Treating the “Quiet Epidemic” — Reducing Administrative Harm in Healthcare

On the journey to providing safer care, decision makers often prioritize efforts to reduce medical harm incidents. However, as we look across the continuum of care, we must consider that the single biggest clinical risk to any organization is, in fact, its workforce — and one of the most consequential items impacting the workforce is administrative harm.

On the surface, it makes sense. With medical harm incidents, there is an obvious impact on patients and their providers, as well as the risk for reputational damage and potential legal action for the organization. Administrative harm, acknowledged by some as a “quiet epidemic” of inefficiency and decentralized process administration, might easily be dismissed.  

However, there are very real costs associated with inaction. Administrative harm leads to overworked and under-resourced teams that are prone to burnout, turnover, and unable to effectively triage patient requests. And when patients feel that impact, it can hurt satisfaction and cause irreparable damage to an organization’s reputation.  

Healthcare providers enter the profession to help patients, but administrative inefficiencies can monopolize valuable time and often only help in theory. After 25-plus years of enduring real inefficiency for theoretical outcomes, the industry has reached a breaking point. 

Seeing administrative harm for the threat that it is 

As with all businesses, administrative inefficiency is often well-intentioned. As Hawaii Pacific Health discovered in their quest to get rid of the “stupid stuff,” most administrative harm is born from legacy tasks and miscommunication: makeshift or “shadow” documents that shouldn't exist, processes that could be handled more efficiently, or work that is required but the value is not fully understood by all stakeholders. 

In many cases, those dealing with administrative harm are not involved in the decisions that create it, and when harm is finally addressed, it's usually retroactive and often in response to organizational crises. Rather than wait to discover a problem, organizations can benefit from seeking them out and adopting proactive measures to address the root causes of strategic, operational, and medical shortfalls.  

At the end of the day, administrative work is inevitable — these processes are critical to a functioning healthcare organization — but the challenge is doing so as efficiently as possible. In a report on administrative simplification, McKinsey observed that, “the goal is not to reduce administrative spending to zero but rather to gain the highest value for each administrative dollar spent without sacrificing quality or access.”  

Administrative work should clearly support providers in carrying out their clinical work and delivering the safest care possible, not hindering it. 

Alleviating administrative harm systemically 

As technology has evolved, our patients have come to expect greater availability, mobility, and ease of use. We owe the same to caregivers and administrators as they work to serve these patients and juggle the myriad of technologies provided in the name of efficiency. In addition to providing safer patient care, the right solution can address foundational weaknesses that often contribute to administrative harm, such as inefficient scheduling, locating a current policy, or open “loops” between file managers and submitting users.  

For change to be effective, it must be systemic. Based on our work with customers, we’ve identified a few lessons learned and how individual healthcare organizations might alleviate administrative harm: 

  • Don't just automate, streamline. It’s essential to revisit processes and work with a trusted vendor/partner to ensure workflows meet desired goals and deliver cross-functional impact; while it’s tempting to simply automate everything, sometimes change needs to be more fundamental. It’s helpful to start by understanding and appreciating the importance of human factors in workflows and technology. 
  • Focus on scalability. Organizations often turn to manual or siloed processes because it’s easier in the moment, but this mindset can be disastrous long-term; RLDatix products are designed to streamline and automate administrative processes across the continuum of care, which is most effective when it eliminates silos, alongside the extra steps and redundancy that restrict organizational growth. 
  • Empower the end users. To truly address the problem of administrative harm, healthcare leaders must provide their teams with a value proposition — if you want to foster buy-in, connect the dots and help staff understand the importance of change. 
  • Inspire through impact. We love to see customer wins, and we have helped clients reduce administrative excess in paper-heavy functions like credentialing. However, we also appreciate that everyone comes to change with different levels of technological comfort and expertise; staff focusing on specific tasks may feel (at first) that innovation makes their jobs “harder” than, say, printing a piece of paper, but if they can see the negative impact of that one sheet of paper multiplied across hundreds or thousands of people, it helps put the solutions in perspective. Encourage your team to “lean in” by offering them a new way to engage with the work. 

Creating a culture of continuous improvement 

Across the industry, experts are starting to revisit the value-add of “how we’ve always done things.” In fact, many governing bodies are beginning to cut standards that no longer make sense, based on industry data and the reward for associated efforts. 

As we work with our clients to proactively address existing or potential instances of administrative harm, we’ve found that it’s helpful to regularly evaluate processes to ensure they meet current needs and won’t create future problems as staff turnover and organizations implement other technologies. Early detection of administrative harm and surveying stakeholders is critical to success. 

It’s also beneficial to conduct regular “health checks” to assess system utilization and course-correct where red flags arise. As with anything in healthcare, putting off administrative checkups can lead to worsening conditions and more widespread issues. (We call them healthcare systems for a reason.) 

Ultimately, reducing administrative harm doesn’t end with a single go-live, and ongoing governance is key. Make sure you know your data, define your KPIs, celebrate successes, find opportunities in lessons learned, and treat every new form or process as a Plan-Do-Study-Act (PDSA) activity

Imagining a harm-less world 

Healthcare organizations that invest in administrative harm reduction set the stage for improved quality and accuracy in patient care, as well as a more satisfied and efficient workforce. There are also administrative spending benefits from efficiently managed administrative processes — McKinsey estimates about 30 known interventions could deliver up to $265 billion in annual savings for US healthcare, and of that, an estimated $175 billion can be controlled and implemented by individual organizations. 

When it comes to the wellbeing of our patients and staff, we quite literally cannot afford to waste time and money on administrative excess — and, ultimately, harm. 

Learn how RLDatix can support your organization and reduce administrative inefficiency. 

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