Solving Problems between Departments: Pediatric Administration, Pediatric Scheduling, and Referral Management

When a department first puts an idea board up and begins to hold weekly improvement huddles, they are often encouraged to focus first on the problems that are entirely within their “span of control”: those things that the department can fix quickly and cheaply without another department needing to get involved.  But we all know that many of the biggest, most frustrating barriers that caregivers here at UMass Memorial face are between and across departments.  These problems can be very hard to fully understand and fix, but like any other problem, the people who are best placed to fix those problems are the ones at the frontline, doing and experiencing the work.

The Background to the Story

SHARE Rep Maria Wentworth and the idea board she helped start
SHARE has been working intensively over the last several months to bring all the idea boards in Patient Access Services at the Worcester Business Center up to 5 star status, including the pediatrics schedulers and referral management.  As it turns out, SHARE has also begun coaching a newly re-launched idea board with the Pediatrics admins at the university campus (championed by SHARE rep Maria Wentworth, among others).  At the huddles, SHARE Organizer Will Erickson heard Pedi admins voicing concerns about both the process for scheduling pediatric appointments and patients showing up for appointments without a completed referral. Will offered to facilitate an idea board visit, bringing one of the admins over to the WBC to attend the huddles there.  The two departments at the WBC embraced the idea (with the schedulers even agreeing to change their huddle time to make it more convenient for their guest to attend). 

Visiting another Department's Idea Board Huddle

 A little over a week later Jess Kowaleski, the lead for the admins, began her day at the WBC, a building she hadn’t previously visited.  First came the schedulers’ huddle, where she heard about how difficult it can be to schedule certain appointments, and answered questions from staff about the best way to escalate scheduling issues.  It was their best attended huddle ever, and several new ideas resulted from their conversation.  Later, after attending the PAS management huddle, getting a tour of the ten or so idea boards on the 5th floor of the WBC, and checking out the IS visual management system on the 4th floor, Jess attended the referral management huddle.  At that huddle Jess heard about many of the problems the staff there face, as well as things the Pedi admins can do to make it easier for a referral to be completed (such as sending a task rather than an email).  Jess even hung around afterward to observe SHARE member Jackie McPhee complete a few referrals and better understand how difficult the current process is. 

Finding Solutions -- Much Easier when You Understand Each Other's Work

When you don’t fully understand another department’s part of a process and are frustrated by that process’ unreliability or difficulty, it is sometimes easy to blame the staff in the other department.  This idea board visit resulted in a lot of new great ideas and made impossible fixes suddenly seem possible, but it also strengthened the respect these teams felt for one another’s work: a critical foundation for future improvements. 

Could this Work for Your Department?

If your  department has been coming up with fewer ideas lately, don’t be afraid to push the scope a little.  Try asking your coworkers what ideas they wish were on other departments’ idea boards; what could other departments do or change that would make it easier for you to do your job well?  A next step might be to arrange a visit with that department where you ask what your team could be doing to make that department’s job easier.  If you’re interested in thinking more about how to do this, contact