How do we ensure that managers are able to devote more time to knowing and growing their people?

Designing an effective daily work process for managers was the focus of a recent Rapid Process Improvement Workshop within Saskatoon Health Region.

“To be able to manage every day, I need to have a certain amount of control over my day,” said Dan Florizone, President and CEO of Saskatoon Health Region and a member of the RPIW team. “One of my frustrations is when my day gets eaten up, and I’m not as productive as I’d like.”

That’s a theme for managers in Saskatoon Health Region.  Over the past months of improvement work, increasing manager capacity has been a priority.  This RPIW was meant to achieve just a small portion of the massive change that needs to happen in order to allow managers less time in meetings and in doing paperwork, and more time on the floors of their unit, managing their staff.

The Region’s communications team put together a short video, asking staff what they see their managers doing and asking managers what they do each day.  Both said that managers don’t receive proper training on how to be a manager, and that managers spend too much time in meetings, checking email, being pulled away from their staff, putting out fires and running from place to place.

“I think (managing) is a really hard job,” said Linda Nachtegaele, RN, in the video.  “I’ve said to my manager several times, ‘I would not want your job.’”

“Managers are just not set up for success in our current state,” said Donna Bleakney, one of the co-leads of the RPIW.

As part of their design process, the team identified three areas in which managers need to invest their time – knowing and growing their people, understanding and managing their operations, and improving their processes.   Currently, managers are not spending the bulk of their time in these areas.  Instead, they are being pulled in too many directions and have too many tasks to accomplish throughout their day.

The team came up with several solutions to help managers keep control of their days, including standardizing their calendar so they have meeting-free days and setting time aside every morning and afternoon to spend on the floor. The design team feels this will result in a more focused and balanced workload, freeing up time for managers to spend on other work like knowing and growing their staff, instead of in meetings.

An idea sheet from the RPIW

Standardizing a manager’s schedule to include time away from meetings and on the floor of their units will make it easier for them to know and grow their people.

The five managers who were part of testing this process felt good about having time set aside without meetings, the team reported, and they will continue to monitor and tweak the calendar standardization as time goes on.

As the team found that managers were spending a lot of time searching for necessary information for the running of their unit, they designed a Manager’s Operations Book (MOB), which the IT department is currently working on.  When it is up and running, all the information necessary for managers will be found in one virtual location, alongside a dashboard with up-to-date data on their unit.  Gathering all this information in one spot will result in a 98 per cent time savings for managers looking for information, the team reported, and a 100 per cent savings of frustration.

The team also created tips and tools for effective email management for managers in the interest of time savings and better organization, and have established criteria for meetings, making it clear to managers which meetings are a priority for them to attend. This, the team feels, will result in a more defined, predictable schedule for managers.

Overall, the improvements the team is suggesting will give managers more control of their time, better tools to be more effective with their time, the potential to explore physician-management partnerships, and an organizational commitment to addressing manager capacity in other ways. As this was a design RPIW, the changes will not go live across the Region right away. An implementation plan is currently being developed while testing with certain units continues.

Helping managers will have an effect on patient care, the team says.

“I can see huge improvements for me as a trickle-down (of these changes),” said the patient and family advisor at the team at report-out.

“The most important individuals in our organization are those who take care of our patients and the managers who support those staff members,” said Nilesh Kavia, Vice-President of Finance and Corporate Services, and co-sponsor of the team with Jackie Mann, Vice President of Integrated Health Services. “It’s really important that we make sure we support them, and set them up for success.”

Though the test units for these processes were nursing units, the outcomes of this RPIW can be applied to all managers, regardless of what kind of unit they manage.

“I learned a lot this week,” said Florizone. “Not all of us are nurse managers – we have various areas of work. But I can take the lessons learned in this RPIW and see how they apply to me.”