Swivel Chairs and Shared Screens: How Physical Proximity Can Boost Productivity

“The single thing that has most boosted my productivity this year has been having Matt sit next to me.”

The person speaking was one of my senior healthcare analytic professionals.  She handles the patient safety portfolio, which includes measures that are populated with “difficult data.” For example, if the goal is to reduce hospital-acquired conditions, the data-indicating events might not even be recorded in the electronic health record; they might live on some desktop application that is only accessible using manual exchange.

The factors contributing to the events, such as inserted lines or devices, require very complicated code to track, where one has to be very clear that the unit of observation is the patient, who can have multiple insertions entered or removed at different times in different locations, and with different physicians on service.  The data can appear in flowsheet form, which then must be pivoted to be analytically useful; clean pivots and clean data coming from multiple sources require SQL skills that many analytic professionals don’t necessarily have.

The person handling the patient safety portfolio is a good analyst. She works with the nursing improvement teams to help them understand what the graphs are saying and where their improvement opportunities are. But to even find the data she requires, she needs someone who is certified in Clarity, and until we hired Matt and some others, we had no one on the team with that certification or expertise. Once she found the data she required, she would need creative SQL statements to master them, especially ones that would execute without crashing the system.

Until Matt started sitting next to her, she would obtain data management support by placing a request with the IS Clarity report writing team — which is located on the fourth floor of a creaky building half a mile away, across a busy street in a dilapidated urban neighborhood. They respond to requests using a queue-based service model: Tell us what report you want by entering requirements into our system; when it’s your turn, we’ll call to clarify any uncertainties. We’ll then prepare the report, hand it back to you, and move on to the next request. Most communication happens through email, sometimes by telephone. It’s almost never face-to-face, as that would require an hour or more of travel time.

Matt had been a Clarity report writer, and he was looking for growth opportunities. I had recently created some positions in data management and business intelligence to provide direct service to the analytic professionals. In the clinical research world where I got my professional start, the most productive and successful analytic teams had dedicated technical and data management support co-located with them. When I experienced this early in my career, I took it for granted. Having migrated into the world of healthcare delivery, I saw that it doesn’t exist unless you create it mindfully.

When Matt applied for one of these positions, we hired him and sat him in a cube where he was surrounded by the analytic professionals. Now when the safety person needs help finding the data or gathering them together with SQL, she can swivel her chair and ask Matt. Sometimes they sit side-by-side looking at the screen so they can point at what needs to be done. This helps Matt understand why she is asking about arcane data elements that live all over the place. He also gleans knowledge by listening as she speaks with her clinical customers.

Matt attends the weekly staff meetings, where he and other support personnel give presentations about programming tricks-of-the-trade or walk us through software upgrades that can adversely affect their work. Our staff meetings involve swiveled chairs and sitting together looking at the screen; this is the how information is exchanged. It sure beats writing down the requirements that you barely understand, submitting them into the queue, and waiting.

When I first told my staff we were bringing in analytics professionals and we would create a wing to provide technical and data management support, I was greeted with a combination of relief and concern; relief that people will be right here, dedicated to me and my problems, and concern that if we bring these people into our team, will that turn us into an IS shop? We pride ourselves on the close support we give our customers, and we didn’t want to become transactional.

One of the people who expressed the most intense concern was the analytic professional with the safety portfolio. But she, like others, converted. Our employee satisfaction results leaped in the past 18 months, and when we reviewed the reasons why, we found that a key factor was the inclusion of the embedded and dedicated IS support to the team.

Those providing the support love it as well, as they can now see directly how their skills and expertise provide immediate help to others. By sitting next to the analysts and attending the same staff meetings, the technical and data support personnel get closer to improving care; it gives them a deeper reason for going to work than just earning a paycheck.

One person who had heard rumblings of creating an enterprise-wide strategy around data management and analytics feared that this would mean that he and others would “go back to IS”. He expressed his concern to senior leadership: We want to stay here. We don’t want to work there.

I am convinced that co-locating data management and technical support with analytic professionals is a necessary condition for success. The physical proximity is key.