To address these challenges, the provider launched an internal transformation aimed at aligning roles and responsibilities. While the transformation did produce common job titles and staffing allocations, variation in roles and responsibilities remained. To reinforce the new model, strict HR policies were enacted. “Shadow titles” were created, where employee titles did not match their true focus—this limited management’s true visibility and oversight of the operations across the clinical organizations. The company partnered with WP&C to address the shortfalls of the transformation and the persistent challenges of scalability and clinician retention.
The provider needed help 1) retaining its clinicians and 2) developing an operating blueprint with a focus on organizational design. This new blueprint would improve clinician support, enable center-level accountability, and standardize current operations and future growth. WP&C performed the following:
1: Aligned on the target operating model design principles
Through a series of workshops with leadership and front-line employees, target operating model design principles were defined to ensure the future state organization would execute on the strategy. Design principles examples included letting clinicians operate in their specialization without unnecessary administrative burden, having an operating model that can scale and adapt to local market needs (e.g., size & density of centers, number and types of providers), and reinforcing center-level accountability.
2: Developed an organizational baseline against end-to-end value chain
Through a visualized mapping of a shared, end-to-end value chain (systems view) of the organization, it was possible to uncover drivers of overlap, friction and variation. Activity and effort drivers were assessed to inform target staffing ratios.
3: Uncovered drivers of clinician turnover
To uncover the true sources of turnover, a clinician lifecycle analysis was conducted to assess what clinicians value and at what level, compared to how the organization was perceived to be performing in each effort. The assessment identified that the largest and most impactful gap was addressing lack of operational support from center-based roles and shared services.
Clinician Lifecycle Assessment: What Clinicians Value vs. Provider Performance
4: Defined the future state design
To align on a high-level blueprint that could be converted into a detailed design, WP&C facilitated a target operating model workshop with clinical and operations leadership to evaluate multiple options against the design principles. Following the workshop, the selected high-level target operating model was expanded into detailed and standardized job descriptions and supporting transition artifacts (i.e., day-in-the-life, value chain view, role summary).
5: Developed a deployment strategy and playbook
To inform the change management and communication strategy, a stakeholder impact analysis was conducted to define key stakeholder groups and understand the type and expected magnitude of change for each group. A detailed deployment playbook was developed that contained key workstreams, activities, timing, sequencing, and required resources to enable and deploy the new blueprint. A cascading communications plan (audience, topic, communicator, message notes, and timing) was developed to assist with each deployment phase.
A scalable operating model blueprint was developed to adapt to different local market conditions (e.g., provider types and volume, center density, revenue) and to strengthen staff support, retention, and center-level accountability. The new model has redefined roles, responsibilities, staffing ratios, and spans of control for 30 roles.
To enable a smooth transition to the new operating model, a 6–12-month enablement phase was developed, along with a phased deployment strategy. The stakeholder impact analysis uncovered that the recent transformation had created high levels of sensitivity and concern within the organization.
Additionally, the high degree of variation in roles, responsibilities, and reporting structure, including the “shadow titles”, prevented management from mapping the current organization into the future state blueprint. The enablement phase was designed to allow effective change management and communication.
In the year following WP&C's engagement, operations and clinical leadership executed the deployment playbook and communication strategy and successfully deployed the operating model blueprint. This resulted in increased organizational efficiency and improved clinician retention.
