The Power of Standard Operating Procedures ft. Tosha Boyd
In our latest episode of CareCraft presented by Panacea, we had the pleasure of speaking with Tosha Boyd, founder of The Leo Process. With a wealth of experience in quality and operations, Tosha shared invaluable insights on the significance of Standard Operating Procedures (SOPs) and how they can transform your business. Whether you're a solo practitioner or managing a growing team, implementing and maintaining robust SOPs can be a game changer. Here’s a deep dive into the value of SOPs, actionable steps to create them, and best practices for keeping them up-to-date.
Understanding the Value of Standard Operating Procedures
Standard Operating Procedures (SOPs) are essential for any organization aiming to streamline operations and ensure consistency. Here’s why SOPs are crucial:
Consistency Across Operations: SOPs ensure that every task is performed in a standardized way, which minimizes variability and improves service consistency.
Enhanced Efficiency: By documenting procedures, you reduce the time spent on training and troubleshooting. Staff members can follow clear, step-by-step instructions, leading to faster and more accurate task execution.
Scalability: For growing organizations, SOPs make it easier to onboard new staff and scale operations without losing quality. Tosha shared a success story where SOPs allowed a home care business owner to delegate tasks and manage operations remotely.
Better Decision-Making: SOPs help in making informed decisions by providing a clear framework for operations. They also facilitate quick adaptations when changes occur, like transitioning to new software or revising procedures.
Actionable Steps to Establish Standard Operating Procedures
Getting started with SOPs can seem daunting, but breaking it down into manageable steps can simplify the process:
Identify Key Processes: Start by documenting repetitive and client-facing tasks, such as billing and client assessments. These are critical for operational success and will have the most immediate impact.
Involve Process Owners: Engage team members who perform these tasks to document procedures. Their firsthand experience will ensure accuracy and completeness. For example, have your billing coordinator document the billing process.
Create Clear Documentation: Use clear, step-by-step instructions to outline procedures. Include details like responsible personnel, timelines, and necessary resources. Avoid vague language and ensure that even someone unfamiliar with the process can understand the instructions.
Test and Refine: Have someone outside of the process review the SOP for clarity and completeness. Make sure it passes the “grandma test”—if your grandma can follow it, you’re on the right track.
Implement and Train: Distribute the SOPs to relevant staff and provide training to ensure they understand and can follow the procedures. Regularly review these documents to keep them up-to-date.
Best Practices for Maintaining and Re-Evaluating SOPs
SOPs are living documents that should evolve with your business. Here are best practices for maintaining and updating them:
Regular Reviews: Schedule annual reviews of your SOPs to ensure they remain relevant and accurate. Even if no significant changes have occurred, this review can help catch minor updates or errors.
Update in Real-Time: When changes occur, such as new software implementations or process improvements, update your SOPs immediately. This ensures that your documentation remains current and accurate.
Use Data for Improvements: Regularly analyze performance metrics and feedback to identify areas where SOPs might need adjustment. Data-driven decisions help in refining procedures and improving efficiency.
Encourage Feedback: Solicit input from staff who use the SOPs daily. Their feedback can provide valuable insights into practical challenges and areas for improvement.
Document Workarounds: If deviations from SOPs become frequent, it’s a sign that the procedure might need revisiting. Document these workarounds and assess whether they indicate a need for a new or revised SOP.
Conclusion
Implementing and maintaining effective SOPs is essential for organizational success. By following the actionable steps outlined above and adhering to best practices, you can establish robust SOPs that enhance your operations and set your business up for long-term success.
For more insights on this topic, be sure to listen to our full conversation with Tosha Boyd on CareCraft here.
Looking to bring an expert in to help establish SOPs? Tosha is offering a 10% discount for listeners. Use code PANACEA10 at The Leo Process.
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Transcript
[00:00:04] Ariadne: Welcome to this episode of CareCraft presented by Panacea. I'm very excited to be joined today by Tosha Boyd. She is the founder of The Leo Process, a consulting firm that specializes in business operations and process improvement. She has a master's in public health from Indiana University at Indianapolis and a strong track record in healthcare, having worked in quality and operations for Medicaid case management programs.
She's earned her Lean Six Sigma black belt and is an expert in streamlining processes, helping organizations improve patient outcomes and saving millions in financial performance. So welcome, Tosha. We're thrilled to have you with us today.
