Job Redesign – UWHC Receptionist
By: Kel Chakphet, Rachel Hinkes, Kurosh Ruch-Kamgar, and
Mike Wisnefsky
Industrial and Systems Engineering
University of Wisconsin – Madison
Submitted for ISyE 653, Professor Carayon
December 16, 2009
Table of Contents
Executive Summary ………………………………………………………………………3
Methodology ……………………………………………………………………………...4
Job Evaluation …………………………………………………………………………….6
Redesign Constraints ……………………………………………………………………10
Job Redesign …………………………………………………………………………….11
Conclusion ………………………………………………………………………………17
References ………………………………………………………………………………... i
Appendix A
References from Update II ………………………………………………………. ii
Appendix B
Presentation Outline ……………………………………………………………. iii
Observation: Northeast Clinic Example ………………………………………... vi
Appendix C
Pluses and Minuses: Referencing Job Analysis ……………………………….. ..ix
Appendix D
Gantt Chart ………………………………………………………………………..x
Appendix E
Chart Evaluating Job Redesign Effects on Specific Job Minuses ……………….xi
Executive Summary
In this project, our team worked with different UW Health Clinics in Wisconsin to improve psychosocial aspect of the receptionist position. Our project goal was to provide an in depth analysis and evaluation on work system elements (task, individual, organization, environment, and technology) of receptionists at UW health clinics with the intent to propose a redesign solution that aims to eliminate/reduce obstacles, inefficiencies, and common stressors. Our team in coordination with receptionists and clinic managers was able to obtain useful feedback, concerns, suggestions, and other qualitative data. After data collection was completed, each element of the work system was analyzed based on the psychosocial aspects within them, as supported by the Job Enrichment Theory, the Theory of Stress, the Balance Theory, and the Scientific Model.
Interaction with others (doctors, nurses, technicians), job variability, good relationships within the receptionist office, and easy use of technology were classified as positive factors in a receptionists work system. On the other hand, disparity in training methods, temperature comfort levels, noise disruptions, and patient privacy issues were classified as negative elements in the system. Obstacles were taken into consideration when making our job redesign suggestions. For all redesign suggestions we maintained or improved the utility levels of all positive facilitators already existing within the job position.
We recommend hiring an external consulting group to develop a standard operating procedure for each task and a training procedure to be followed by all receptionists. We expect to see a reduction in role ambiguity, stress, and inefficient work methodology as a result of our job redesign suggestions.
Noise and temperature discomfort has lesser flexibility on the redesign; however, we were able to reach a redesign conclusion. For temperature control, we proposed distributing a survey to determine the “preferred” temperature for receptionists. We also proposed receptionists be able to voice their concerns about temperature control to management, in an effort to eliminate “learned helplessness within the job.” For noise control, relocating printers and faxes and using sound barriers would immensely reduce the noise traffic in receptionist work areas.
Performing all of these redesign suggestions will improve the receptionist job position throughout the UW Clinic system. As receptionist’s jobs improve, they will be able to work better, and patients will receive a better experience when interacting with them. These improvements to the receptionist position will make UWHC a healthier and more productive place to give and receive healthcare.
Methodology
Since our Job Analysis of the receptionist position, we have continued observations and analyses. Observations have been done specifically at the Verona, Northeast, and Wingra locations. These have contributed to our final report through ‘filling-out’ our sense of the essence of UWHC work-systems; and through conversations with supervisors, receptionists, and observations of staff, we have gained the perspective out of which we have been able to put forward our final recommendations.
Our timeline was updated from the previously offered Gantt chart (Appendix D). Specifically, our refined method was to use our analyses, progress report, and revised job analysis to compile pluses and minuses and develop meaningful redesign solutions. New observation data, such as information found in Appendix B, also contributed to the selection of pluses and minuses to be focused on, as well as providing further evidence for the development of our redesign ideas.
