AI only gets you so far. The rest is up to the leaders.
"Administrivia". It's one of my colleague Dr. Paul DeChant's favorite words. According to the Oxford English Dictionary, the earliest evidence for administrivia is from 1937, in the International Journal of Ethics. Paul invokes it to refer to the raft of processes and requirements that devolve upon clinicians and which take time away from doing what they have trained to do and most want to do: take care of patients.
Paul invokes “administrivia” to describe the nearly 2/3's of a typical clinician's time that is spent variously entering data into the EHR, dealing with prior authorizations or frank denials from insurers, coding, filling out requisitions, in basket management, and responding to queries from Health Information Management, Corporate Compliance, HR, Medical Staff Office, etc.
Here's the thing: while a good portion of what's subsumed under the broad rubric of "administrivia" can be eliminated or at least markedly improved by emerging AI-enabled technologies -- especially those designed to tame the EHR monster, tilt with insurers, and streamline coding/compliance/revenue cycle matters -- there are still plenty of aspects of "administrivia" for which there are no tech solutions.
These include the organization's policies and procedures, staffing decisions, task/work allocation methodologies, compensation models, management practices, and culture. Taken together, the "administrivia" burden from these elements can be at least as great if not greater than those which are amenable to being handled by generative AI.
What we are seeing is that hospitals and health systems are being increasingly drawn to the shiny new AI objects as the cure-all to clinician burnout. Don't get me wrong: I am strongly in favor of using AI to liberate physicians and nurses from the drudgery of data entry and navigational complexity inherent in EHR's.
But while these are welcome and important advances, leaders who are truly committed to reducing clinician burnout, lessening turnover, increasing retention, and improving operating results will want to look closely at opportunities to re-examine the work environment, redesign work practices, and update management practices that also create or substantially contribute to "administrivia".
Organizational Wellbeing Solutions for Hospitals, Health Systems, and Medical Group Practices: Leadership-Driven Changes
The locus for curing clinician burnout and staffing shortages runs through the C-suite. Here are examples of leadership-driven changes to the workplace that my colleague Paul DeChant, MD, MBA and I often recommend:
regard clinicians as knowledge workers who are given significant latitude to make clinical decisions without unnecessary administrative encumbrances or delays
consistently apply one or more of the improvement sciences (Lean, Six Sigma, operations research, agile, design thinking) in consultation with front-line staff to improve workflow and reduce delays, waste, inefficiency, and job skill mismatches
expect all leaders, but especially senior executives, to do periodic job shadowing of front-line staff (where observing and deep listening are emphasized) in lieu of "rounding" (a largely ineffectual, if widely practiced activity)
create and require leader standard work (LSW).
develop and deploy a sophisticated, deeply ingrained, and rigorous daily management system (DMS) supported by visual display boards or monitors
judiciously invest in AI/ML solutions -- selected, tested, and endorsed by front-line staff -- that eliminate or at least markedly reduce data entry, administrative requirements, and/or repetitive tasks that are non-value add
support near-continuous optimization and remediation of the EHR (there's no such thing as "it's all set")
get rid of superfluous or outdated policies, procedures, redundant approvals, and other stupid stuff (GROSS)
Ready to transform your hospital or workplace?
Are you frustrated by adversarial relationships between front-line clinicians and senior leadership? Organizational Wellbeing Solutions was formed to enable senior leaders to identify the specific drivers of clinician burnout in their organization; and to support leaders in designing and executing a comprehensive plan to stop clinician burnout, increase retention, and improve operating results. A hallmark of our consultancy is correcting the all-too-frequent distrust and alienation clinicians feel toward the c-suite generally and the CEO in particular. Let us help you help your organization and its clinicians develop a more trusting, aligned, and productive working relationship.
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