One of the biggest problems in management, no matter what the industry, is coordination. In many companies, too often departments operate in silos. What they do is act as black boxes, in which each is largely autonomous. The entire organization is supposed to work by having the black boxes connect with each other, passing along information and work product. The upper management team coordinates their fiefdoms for the operation of the whole.
However, the frequent result is suboptimization, a term used by organizational specialists. Although each department may design its work to be efficient, with an eye to what drives metrics that govern compensation, the overall operation may be far less than optimal. It’s hard to think of an economic sector where that is more true than in healthcare. Here’s an example from the Association for Talent Development written by Debra Walker, Vice President of Development Dimensions International’s Health Care Practice:
I was speaking with a young woman who’d recently been treated for cancer. Shaking her head in exasperation, she recounted a series of “unnecessarily painful” experiences. There was the diatribe by the condescending oncologist about the in-network infusion center to which he was “forced” to refer patients. And the day her treatment was delayed because radiology hadn’t received oncology’s report. And how she had to repeat her clinical history and review her medication regimen four different times, in four different offices, in two geographical locations—in one day. And the close encounter with a supplement—”anaphylaxis in pill form”—recommended by a nutritionist who knew nothing of her severe allergy. The woman said the added burden of plugging the communication gaps around her own care was almost more than she could bear.
This should be no surprise to anyone in healthcare, or anyone who has been a patient. The industry is particularly susceptible to the problem because a number of factors, including the following:
- history as a collection of independent cottage industries
- wide array of specialized knowledges needed for complete patient treatment
- recent waves of consolidation at all levels
- still development standards and implementations of electronic information sharing
- geographic restrictions on care delivery resulting in some amount of reinvention of solutions
As Walker noted, the inherent communication and organization problems in healthcare require some different approaches to solutions. Internal personal networks among people in different departments can help solidify cooperation. Fostering a consumer mindset helps put everyone’s focus in a similar direction. And leaders will have to find ways to align different practice areas, strengthen cooperation, and create managerial and compensation models to help move employees toward the communications the organizations need.
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