The roles over this stage of the project process changed slightly to a structure of division of responsibilities, rather than a structure based on roles. Rachel, however, was instrumental in organization and structuring the completion and subsequent compilation of the separate parts of the project. Special tasks included developing a presentation, which comprised of putting together an outline, and designing and writing the slides. The latter was primarily done as a team, while Rachel drew up this outline and started each piece of the project for us. Further, in writing the report, Kurosh focused on topical choices and citations; Michael and Kel focused on data linkages.
Observations were conducted using the now-familiar work-system model of tools, tasks, organization, individual and environment. While at the several clinics, data was also collected by simply recording information that could potentially be viewed as important later. Our group has found that data synthesis tools frequently arise out of the direction of the data itself. For example, in previous reports we had gathered data into charts, as required by the objectives of developing a survey of the receptionist position. In kind, our redesign has required focus on themes, which have emerged from the data in the form of pluses and minuses; those pluses and minuses that have accumulated the most integrated data and attention, after analysis, thought, discussion and re-observation, have here made up the bulk of our redesign solutions. Specifically, the tools we have used, as data collection requirements have matured, were outlines and observation ‘write-ups’(Appendix B). The writing and execution of our outlines both answered and asked questions of what we needed to further know. Our presentation, for example, served as a seminal meeting and initial forming of ‘blocks,’ out of which ideas, found herein, were sculpted. And so the process of putting together a job redesign involved a continual refinement of outlines, supported by other peripheral datum. Conveniently, these outlines have been very useful as coordination tools. They, and the writing and editing of this very paper, represent a nexus of work and body of evolving production. We, are pleased, thus, to present the final and formal verison of our job evaluation and redesign of the receptionist position.
Job Evaluation
We used results from our job analysis to conduct a job evaluation. The job analysis consisted of questionnaires, phone interviews, personal interviews, and on-site observations. A table of the questionnaire results has been created and can be found in our report on job analysis (Table 1, at the bottom of page 8). The interviews and observations served the purpose of following up on ‘leads’ and information received through the questionnaires as well as the purpose of gathering data and developing understanding of clinic operations.
The results from our job evaluation are summarized in Table 1. The italicized bullet points are areas that affect the psychosocial aspects of a receptionist’s job and are the areas we will be focusing on throughout the rest of this report. A table in Appendix C has been modified with page numbers that will direct you to the areas in Report 1 from which the pluses and minuses were created.
Table 1. Plus/Minus Evaluation
Pluses / Minuseso Interaction between doctors, x-ray techs, and medical records
o Job rotation to medical records
o Variety of tasks
o Adequate storage space
o Good Relationship among colleagues
o Computers are easy to use
o Enjoy providing service / o Non-consistent practices
o Disparity in training method length
o Lack of communication
o Temperature and air quality issues
o Low patient privacy
o Noise disruptions
o Lack of writing space
o Dealing with rude customers
o Physical pain from holding phone
We will first discuss why the interactions receptionists have with doctors, x-ray techs, and medical record staff (p. 10 – Report 1) is a psychosocial plus of the job. Using Herzberg’s theory of job enrichment it is evident that interactions aid in psychosocial and professional growth by creating a sense of achievement, responsibility, advancement, and opportunity (Appendix A – Update II, paragraph 2). A receptionist can feel a sense of achievement and responsibility when she completes tasks that aid in the work of other University of Wisconsin Health Clinic staff. These tasks can include scheduling appointments for appropriate times, correcting claims, registering patients, and taking important messages for either nurses or providers. Advancement and opportunity for receptionists are created through the same interactions by allowing receptionists to build their skill base, which creates the potential for receptionists to advance to other positions within the clinic.
Receptionists have also reported that they are motivated to provide the best service possible to patients (also referred to in Appendix A - Update II, paragraph 2). According to Herzberg’s theory of job enrichment (Carayon, Job Characteristics Approaches Lecture), they have grown with the job, while providing service and receiving direct feedback in the form of acknowledgement and kind words throughout their career. Overall, receptionists have become experts in patient handling, both on the phone and in person. This sense of expertise allows them to interact with patients in an experienced and comfortable manner.
