Management focusing on how dollars are spent
In these days of tight budgets and economic uncertainty, running your occ-health operation as efficiently and effectively as possible is more important than ever.
"It’s always been important; but today, business and industry are looking very closely at how dollars spent, and the importance of conveying that [message] is greater than it has ever been," says Nan Migliozzi, RN, MSN, COHN-S, chief of the injury prevention section of the Ohio Department of Health in Columbus.
"The occupational health office needs to be efficiently run because these professionals are really being pressured to reduce costs and to bring to their functioning capability the types of tools that are beginning to show up in the other parts of the enterprise — electronic tools, better ways of thinking and making decisions, improving communication skills, and targeted training and education," adds James E. Leemann, PhD, Scottsdale, AZ-based president of The Leemann Group, a management consulting group that offers the use of systems thinking approaches to redesigning organizations, and an adjunct professor with the Tulane University Center for Applied Environmental Public Health in New Orleans.
"I think everybody is busier and the speed of expectations has increased," notes Polly Gerber Zimmermann, RN, MS, MBA, CEN, occupational health nurse, author, and lecturer based in Chicago. "In my book, [Nursing Management Secrets], I note a statistic I found in USA Today that showed the average manager has an estimated 200 to 300 hours of undone work. In that environment, people need to work smarter, not harder. In addition, in hospitals today we have less secretarial help, so you have to do more of the paper-work management yourself rather than delegating it out."
Keys to success
In order to successfully improve productivity and efficiency, say the experts, it takes a combination of the right approach and the right strategies. In terms of how to approach the challenge, says Migliozzi, "I think one of the things that is really key to our being successful in our roles and being able to move with the industries and businesses we work in is the ability to plan and to set goals."
We all set short-term goals, she says, "but you also need long-term goals; that’s a critical part of keeping us most efficient. This involves some time management strategies — keeping in front of me what the long-term goals are, and setting smaller steps so that each week or each month I can measure my progress," Gerber Zimmermann explains.
"From my systems thinking background, it’s important to me to note that oftentimes we think about improving efficiency, but not effectiveness," Leemann observes. When you speak of efficiency, he explains, you are talking about doing things right. When you talk about effectiveness, you are talking about doing the right things. "We tend to get tied up with efficiency, and lose sight of effectiveness," he asserts.
The problem, he notes, is that with the wrong approach these two areas could be working at cross-purposes. "What you may run into is this: Is the productivity improvement you are working on the right thing you should be working on?" he poses.
If you’ve performed the same task for, say, 15 years, says Leemann, you tend to develop blinders. "You must ask yourself if the environment has changed to the point that you need to rethink what you do; is it really adding value to the organization even though it’s something you’ve done for 15 years and been rewarded for?"
In situations like this, says Leemann, you have to take a long, hard look at the work flow processes in the occ-health and safety arena. "Think about those things that take the most amount of time and that, if you were really honest with yourself, do not add value," he suggests.
"Usually, the things that fall into this category are very high-intensity, transactional work flows like manipulating a lot of data, keeping track of a lot of disparate data, or creating massive databases to keep track of exposures. These people often can’t get management to pay for the software, so instead they go out and create their own Excel database. In the end, that ends up costing many times what the software would have cost."
What it comes down to, Leemann says, is the business concept of the time value of money. "Do you want your industrial hygienist spending a third of her work time creating a database? I don’t think so," he asserts. "I’d rather have some whiz kid from college do that for $6 an hour."
You truly have to be conscious of what you do during the day — almost every minute of the day, Leemann continues. "Could you at the end of the day or year truly charge your client for what you’ve done for them? Would they have paid for that? It’s sometimes hard to face the mirror and try to justify."
Some practical strategies
Gerber Zimmermann offers some practical strategies for directly impacting your office productivity. They fall into these three categories:
- e-mail;
- filing and folders;
- time management.
"One of the things that plague all of us is spam," she observes. "They say you should have two e-mail addresses — one for friends and one for business. I also suggest you get a third e-mail for any public source — like on-line purchases or listservs — because that’s where these people get your e-mail address. Also, you should never respond to spam — even to unsubscribe, because that cues them into the fact that it’s an active e-mail address."