[00:00:43] Tosha: Thank you so much. I am excited to be here, Ariadne. And again, thank you for the invitation.
[00:00:49] Ariadne: Well, could you start by telling us a little bit about your journey in healthcare and how you became so passionate about operations and structuring systems?
[00:01:00] Tosha: It's been a very unique journey. Let me say that I started in healthcare at the age of 16 in the medical records department. So it was an opportunity to leave high school like many others working a half a day program, right?
So I realized I had enough credits and I could get a job working half a day. The counselor said, Hey, there's an opportunity in the medical records department at a level one trauma center. And so that's how I started, but I always had an interest in the healthcare field. I wanted to be a nurse early on.
I don't know what sparked my interest. But anyway, so after working in medical records, moving into what is that called, like the 24 hour nurses hotline, I also worked in the emergency room, so again, level one trauma center. I saw a little bit of everything gunshot. wounds, stab wounds, everything. And so with my education, I didn't get into nursing school.
And as an 18 year old, it was not intriguing to me, I guess, to drive an hour away to try to get into one of the other universities. And I said, forget it. I fell into public health. I believe it was the guidance counselor that was like, Oh, well, you know, there's this emerging field. Of public health.
And she was like, you can be the administrator of a long term care facility. I was 19 years old. What is a long term care facility, ma'am? What is public health? Right? So I spent a semester just exploring. I finally said, forget it. Study public health, attain my bachelor's. After that, as I was applying for jobs, I realized that a lot of jobs were requesting for one who holds a master's degree, went back to attain the masters, moved away from Indiana to North Carolina.
When I got there, I could not find a job to save my life in my field. So I had worked before leaving Indianapolis for about three years in my field doing case management. I was on the healthy babies project, I believe that was. So I worked with teenage moms and their babies as a case manager. And I also did HIV case management.
And so, like I said, I got to North Carolina, no job lined up, applying, applying, applying. One day I saw a job that was in the field of quality. I didn't know anything about it, but it was an HIV case management program evaluation position. So we traveled across the state to monitor compliance. So going into whether it was a Ma and Pa or a health department, whoever was providing Medicaid reimbursed HIV case management services, I was responsible for going in and evaluating compliance.
So yeah, so that's how I fell into quality and actually that very first job. I don't even recall what my supervisor saw in me but he was like, I need you to document our processes. I literally had just stepped into that job two weeks prior and he had me documenting processes. I didn't know what a process map was, what an SOP was or anything.
And so from there, I just really started to understand and appreciate the value of written documentation. So when I started that position, they didn't have an orientation. There was nothing written. I was learning. Yes, by observation, but if you're like me, I'm a very structured and I can be a compliant person.
You want. or need items to be written down, you know, to refer to. So I don't have to keep interrupting your day by asking you, like, how do you do that again?
[00:04:17] Ariadne: It seems like your career has been defined again and again by just jumping head in and, you know, making the most of the situation.
So that's incredible. So for today's discussion, we were going to focus more on those standard operating procedures and really. What are they? Why are they important? And how do you go about starting to think about establishing them for your own business? So maybe we can just start at the very beginning, like what are they and why do you think they're so vital to an organization success?
[00:04:47] Tosha: Absolutely. So by definition, an SOP is a standard operating procedure manual, right? With an SOP, you're documenting step by step how to perform the procedures and you want to include different elements such as who's responsible for the task How often should they perform it? What resources do they need if it's a computer system, you know, what's the actual name of it whether it's panacea How do you log into it?
Right? So again step by step you don't want to you want to minimize ambiguity All right, and give clear timelines. So for instance, if you're a care manager and you're talking about entering notes into your case management system, well, give clear direction there.
Should they be in the chart within 24 hours? You don't say language like vague language, like as soon as possible.
[00:05:39] Ariadne: Got it. And how have you seen SOPs, or these operating procedures, contribute to better outcomes and overall efficiency?
[00:05:49] Tosha: Well, I have a question for you, in order for me to answer that question.
Have you ever been to Chick fil A?
[00:05:55] Ariadne: I have been to Chick fil A.
[00:05:57] Tosha: Have you been to more than one Chick fil A?
[00:06:00] Ariadne: Yes.
[00:06:01] Tosha: Have you been to a Chick fil A in a different city in which you live? Yeah, on a road trip. Okay, next question to that. I promise I'm gonna answer your question. When you pull up to the window and you collect your food and you say thank you.
