failing to plan, is planning to fail - benjamin franklin
empowers people at every level to constantly improve and redesign their work while the process plan identifies and determines the best possible approach to creating a 'roadmap' for the person's journey back to health
Statistics show that there is only a 50% chance of an injured worker returning to their job after a 12 weeks' absence with the percentage dropping to 25% after a 6 months' absence. In order to achieve the earliest possible return to work, specific and expeditious action is required throughout the entire treatment and recovery process for optimum outcome. This requires getting the right information to the right people on a timely basis and providing the relevant data and access to experts.
Workers' Compensation is regulated at either State or Federal level dictating all the claims processes ranging from medical treatment rendered, to compensation for incapacity and impairment benefits through to claims settlement options. With this control in place, many of the tasks performed throughout the claims process are operational in nature - that is, repetitive, well-defined and documented tasks performed in a prescribed order for every claim. Effective operations management is vital for claims processing. Every activity, including determination of compensability and indemnity management must be both effective and efficient, incurring minimal expense costs to the claim. Every duplication, each reminder and slip-up adds to the cost of the claim.
Claims are commonly grouped by characteristics to assist with defining the processes a claim requires. A common group approach for example, is based on the expected period of incapacity from work or impairment suffered, including disfigurement or occupational disease. Claims that don't fall into the operational claims framework need to be treated as a 'tailored' or 'bespoke' claim.
The transition from an operational claim to a 'bespoke' claim may be based on characteristics associated with psychosocial issues, or existing medical conditions (comorbidities) such as cardiovascular disease, cancer, diabetes, coronary heart disease, stroke, Chronic Obstructive Pulmonary Disease (COPD) or identification of fraud and other issues. Claims that fall into the 'bespoke' group are generally the 15% of all claims, but which account for 75% of total costs and therefore demand attention.
Today, in managing a 'bespoke' claim, many claims administrators are not using a process plan. The best position that can be initially established without implementing a process plan is, (1) the estimated cost is inaccurate by at least 50% because instead of the estimation being apodictic, it is based on subjective judgement where a conservative guess is expressed in terms of probability and (2) the probable outcome for all those affected is also likely to be uncertain because of resources chosen most likely being fragmented and lacking in cohesion in dealing with the disability. A process plan cannot eliminate uncertainty, but it can play an important role in controlling uncertainty.
Psychologist Albert Bandura's theory of "Self-Efficacy" is "the belief in one's capabilities to organize and execute the courses of action required to manage prospective situations." Minder strongly correlates to Albert Bandura's theory of "Self-Efficacy". Both Minder's and Bandura's theory embrace identifying of goals in order to action tasks efficiently for optimum outcome and the belief that in situations of self-doubt, sustained efforts and encouragement are major principles in recovering from setbacks and believing in one's ability to succeed.
Minder's process plan approach to a 'bespoke' claim adds precision to the treatment and recovery process by:
- focusing on the selection of resources for the execution and completion of each unique step so as to reach the ultimate desirable outcome for all parties,
- providing the means to continuously and efficiently share in the understanding of the recuperation process which aids multi-professional/multi- and inter-disciplinary communication and decision-making about future treatment and goals and,
- creating a living document, which can be revised and added to as new initiatives are identified thus increasing predictability and reducing redundancy. The number of steps and the level of detail involved will depend greatly on the complexity of the disability.
A process plan basically outlines a who-does-what-and-when-script. It encourages all stakeholders to share and participate in the treatment and recovery process of the disability through communication and collaboration. It helps stakeholders become better organized by managing their tasks and identifying progress at each milestone and it constantly improves the effectiveness and efficiency of tasks associated with operational management subliminally, through the reuse and sharing of the process plan through templates.
Minder provides the means to manage the five elements associated with a process plan. They are:
(1) Uniqueness. There are many steps required in the treatment and recovery process of a disability, with integrated operational management being a key consideration within a process plan. While many of the steps are operational, others are unique to the disability being addressed.
(2) Prioritization. There needs to be a clear understanding of the processes and tasks required to be performed. To deliver the highest quality results for an activity, the assigned resources need to focus all their attention on these tasks.
(3) Duration. In addition to establishing prioritization, the question of "when is it required by?" also needs to be addressed.
(4) Agreement. Credibility of the process plan is established when there is a buy-in by all the resources participating, especially the person suffering from the disability as well as all those affected by the disability.
(5) Accountability. A process plan represents the tailored requirements for a 'bespoke' claim, which by its very nature will have many unknowns requiring one person to have full accountability for all the activities and tasks - nothing starts and nothing changes without leadership.