A productivity improve­ment program for the Department of Health Services of county in the western United States lasted seven months with two full-time consulting staff and two full-time resources from the county’s Department of Organizational Development.

 Department Overview

 The Department of Health Services primarily provides indigent health care to county resi­dents.  The approach included working with county employees to develop and implement specific recommen­dations for productivity improvement.  The scope of this program included Accounts Payable, Data Processing, Claims Processing, Income Recovery, Long-Term Care, and Utilization Review functions of the Department.

 Project Overview

Two goals were established for this program.  The first is a commitment to a participative approach to productivity improve­ment.  The second is to train Organizational Development staff.  The strategy for this program was to select an area of the County to be used as both the initial implementation area and the training ground for the Organiza­tional Development staff. 

Five individuals from the Office of Organizational Development were selected to participate on this project.  This group received extensive training in the techniques mentioned above.  Also receiving training was the management team from each of the areas within the Department of Health Services.  The Department of Health Services was divided into twelve areas.  Within each area, focus groups were established to develop and implement specific recommen­dations for productivity improvement. 

The methodology employed was included: 

• flow-charting all essential work processes;
• mapping all major processes to uncover potential reengineering opportunities;
• observing all essential tasks to establish time required for completion;
• establishing definitive quantitative relationships between measurable work volumes and staffing require­ments;
• reviewing organizational structure and span of control and recommending structural changes to improve span of control, accountability, and process flow;
• training all supervisory and management personnel in tools and techniques associated with determining staffing require­ments, defining appropriate spans of control, and work simplification.

Project Results

In one area, work assignments were shifted to allow parallel processing of incoming claims.  Other recommenda­tions included the addition of a second shift to avoid capital expense associat­ed with the purchase of computer terminals, automation of a link between two previously separate computer systems to eliminate the need for manual re-keying of data and to improve the cycle time of the bill-paying process.  In another area, work loads were balanced resulting in reduced backlogs.  In a third area, reject causes were documented.  Once documented, formal action could then be taken to eliminate that cause and its corresponding rework. 

In other areas, work volumes were determined to have decreased as the result of automation.  Staffing had not been adjusted to account for this.  Such staff were now identified as available to be transferred to areas that had been identified as understaffed.