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Delegation and Inspection

Effective delegation is one of the hallmarks of an effective manager. However, this is easier said than done. When Delegation is ineffective, there are holes and gaps in your processes and procedures. Many times, you do not know about these gaps, because most practice systems involve significant delays, both internal and external. A perfect example involves insurance billing; I your process is incomplete or has gaps, the minimum amount of time before you know about it is 2 weeks, but many times it’s several months.

Here are some simple steps and concepts in improving your delegation skills: (I’ll use the word “target” instead of “delegatee”. It’s a little more military sounding, but is not as bureaucratic!)

Be sure the target knows the desired end result.

You need to go out of your way to describe and to detail out what the end result should look like. This includes normal ranges, ratios and work time needed. Let’s return to the billing example. Delegating the back-end financial responsibility to an employee is a critical piece of delegation. We would describe the amount of receivables, the proportion of old to new, the number of patient statements being sent per month, and the work time required to accomplish all of this.

You’ll know you are not delegating properly in this area when the employee confuses effort with end results. Most common phrases are, “I’m trying as hard as I can”, and “I don’t have enough time to do [task X]”.

Be sure the target has bottom-line, end result responsibility for an area.

The employee needs the mentality of “signing off” on a task or project. Using the billing department again, she would need to come to you, her supervisor, and say, “Here are the non-responsive or non-paying accounts. I’ve followed our normal procedures to this point. Is there any reason I should not send these accounts to collection?” In other words, she is identifying the problems, not hiding them, attempting solutions and then going to the final step.

You’ll know you are not delegating properly in this area when you are the one who identifies problems and implements solutions.

Bottom line concepts can be objective and financial, but they can also be more subjective and difficult to measure. Examples would be:

  • Does the staff seem happy and satisfied with the workplace?
  • Are we communicating regularly and effectively with our patient base?
  • Are we a positive influence in the community aside for the health care provided?

Be sure the target know what to do, how to do it, and why she’s doing it.

This nested set of ideas is analogous to Sinek’s “Begin With Why” concept. The details of what to do and then how to do it are a part of every employee’s training, whether conscious and linear or not. The “Why” relates to the company mission and is often poorly communicated or is not communicated at all. This is the all-important contextual idea that every employee is responsible for understanding when he/she has bottom line responsibilities. An example of this would be, WE want to communicate to our patient base regularly and effectively because we want to be sure that they have a full set of information upon which to base health care decisions.”

You’ll know you are not delegating properly in this area when a slight variation on a typical theme arises, and the target does not know how to handle it by herself.

Does the target perceive that you are inspecting the process (micromanaging?)

This is the biggest area that doctors fail at. The idea here is that you want to define the end results, be sure the target knows what, how and why to do the necessary tasks, and she has the necessary time and tools to do it. Then, butt out!

This does not mean that you ignore things. This is like letting go of the handle bars on a mountain bike. Lousy prognosis.

What you do pay attention to is the end result. Are we gettout what we expect and when we expect it? If not, we go back to the process and find out where the bottleneck is. WE do not do the job for the target. wE also do not shape the job around the employee, but that’s a different area of failure!

Here’s the real head-scratcher: Deming and others have proved conclusively that inspection in service and manufacturing does not improve quality! It seems impossible, but it’s undeniable. Deming is the management expert sent to Japan in 1947 to help the Japanese rebuild their industrial base, so we should listen! In his analyses, quality issues come from problems in training, direction, and processes and produce an error rate. Inspection finds the failed pieces, but we just keep producing more of them if we do not fix the source problem.

You’ll know you did not delegate well in this are I you find that you are the Inspector General and have bottom line responsibility instead of the target. Inspector General or Inspector Clouseau? Hmmm…

We offer a comprehensive consulting service for Chiropractic practices, focused on helping you serve your patients. Focus areas include patient experience, communication, finances, employee management, compliance and practice roadmap for long range thinking and planning.  Contact us to discuss how we can help you reach your goals and dreams.

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Filed Under: Finances & Tracking, Office Management, Personnel

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