Following the same theory the ability for direct communication with authority is also a benefit to the psychosocial area of the job. Receptionists are able to communicate with doctors and administration, which allows them to learn how to fulfill their tasks in a way that best benefits the clinic. This essentially allows for the receptionists to continue learning throughout their career. They learn how certain doctors prefer messages to be written or how management would like reports to be filled so that they are easier to read; in the words of one receptionist from the Wausau clinic, “we are always learning something new every day!”
The method of the Balance Theory indicates interactions, within the receptionist position that are found to be a benefit with regard to social contact and support, may be categorized as a plus or positive (Smith and Carayon, 2001). By opening communication and allowing interactions throughout the clinic, receptionists have a wide base of support systems to reach out to with problems, concerns, or questions. Another facilitator we found from our analysis is positive relationships between co-workers (p. 26 – Report 1). Good relationships are the base of a healthy work place, and this quality certainly helps “balance” the mental load keeping receptionists form being over-stressed.
The next aspect we will discuss is why a variety in tasks (p. 16 – Report 1) presents a plus in the psychosocial area of a receptionist’s job. Again referring back to Herzberg’s theory of job enrichment, task variety creates opportunity for new learning and control over personal and office resources. Because receptionist jobs are mainly focused on assisting walk-in patients and phone call patients, the time they will be busy actively serving them will vary significantly (Job Analysis, Tasks – line 6-8). Since the time serving the patients varies it is necessary to have other tasks for receptionists to perform during the downtime (p. 10 – Report 1). These tasks can vary from brochure folding to taking online courses. The variety of tasks and the introduction of new tasks on a regular basis create a constant opportunity for new learning and for new skills to be developed. The control over resources, previously mentioned, mainly refers to the receptionist’s ability to order supplies as needed and to allocate her time and personal resources as she sees fit. The variety in a receptionist position allows this decision-making aspect; this creates a sense of responsibility and control, which, according to the Karasek model of job strain, aids in physical and psychosocial growth and helps to reduce stress (Carayon, Job Stress and Well Being Lecture).
Interactions with others and a variety in tasks have proven to be positive psychosocial areas of a receptionist’s job. We will now discuss three of the psychosocial minuses that we found throughout the job evaluation. The minuses we will discuss include disparity in training methodology, temperature and air quality issues, and noise disruptions.
Disparity in training is an important minus because it equates to a lack of standards (p. 2 – Report 1). The scientific method discussed in class suggests that scientific methods or standard operating procedures are more beneficial to job design than rule of thumb methods. Management currently has little insight regarding methods of operation because no standards exist against which to measure performance. The lack of standards also makes it hard to compile information and documents created by different receptionists throughout the UW clinics. Role ambiguity also results from an absence of standards; because there are no standard operating procedures, a receptionist may not know exactly what he is responsible for within his job.
The next two issues will be discussed together. Temperature and air quality and noise disruptions (p. 19-20 – Report 1) abet psychosocial stress by creating psychological ‘loads.’ The Balance Theory and the Theories of Stress by Hans Selye both suggest that people develop physiological reactions to environmental demand (Carayon, Job Stress and Well-Being Lecture). This is a negative impact arising from the current job design of receptionists. If a receptionist comes to work dreading the cold environment she will be in all day, she may already have psychologically impacted her ability to perform in an open and inviting manner because she will be disquieted by the omnipresence of the temperature stressor. To add to this, cold temperatures have been shown to reduce both finger dexterity and psychomotor function (Karsh, Physical Workload Heat and Cold Stress); and given that a receptionist’s job involves primarily her vigilance and attentiveness (Job Analysis, Individual Characteristics – paragraph 2) and manual dexterity – for the purpose of using her computer and phone and for the purpose of handling files - the presence of cold may both interfere with the performance of her job tasks and also lead to feelings of incompetence and helplessness over the long-term. Similarly, if noise is a constant irritant and problem, it can produce negative psychological responses that cause the receptionists to be frustrated and stressed; this again hinders their ability to perform as they should. Possible impacts of this could include an inability to focus on tasks or an inability to address patients in an easy manner, so to at least not increase the patients’ potential discomfort (as a result of vulnerability) throughout their experience at the clinic.