Do you recall what they typically say to you?
[00:06:20] Ariadne: Ooh
[00:06:21] Tosha: It's a hard one. It's a hard one.
[00:06:22] Ariadne: I haven't been in a while.
[00:06:24] Tosha: Okay. Typically, no matter which Chick fil A you go to, they answer to your thank you, my pleasure. Can you recall that? Yeah, I can. So how do you think they have attained that level of standardization?
So again, no matter which Chick fil A you go to, no matter who's working, whether it's Sally, John, Tamika, who's working, right? It's a standard. It's a standard that they have adopted as their best practice. And evidently they again have documented it and they're using it as a way to train their staff because they understand the value in consistency.
When you're consistent, meaning your customers, your clients can expect pretty much the same manner of service. So for Chick fil A known for high quality of service, right? I doubt that a lot of us find that Chick fil A has the best fried chicken tenders, right? But it's that quality of service. It's the efficiency.
You can go to Chick fil A during what rush hour for dinner or for lunch and get in and out of there. So they have efficiency. Well, you do that with documenting SOP. So when you ask about outcomes, that's one of your outcomes, right? Increased Consistency, which leads to increased customer satisfaction.
[00:07:41] Ariadne: And really like an ability to scale, right? Because, you know, Chick fil A is doing that at a huge scale across the whole country to your point.
[00:07:50] Tosha: Absolutely. Huge scale. When we talk about Chick fil a, I like to talk about their, their ability to generate revenue. I think the statistic is they are the top three fast food chain, despite being closed on Sunday, so they're only operating six days a week in comparison to seven days a week, right? And they are behind, so in that third spot, they're behind McDonald's and Starbucks.
McDonald's has three times as many restaurants or locations than Chick fil A. Starbucks has four times as many restaurants. But again, Chick fil a has able to amass a revenue that falls shortly behind them. That speaks a lot to their, their scalability, their growth, their ability to drive the revenue with fewer restaurants and open fewer days.
[00:08:43] Ariadne: Super interesting. So can you maybe provide some examples specific to care management where you've seen those operating procedures really make a significant difference in how the organization has been able to grow either their team or their revenue?
[00:09:01] Tosha: Yes, SOPs are definitely a contributing factor.
So there's a success story that comes to mind early in my consultant days working with a home care business in Indianapolis. And so when I arrived, one of the first things I realized that there was nothing documented and the owner, her goal was to Move out of the day to day. She actually had aspirations of moving across the country.
Well, in order to do that on our roadmap that we built for that developed for her was to start documenting your processes and procedures because they allow you to delegate. Not only are you maintaining that organizational knowledge, right? So you're building this business and you need to capture how is it operated?
But it allows you to train individuals and to delegate. So if your goal is to move out of the day to day, as hopefully it is, then you need SOPs. So again, with those SOPs, she was able to move out of the day to day, able to hire additional staff, and she was able to move across the country. And so she manages her business remotely.
[00:10:06] Ariadne: Wow, that's incredible. So for organizations that are just getting started, maybe they haven't documented anything today, where should they start?
[00:10:17] Tosha: Good question. Just getting started, haven't documented anything. You definitely want to document your repetitive tasks, right? And that's pretty much going to be everything that you do there.
I can't even think of any tasks that you would do one time, but repetitive and client facing. So it's your billing, right? We know we got to get that. Accurate, right? Because if you're billing Medicaid, it's going to be kicked back, right? And possibly even insurances and even private pay companies, right?
If you send Mr. Williams family an invoice, they're like, what the heck is this? It's not what I was expecting. So I would say start with your billing processes because in order to have a sustainable business, right, you have to get to the money. So a part of getting to the money is having Accurate billing and how you increase accuracy is documenting your SOP.
So starting there and then what would be our next one? Client facing visits. So how should the assessments be facilitated, right? So that way, no matter who is facilitating that assessment, it is consistent. Even if you are a solo practitioner right now. Likely your goal is to bring in someone up under you, but even for your own consistency like we're humans, right?
We're not robots. So there are times where you may not remember everything now Which system am I supposed to go into and what step is it? Especially if it's a new system So if you document you can easily refer to your SOP
[00:11:53] Ariadne: As you think about improving those SOPs over time, is there a particular way in which you recommend individuals evaluate kind of what they have documented today and what they need to improve on?
