Materializing Bureaucracy: how to (innocently?) generate inefficiency

Inefficiency and bureaucracy represented with a lot of paper modules to be compiled

Have you ever been asked to define and perhaps regulate the process through which a doctor, observing the symptoms of the emergency room patient and collecting the minimum necessary information, arrives at the diagnosis and the intervention to be carried out? I would say no, I suppose. Perhaps you have had to organize the waiting queues according to the triage performed on the patient. Or, perhaps, collect the software requirements to document the intervention or design the forms to request material or drugs.

This isn’t business

All of these things are important but they are not the focus of the healthcare profession, which requires a doctor to decide what to do, based on what he/she sees, his/her studies and his/her expertise. However, the medician profession – not business analysis – dictates the rules stating what to do.
That’s why there are many cases where we analyze, implement and prescribe processes that are collateral of the core business. Whenever important creative or professional content is involved, it is like this. Our work is like this. No matter how high the pile of papers that we have to compile for each project: our sensitivity in arousing and understanding the requirements or in finding the most suitable solutions can hardly be substantially regulated (in this regard, see the BABOK chapter 3).

What’s the matter? It’s that, in situations like these, we have more often to describe collateral processes than to work on the core business.

They are processes that generally want to reach the objectives of

  • compliance with external standards
  • cost containment
  • protection from lawsuits brought by users
  • Customer relationship or customer satisfaction monitoring
  • (you continue)

Professional erosion

From the first moment we are hired by the legal department to have the doctor collect certain information each time he sees a patient, we are well aware that what we are about to design is something that will divert resources from the core business of healthcare professionals. A doctor, with his two fingers more accustomed to the scalpel than to the keyboard, takes, let’s say, five minutes to fill out our beautiful form at each visit. Multiply it by the doctors, the daily visits, the days of the year, the hospitals in Italy and the salary of a doctor and see how much he earns (21,000,000 services for 5 minutes spent, at 1 euros per minute they make 100 million €/year).

In many cases, these projects do not have enough budget or arise too close to the deadline to be tackled worthwhile. It is clear that, as collaterals, the perceived value of decision-makers may not be high.

And here inefficiency and bureaucracy lurk, because each letter more to type on the keyboard reduces the time for patients in the queue.

Can inefficiency and bureaucracy be minimized?

As business analysts, our main goal is to minimize the impact. Reduce the daily cost of compliance as much as possible, improving efficiency and productivity and reducing the bureaucracy rate.

In theory, we would all agree on this, except that companies usually DO NOT invest in this type of optimization for at least two reasons:

  • (According to Human Resources) The time freed up for people will not be spent on greater productivity but on relaxation in performing usual tasks
  • (According to the Budget Office) Personnel cost is a fixed one, i.e.: I pay people the same even if they do nothing. Since I already pay them, they might as well fill out the reports by hand; why spend even more money (often OpEx: regulatory evolution) on more sophisticated solutions?

If you’ve come across these kinds of reasons, you’re in great company.

In conclusion, let’s broaden our gaze

They appear sensible speeches (and sometimes they are). But they are also part of the great chapter entitled “How to (innocently?) generate inefficiency”. In a nutshell, instead of trying to fill our collaborators’ day with valuable work, with highly professional content, we cram it with collateral activities. Nobody knows why, inevitably losing motivation and satisfaction, as well as introducing inefficiency and bureaucracy in the system.

Let’s broaden our gaze (because every little stone builds a wall). Don’t you also think that all these have to do with the enormous problem of productivity and competitiveness, inefficiency and bureaucracy of our beloved country? Comment folks, comment…

The data on the number of first aid services are taken from the AGENAS website. Unfortunately, the link is no longer available. A comment from Il Sole 24 Ore is available. Physician salary data is referenced from various sources, including this one. Approximatively, considering the working time and general costs, I would have arrived at around 1 € per minute. The sense is to give an order of magnitude and demonstrate if needed, that a small inefficiency can generate large costs.

Published by Gianni Tommasi

For many years an organizational business, he makes sense of his work by trying to solve more problems than he creates. Despite his size, he has made agility the essence of his professional life; he believes in teamwork as much as in remote work, because you don't need to go to office just to work, but rather to create. And he thinks that intelligence should always be appreciated, even when it's artificial.

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