HLTH 4000 Week 9 Management Decision Paper Example

Should the Clinic Move Scheduling Calls Off the Front Desk and Into a Dedicated Phone Team? A Decision Paper With Three Options, Five Criteria and a Recommendation

Student Name

Walden University

HLTH 4000: Introduction to Healthcare Management

Instructor Name

Month Day, Year

Should the Clinic Move Scheduling Calls Off the Front Desk and Into a Dedicated Phone Team? A Decision Paper With Three Options, Five Criteria and a Recommendation

The Decision

At our multispecialty clinic, the same nine patient access representatives both check in patients at the front desk and answer the scheduling phone line, rotating between the two through the day. During the morning peak, the desk and the phones compete for the same people, and the phones usually lose: last quarter, 9% of calls during the 7:30 to 9:30 block were abandoned before anyone answered, against 4% the rest of the day. The practice manager has asked me to recommend whether to keep the current arrangement, separate the work into a dedicated phone team and a dedicated desk team or try a middle option. The decision has more than one reasonable answer, and whatever is chosen will need to be defended to physicians, staff and patients. This paper sets out the options, the criteria, how each option scores and a recommendation.

The Options

Option 1: Keep the current rotation. Representatives continue to rotate between the desk and the phones, with the schedule adjusted to put one more person on phones at the morning peak.

Option 2: Full separation. Create a phone team of four representatives who answer only calls, working in a back office, and a desk team of five who handle only check-in.

Option 3: Partial separation with a float. Assign three representatives to phones and five to the desk, with one float representative who moves to whichever side is busier, guided by the live call queue display.

The Criteria

Five criteria were chosen before scoring, in consultation with the practice manager: (1) phone access, measured by morning abandonment; (2) desk access, measured by check-in wait time; (3) cost, including any new equipment or space; (4) staff experience, including skill variety and workload; and (5) resilience, meaning how well the arrangement absorbs an absence. The first two are weighted most heavily, because patient access is the team's core purpose. Choosing criteria before scoring the options is a basic safeguard against picking an answer first and justifying it afterward (Buchbinder et al., 2021).

How the Options Compare

Table 1 summarizes the assessment. Ratings are judgments based on the team's data and on the experience of two other clinics in our system, one of which separated its phones last year.

Table 1

Assessment of Three Options Against Five Criteria

Note. Ratings are qualitative judgments; costs are illustrative.

What Staff Said When Asked

Before writing the recommendation, I asked each representative which arrangement they would prefer and why, in short individual conversations. Four preferred keeping the rotation, mainly because they liked the variety. Three preferred full separation, two of them because they disliked switching between the desk and the phones mid-task. Two had no preference. Several raised the same concern: that whoever was assigned to phones full time would feel cut off from the rest of the team. That concern shaped the recommendation, because the float role and keeping the phone team near the desk, rather than in a back office, both reduce the isolation people worried about. Staff preferences were not the deciding criterion, but they told me which risks of each option were real for this team rather than hypothetical.

Recommendation

I recommend Option 3, partial separation with a float. It addresses the core problem, phones losing to the desk at peak, nearly as well as full separation, at less than half the one-time cost and with better resilience to absences, which matters on a team of nine. It also keeps some variety in the work: the float rotates, and representatives can apply for float shifts. Option 2 would likely produce the lowest abandonment rate on a full-staffed day, but a single absence on a four-person phone team would undo much of the gain, and phone-only work in a back office risks the turnover we have tried to reduce. Physical separation would also weaken the everyday coordination between desk and phone staff, the kind of cross-role relationship that research links to better performance in time-pressured operations (Gittell, 2001). Option 1 is the least disruptive, but the improvement it offers is too small to justify keeping a known problem.

Research on job design supports keeping some variety and autonomy in front-line work where possible, because both contribute to motivation and satisfaction (Hackman & Oldham, 1976). The float role is a way to keep both while still protecting the phones.

Risks, Conditions and How the Decision Will Be Reviewed

Option 3 depends on the float actually moving to where the demand is, which requires a visible call queue display at the desk and a clear rule for when the float shifts. Without the display, the float would drift to whichever side is physically closest, usually the desk. The recommendation is therefore conditional on installing the display before the change. A second risk is that physicians may object to scheduling calls being answered by a team they do not see; I will explain the change at the next provider meeting and invite their offices to report problems directly to me.

The decision will be reviewed after three months against the first two criteria. If morning abandonment has not fallen below 6% or check-in wait times have risen by more than two minutes, the practice manager and I will reconsider, possibly moving to full separation if the problem is phone capacity or back to rotation if the problem is the float rule. Writing these review conditions in advance means the decision can be defended afterward on its evidence, whatever the outcome.

References

Buchbinder, S. B., Shanks, N. H., & Kite, B. J. (Eds.). (2021). Introduction to health care management (4th ed.). Jones & Bartlett Learning.

Gittell, J. H. (2001). Supervisory span, relational coordination, and flight departure performance: A reassessment of postbureaucracy theory. Organization Science, 12(4), 468-483. https://doi.org/10.1287/orsc.12.4.468.10636

Hackman, J. R., & Oldham, G. R. (1976). Motivation through the design of work: Test of a theory. Organizational Behavior and Human Performance, 16(2), 250-279. https://doi.org/10.1016/0030-5073(76)90016-7