How Will This Module Help Me?
Help identify the “stupid stuff” in your day-to-day as a clinician
Provide a standardized organizational process to eliminate the “stupid stuff”
Share real examples of organizations that have successfully reduced unnecessary burdens
Unnecessary tasks have introduced a heavy burden into the daily workload of physicians and other clinicians and are thought to be at least partially responsible for physician burnout. Electronic health record (EHR) systems in particular have created significantly more work for physicians. Physicians themselves are often in the best position to recognize the “stupid stuff” in their day-to-day but may not feel empowered to speak up unless asked. Learn how to create a simple program where suggestions for change can be solicited and effectively carried through in your practice.
Five STEPS to Reclaim Your Day by Getting Rid of Stupid Stuff
Appoint a High-Level Champion to Lead the GROSS Initiative
Engage Appropriate Departments to Support the Cause
Engage Teams and Clinicians in Gathering Information
Triage Suggestions for Appropriate Next Steps
Celebrate Success
Step 1 Appoint a High-Level Champion to Lead the GROSS Initiative
Quiz Ref IDThe most appropriate champion will likely vary among organizations, but it needs to be someone high enough in the executive chain to make eliminating the “stupid stuff” a serious organizational initiative. In organizations where there is a Chief Medical Information Officer (CMIO), he or she would be an excellent choice for champion (and if not the champion, he/she must be on board with the GROSS initiative). Having the CEO/COO on board is also essential. Additionally, it is useful to include a practicing physician who uses the EHR to act as a partner in leading the cause. Including physicians in the GROSS initiative gives credence to leadership's seriousness about understanding the burdens that need to be improved.
As the project expands across the organization, there may be many champions from operational and clinical leaders to front-line EHR users who begin to view their work with more passion and vigor.
Step 2 Engage Appropriate Departments to Support the Cause
In addition to appointing a high-level champion, it is important to include other departments to support the initiative. By engaging common stakeholders, the initiative is set up for greater success, particularly if other departments can significantly improve their processes and work towards a common organizational goal. It is also recommended to include other departments at the beginning of your planning stages to prevent any potential barriers or delays to a solution. Please see the table below for common collaborations.
Step 3 Engage Teams and Clinicians in Gathering Information
Let everyone in the organization know that this initiative is underway—you want to get rid of the poorly designed, unnecessary, or burdensome work, but you need to first identify where this work lies. Advertise on the intranet page, in internal newsletters, and/or in department meetings. Ask clinicians and physicians to consider their daily documentation and other tasks and nominate tasks that they believe fall into this category. A catchy title, such as Getting Rid of Stupid Stuff, or “GROSS,” helps. Though calling things “stupid” will be offensive to some, it creates a shock value that can be beneficial to promoting change.
Access [G.R.O.S.S. Idea Submission Form].
Step 4 Triage Suggestions for Appropriate Next Steps
Suggestions should be monitored to acknowledge receipt and subsequent triage. Minor requests can be fixed immediately (called “Just do its”), while suggestions requiring further investigation (“Needs further investigation”) should be sent to one of several work groups. These work groups should include clinicians of the appropriate type to evaluate the request and consider whether the suggestion is possible and whether it could lead to an improved workflow. If the request is found to be valuable, specific individuals should be tasked to create the needed change.
Some suggestions will not be able to be fixed due to rules and regulations that cannot be changed (“Not possible at this time”), or due to the unrealistic nature of the request. For these, a response should be sent acknowledging awareness of the situation along with an explanation of why a fix is not feasible at this time.
Finally, for some requests, a fix already exists but the clinician or care team member is not aware of it. This is often the case with suggestions involving the EHR. For these submissions, solve the problem simply by sending a response that details how to do what was asked.
All changes (even small ones) that are successfully enacted should be announced and celebrated. Care team members (and physicians in particular) are more willing to spend the time pointing out sources of inefficiency if they see proof that change is possible. Smaller changes can be included in regular IT updates; larger changes can be highlighted by office managers and other organization leaders for future investigation.
A successful Getting Rid of Stupid Stuff program does not need to be complicated. The essential elements include a visible leadership commitment, concrete examples to work from, and an IT and governance structure to evaluate the feasibility of requests and implement effective changes. Early and regular communication about the program and its early successes will help to generate interest and increase confidence in the program.
Journal Articles and Other Publications