new improvements. They don’t see stakeholders and other issues as barriers and excuses to remain stagnant; they see them as facts and sources of feedback that can help them survive.
In case study after case study, the first organizations to innovate and overcome significant market forces usually emerge as industry leaders that eventually acquire those organizations that react too slowly. No doubt, the healthcare industry is facing a huge number of challenging market forces in the coming years as it transfers to ICD-10 (and ICD-11) codes and adopts Electronic Medical Record (EMR) standards. I’m not trying to scare anyone, but being willing to look beyond the healthcare industry to improve these systems and processes could very well be the key to leading the competition instead of losing to it.
The single largest issue I have seen hamper an organization’s ability to learn and adapt is not having a common language. APQC recognized this in the mid-1990s and developed our Process Classification Framework (PCF) (www.apqc.org/pcf). The PCF is a document that outlines the exact activities that occur in major organizational processes. For example, whether you call it “IT,” “information technology,” or “whatever those guys on the 10th floor with all the laptops are doing,” the PCF calls it “7.0 Manage Information Technology.” The PCF then names and numbers every process group, process, and activity that occurs in 7.0. The PCF is intended to help organizations to understand and describe how work actually gets done—within organizational walls, beyond those walls, or even (dare I say it) outside their industries.
The original PCF is a cross-industry framework, but we have also developed industry-specific PCF documents. We fully recognize that although the basics of the payroll process are fairly consistent across industries, there will be significant differences between how a bank delivers services to their customers and how a downstream petroleum organization produces product for their customers. For that reason, when a significant transformation occurs in an industry and the leaders in that industry want to get ahead of the game, they often reach out to us, and we work with them to create these industry-specific PCFs.
So, here is my call to action for you, healthcare industry:
Yes, you are different and unique, but so is everyone. Way too many issues have piled up, and you can’t afford to wait any longer. It’s time to grow up, put on your “big boy” pants, and buckle down, and get the work done in a logical, efficient, and effective manner. I would offer a common language (or framework) as a first logical step.
If you know of any process frameworks or other industry process standards for healthcare, please include them in a comment below. I don’t want to reinvent anything that already exists. I’m also willing to do my part. If you want to help develop a healthcare-specific version of the PCF, please let me know by commenting or by going to www.apqc.org/contactus.