In addition, she says, your public e-mail should have an odd combination of letters and numbers. For example, it should not be something such as [email protected]. Instead, try an address like [email protected], something spammers are unlikely to randomly make up. "In listservs or chat rooms, make up an e-mail address that is long," she recommends. "Instead of pzimmerman@whatever, write the word at’ or put a space between your name and the ISP, and they won’t pick it up. Then, train yourself and your people to only look at your e-mail once or twice a day — otherwise, you will be constantly interrupted and get less meaningful work done."
When dealing with files, she says, buy folders that have the tabs all on one side, and use the other side to trigger or cue you about things to be done. "For me, it’s projects that are current, compared to historical projects," Gerber Zimmermann says. "I use color coding in filing, and you can also do this with floppy disks, so that each color stands for a specific type of project." She also makes sure to have a backup disk for all budget files.
"Many of us struggle with piles of paper, and that represents a delayed decision," Gerber Zimmermann explains. "Make some decisions sooner and place them in a broader category to work through. Also, file them under nouns, not adjectives. Instead of impending run,’ say run impending.’ Create a hanging folder for each catalog you like to keep. When a new one comes, take out an old one out and put in a new one."
One of her time management strategies was adopted from Mark Ellwood ([email protected]). "If someone stops by and shoots the breeze with you and won’t leave, look at your watch and say, Oh, my, look at the time!’ Or pick up a folder and say, I have to do something,’ and then walk out of the room," she advises. "If they still keep walking with you, go to the fax machine and finish there, or go into the restroom — most people won’t follow you there." People don’t perceive you as rude if you interrupt yourself, she explains.
"If you have formal commitments, like conventions, as long as you show up, people remember; it’s not like you have to stay there all the time," she says, addressing another time management issue. "Meeting time should be seen as networking time. Get there early, sit by different people, and use that time to do a little bit of talking."
"I have to make lists," says Migliozzi, addressing her productivity strategies. "If things need to be accomplished, I write them down. At the end of the day on Friday or the first thing on Monday, I make a list of the major accomplishments I need to complete that week."
Outsourcing can be another key strategy, says Leemann. This is especially true when it comes to what he calls transactional work. "For example, one thing that’s important for health and safety professionals today is to get a handle on exposures and do correlations over time, by lining them up with particular employee medical records," he notes. "For example, are they smokers, or nonsmokers? Do they chew tobacco? That a kind of thing can be outsourced."
So, too, can the management of material safety data sheets, which must accompany potentially hazardous chemicals. "For the life of me, I can’t figure out why companies continue to manage this internally," says Leemann. "It’s paper-intensive and costs a lot of time and money."
Strategies that work
Of course, theories and strategies are fine, but real-world improvement in productivity is the goal. Migliozzi recalls one such situation: "In one industrial situation, the company chose to have [occ-med] clinic hours, so the walk-ins are visiting six to seven hours a day," she notes. "But they set aside one hour at the beginning and end of the day for the staff, to allow time for planning or program implementation, like wellness programming. Interruption of the work flow makes it harder to get things done; it’s important to look at the different functions, and create the best balance for the many roles an occupational health nurse plays."
"We led the total redesign of a health and safety program that resulted in a significant reduction in injuries and illness, waste and emissions, and significantly reduced costs," Leemann recalls. "This process stretched out over an 18-month period, with full implementation taking another 18 months. The issue was really redefining workflow processes and roles and accountabilities of each staffer. Using systems thinking can have a remarkable impact on improving performance and reducing costs."
The systems thinking approach he brings to the table, Leeman explains, "looks at not only what you are doing, but also at what the system is doing to you."
For more information, contact:
Nan Migliozzi, RN, MSN, COHN-S, Chief of the Injury Prevention Section, Ohio Department of Health, Columbus, OH. Telephone: (614) 644-8048.
Polly Gerber Zimmermann, RN, MS, MBA, CEN, 4200 N. Francisco Ave., Chicago, IL 60618. Telephone: (773) 539-1048. E-mail: [email protected].
James E. Leemann, PhD, Center for Environmental Innovation, Pulse Project Director, 23068 N. 77th Way, Scottsdale, AZ 85255-4125. Telephone: (480) 513-0298. Fax: (480) 513-0299. E-mail: [email protected].
In these days of tight budgets and economic uncertainty, running your occ-health operation as efficiently and effectively as possible is more important than ever.
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