Improving organisation: defining roles

This post is an automatic translation from a text written in Slovenian. Translation is generated with use of DeepL Pro tool. Original text is postaed and available here: https://paradim.si/category/slovensko-zdravstvo-2022-23/

One of the main words in defining the problem of working conditions, and perhaps the most prominent, was organisation. “We need to do more with the staff we have.” There were a number of calls in this thematic area, and Prof. Marko Jaklič (guest in the Studio at 17.00) also provided some comparative figures to put these thoughts into practice. The field of organisation is a broad field. Two previous articles (the first and the second) have already set out a certain view on the subject, but this time I would like to highlight the word ‘role’.

What is a role?

Defining a role is a decision covering what one will do, what one will have to provide or be responsible for, and so on. As a starting point, let us ask ourselves two questions: (1) what roles should be defined and (2) how should they be defined? The term role emphasises the importance that a given set of characteristics has for the community and the achievement of objectives. Closer terms are job or job role, which emphasise the activities carried out in a role in a more objective and distinct way.

Illustrative example

Let’s go into an illustrative, also very simplified, example in the health sector and in primary medicine (i.e. family doctors). We have the possibility to define 20 roles of our choice.

In the first scenario (going to the extreme for the sake of illustration), we decide on 20 medical roles. We have therefore defined only one role and have 20 ‘family doctors for all’, but we need just as many outpatient clinics. The answers to the questions are:

1. 20 “family doctor for all” roles
2. In this role, the individual does all the work, from making appointments with patients, to seeing them, treating them, preparing their records and so on.

In a situation where the individual is doing all the necessary work, several shortcomings become apparent. For example, there is a lot of shifting from one task to another, learning and improvement in performance is slower, we cannot really dedicate ourselves (prepare, train) to each task in a quality way. This is why society decided long ago to divide work and specialise (i.e. narrowing the definition of roles). In the second scenario, we divide the whole role into three and define three more specialised roles: family doctor, nursing and administrator. We create 6 health teams and operate 6 outpatient clinics. Answers to the questions:

1. Define 6 family doctor roles, 6 nursing roles and 6 administrative roles (18 defined roles in total).

2. The breadth of the overall work is divided into 3 narrowly defined breadths of activities and tasks

In such a scenario, we expect efficiency gains. Additional options can be played with: e.g. if part of the administrative work is shared, does it make sense to define the administrator role as a shared role? This would mean that fewer administrators would be identified, there would be the possibility of running an additional outpatient clinic or medical team, but it would also probably lead to a reduction in specialisation (since not all the administrative work is shared, some of it would have to be done in the individual outpatient clinic).

Let us assume that we stay with the baseline of the second scenario. We still have two vacancies. As we see that some of the activities are repeated in a continuous pattern when the work is carried out, we see the possibility of automating these tasks. Let’s go back to the answers:

1. Add the role of software tool developer.
2. The newly defined role is intended to simplify and speed up activities that are carried out in the regular description of other roles.

Supporting roles

Of course, in the functioning of an organisation, we cannot stay with a static picture. We need to add the time dimension (things change, e.g. employees retire and new ones come in, employees at different stages of their lives act differently, etc.), the work environment dimension (in the case of healthcare, e.g. increasing needs and demands for increased efficiency), the human factor (relationship dynamics, the need to understand change, the effect of gratification, etc.), and so on.

The roles identified in the previous point could be grouped together in an industrial company to form a production function, i.e. the roles most directly concerned with value creation (in healthcare this is patient care). The role of technical support or “IT staff” can also be a close role if it is responsible for automating this core process. What about support (i.e. facilitative) roles?

“Secret” roles

The illustrative example in the background already includes two support roles. The first role is the one in which we, the readers of this paper, are in: the role of the one who thinks about possible forms, decides on one of the forms and finalises it. Moving from one scenario to another therefore involved the role of the manager. The manager has to decide how he wants to solve the problems that have arisen (will it be additional staffing, digitalisation, maybe another solution?) and set up and maintain the system.

Another role? Leadership. As this is my field, I will not go into layman’s definitions (often here a manager is “all that is needed or all that is missing”): the role of a manager is to work with people and to deliver the set plan and the organisation. It is a role that falls under the umbrella of management: it may be the same person, but the nature of the two roles is quite different. It is theleader who has to communicate the change that is ready to be made to all the medical teams, explain it properly and enable everyone to implement it successfully. It is also the leader who brings the information from the implementation of the envisioned change back to management and, if necessary, initiates a new process of planning (e.g. is staffing or digitisation the right way?) and organising (is the envisioned list of defined roles appropriate?). The questions: Is everything OK? Are things (envisioned) working OK? Do you need something to do the job?

Other roles

What else does a non-static, dynamic picture bring? Relationships and organisational culture are needed to sustain effective and efficient performance. It is necessary to have people in the team and in the organisation who work well together, who can get the job done and who also get on well on a personal level. As mentioned above, we need an induction into the role and the working environment on entry, but as we approach exit, perhaps we can contribute more in other ways (HR role, mentoring role).

We are currently witnessing major upheavals in the health sector and in public opinion. Anyone working in the healthcare system can reflect on themselves, perhaps observe their working day or week more carefully, and see how much they are affected by public attitudes: how much time they devote to it, how much energy, how many questions and thoughts they devote to it. I read in a note from the Medical Association that a doctor was recommended to introduce a public relations role: would it not make sense?

Conclusion

The content of this paper, even the last paragraph, is not about advice or hints. When defining roles, it is always worth considering roles that will make a positive contribution to the whole. Whether it is day-to-day work, dealing with people, staying motivated, staying focused and thus improving the quality of our decisions, our relationship with different stakeholders, satisfaction and so on. Whether we notice it or are aware of it or not, every shortcoming comes back in its own channel and in its own way and affects our performance.

If we want to “do more with the staff we have”, we need to look at the organisation and, within that, at the definition of roles. Should an experienced, highly capable doctor do the work, or should he spend part of his time mentoring, training new staff and thereby increasing our capacity? This is just one of the questions that are relevant if we want to build a really good organisation. The central question is: how should we define roles to be (as) efficient and effective as possible?