[00:12:08] Tosha: Its best practice to evaluate them at least once a year. So let's say you have not had a any revisions to that procedure. You haven't changed systems or there's the same individual on your team that is performing that procedure. So let's say just nothing has changed about the procedure. I still recommend my clients to go through the SOP, even if it's looking to make sure the contact information is still correct, right?
Any references. You should reference other documents, so making sure that everything is up to date. But when it comes to, when it comes to editing the SOP as it relates to any procedure change, you want to capture that as much as possible in real time. So the minute that you learn that you have to rearrange some steps in the procedure, or you're moving from one case management system to another. The steps within that system may have changed that you're using.
So that software, maybe the steps have changed, right? Then you want to document that SOP in real time.
[00:13:17] Ariadne: Got it. Okay. And when you are creating an SOP, what is, you know, the key steps to make sure that you're developing it and it's going to be effective?
[00:13:26] Tosha: I always recommend pulling in the process owner. So let's say you are the executive of the company. Now you are embarking upon the journey of documenting your SOPs. And you're starting with that billing one.
Well, if you have a billing coordinator, billing manager, whatever their title is, right, pull them into this process, meet with them. Let them know the goal, the vision. So we are embarking upon this journey of documenting SOPs. Here's what that means. And since they are the process owner, you wouldn't want them to start that documentation process.
So, you know, Tosha, the next time you perform billing, go ahead and take the time to document the steps. So step by step, I need you to record everything that goes on, but. The key is to document it in real time so that you minimize the likelihood of forgetting any steps. And again, it's best to have the process owner do that.
And once they are done, they could then give that SOP to someone else. And I would encourage it to be someone else who does not perform their job at all, right? They don't have any understanding of billing. Maybe this is the admissions coordinator, intake coordinator, right? But they should read it for you know, grammatical errors making sure that it makes sense because the ideal of an SOP is that your grandma should be able to come in and run your business with the help of SOP.
So you want to make sure that it's accurate, but then after you go through that test, then I would send it back over to the executive, especially like in small businesses, if you're just starting out, right? Because more than likely that executive or that owner is They were doing the billing. They were doing intake.
They were doing everything at one point of time. So I would send it back to them to make sure that it is accurate.
Then lastly, let's say there is more than one billing person. If we're using this example, then now the SOP, once it's gone through those two double checks, if you will, now it could be disseminated to everyone that is a, a process owner.
So again, if you have more than one billing person, then it will go to all of them.
[00:15:37] Ariadne: How should they think about prioritizing as a solo practitioner?
[00:15:44] Tosha: I don't think it's any different from the example that I gave a few minutes ago as far as you're in business, right, to make money. And so what I always encourage is getting to the money first. So we know that in order to do that, I need to bill. So if I'm embarking upon the journey of documenting my SOPs, then I'm going to start with billing SOP, move into like your client facing. So in order to build, you have to get them in, right? So what's your intake process or the referral process documenting and then really just go through your entire client journey after that. So building and then if the next one would be referral, then intake assessment.
[00:16:22] Ariadne: Yeah, yeah, hearing you say that it really sounds to me that like the process of creating these. This documentation is almost like a deep dive in your business strategy, right? Like you're looking at every component of like, what drives your revenue? Like, how do you bring clients in? How do you keep them, et cetera?
Is that how you think about it?
[00:16:45] Tosha: Absolutely. Your entire journey. I would start there documenting those procedures. And then after that, move into the ones that are non client facing.
[00:16:55] Ariadne: And how do you balance the need with standardization and operating procedures versus Flexibility in in different situations, because I imagine, you know, there might be reasons that in one particular case, it's different than another.
[00:17:10] Tosha: No, that is a very good question. We have these SOPs. We've said at one point in time, whether it was last year, last month, last week, that this is our best practice. But. In the real world, you know, stuff does happen, right? So let's say that you're billing SOP. You guys have stated and documented that we bill on the 15th and the 30th.
And something happens. I'll have to think of, what could prevent you from billing? Medicaid system is down. All right. And you can't build. Well, that's obvious that we are going to have to, it could be a few things. You could circumvent the process. So meaning if it is an electronic process and now you have the opportunity or you can deal manually.
Okay. So the SOP may have said we do this electronically. However, we understand that today on the 15th, when I went in there, the system is down, but we know the backup process is this manual process. If I'm just thinking about like back in my days of being a registration clerk, yes, we relied on the system, but in the event it was down, we had a backup process, which was manually registering patient.
And so using your best judgment, but if that deviation happens a couple of times, then you may need to reconsider what is that best practice. So just because you document something today on August the 16th, right, it may not be the best practice in 30 days. Maybe you found a more efficient system.
You want to move from Google Forms to JotForms, then absolutely. Now that SOP that you documented, now it needs to be updated.
[00:18:55] Ariadne: That makes sense. I was hearing you speak about that, right? Like you were talking about workarounds for a process, and this is actually something I hear fairly frequently where I'll be talking to someone about their business and they're like, Oh yeah, it's going great. And then you dig into it and they're like, well, yeah, we have these like 30 workarounds for like, we get the system to work.
So I, I, I guess, you know, hearing that to me says that your process is not very good, right? If you've had to develop all of these workarounds, but to them, it's just very much their day to day. And they've stopped considering this, you know, as like, this is maybe not the most efficient system. Right. How do you make sure you're really being critical and thinking about your process and thinking about like, is this the most efficient?
Do we need to, you know, reevaluate? And make a better practice for the organization as a whole?
[00:19:49] Tosha: Data should always drive your decisions so you can improve what you're not like aware of. So if you're collecting key performance measures, right, whether it's you or someone else on your team, collecting that analyzing it understanding why the changes.
Then yeah, that should help you make should always strive to make data driven decisions.
[00:20:17] Ariadne: Yeah, that should help you at least identify maybe where there are those areas that you're underperforming what you would ideally want in your business. Absolutely. So any sort of big you know, technological change or even personnel change..
[00:20:33] Tosha: Technological personnel, frequency, anything, right?
So it doesn't matter. So when you think of the SOP, again, you're documenting the who, the what, the how, the when. So if any of those elements change, then you'll go in and update your SOP. It may not always be a huge overhaul because again, it just depends on what actually changed. It'd be a one minute change from updating the name of the person.
Or the name of the system, or it could be an entire revamp of your SOP.
[00:21:02] Ariadne: So to wrap up, we've really discussed, you know, the critical role of SOPs and How they can contribute to organization success, how to think about establishing them. And of course, the importance of keeping them up to date. What's the one takeaway that you hope the listeners remember from today's conversation?
[00:21:22] Tosha: If you want to free up time, delegate tasks and take a vacation, you need an SOP.
[00:21:28] Ariadne: I mean, that's a great calling card.
[00:21:30] Tosha: Seriously, seriously, whether you are solo, have a virtual assistant, like how are you going to delegate? Yeah, it, it honestly amazes me how many times I meet with business owners or executives are like, well, I gave them a sticky note with everything written down.
Yeah, a sticky note is not a formal written documentation of how the procedure should be performed. Yeah. Sticky notes can get you by for so long. Seriously, if you want to delegate tasks, free up your time, take a vacation or even a less interrupted vacation, you need standard operating procedure manuals.
When you drive consistency, there is a a quote by Deloitte. They are a big four, right? Consulting firms. So in 2018, they stated customers tell an average of nine people about a positive experience with the brand, but they tell 16 people about a negative experience.
So again, if you're driving consistency, You're not leaving room for error, right, which could lead to word of mouth of like, well, don't go to that business. They don't know what they're doing. Every time I go over there, it's something different.
[00:22:49] Ariadne: Yeah. Yeah. That's a good call out for, you know, not just making your life easier today, but really making it so that your business can continue to thrive.
[00:22:59] Tosha: Having SOP really set you apart from, you know, just asking yourself simply like, am I running a Ma & Pa? Or do I want to run a business? Right? When I pass away, do I want my legacy to continue? Right? Well, in order to do that, you need to inform someone how to run your business. You know, you can not run your business 24 hours a day.
And the more people you have on your team, the more your revenue increases. So in order to have more people on your team, you have to have your processes documented.
[00:23:32] Ariadne: Yeah. So thank you so much for joining us and sharing your expertise, Tosha. Where can listeners connect with you if they want to learn more about your work?
[00:23:41] Tosha: Absolutely. So you can follow me on Instagram at the Leo process. Facebook as well at the Leo process on LinkedIn, Tosha Boyd, T O S H A last name B O Y D.
[00:23:56] Ariadne: Awesome. Well, thank you so much, Tosha. I really appreciate it. And hopefully we'll have you back on in the future as well.
[00:24:04] Tosha: I look forward to it. Thank you so much, Ariadne.