A former Harvard School of Public Health Associate Dean says CEOs may be ignoring one of their biggest waste reduction opportunities—cutting the duration of meetings. He offers five strategies for tackling meeting bloat.
This article first appeared in the November 2014 issue of HealthLeaders magazine.
David A. Shore studies meetings for a living. But he hates them.
One reason is because although many people recognize meetings as a waste of time and money, they are ubiquitous—particularly in healthcare.
With exceptions, when Shore, a former associate dean of the Harvard School of Public Health, says meeting time is largely wasted time, statistics are on his side. Shore, who founded the School's Programs in Project Management in Health Care, Forces of Change Program, and Trust Initiative, is also on the faculty of Harvard University Extension School.
In a recent working paper, From "Wasteful" Meetings to Parsimonious Meetings Management: Preserving Human Capital in Health Care Delivery Organizations, Shore and his son Douglas, an associate applications analyst on the Clinical Data Repository team at Partners HealthCare in Boston, argue that vast opportunities await top leaders in healthcare organizations—if they're willing to attack the meeting culture at their organizations.
He says that healthcare management and leadership spend as much as 4.5 to 5.5 hours a day in meetings, representing the single largest expenditure of time for those highly compensated individuals. In 2011, Shore notes, more than $2.7 trillion or 17.9% of US GDP was spent on healthcare, of which, as much as $750 billion, or almost 30% of the total spent, is estimated as waste.
I'd be willing to bet that a substantial portion of you are avoiding preparing for a meeting by reading this.
Meetings Come with Side Effects
Meetings are not included in that waste estimate, says Shore, but they should be. With human capital costs (salaries and benefits) hovering around 40–70% of overall hospital expenditures, human capital greatly exceeds supply chain costs as the second largest hospital expense, he says.
"Meetings are like medicine. They often come with side effects," he says. "Any unplanned economy produces vast examples of waste."
Furthermore, Shore estimates that on average, it costs a hospital $1,400 to hold a one-hour meeting. There is no bigger waster of organizational resources, Shore says.
"When I talk about that average of $1,400, that's a very conservative number because it's the direct cost of salary and benefits," says Shore. "If you add opportunity costs in there (the lost opportunity to do surgery, for example, during that time), that number is easily eclipsed. Take that number and multiply by the hundreds or thousands of meetings that take place in a hospital or health system in the course of a week, and you're wasting a lot of money."
But there's good news, he says. Everyone else dislikes meetings as much as Shore does. That means it's relatively easy to get traction on meeting reduction because there are no "champions."
'Good Traction' on Meeting Reductions
"Change is exceedingly hard in organizations and harder in healthcare," he says. "But this is one area where we've found extraordinarily good traction, because unlike everything else in healthcare where there are champions, there are very few champions for meetings."
As part of a recent engagement, Shore worked with one organization where the chief operating officer was reluctant to heed his advice about cutting down on meetings. As an exercise, he advised her to schedule one meeting a week that she knew in advance she would cancel, just to see if anyone objected.
"The reaction was quite the opposite," says Shore. "People began talking about how impressed they were that she was canceling them. They thought she was being very respectful of their time."
A leader's perspective should be that there should never be a meeting unless a decision is to be made, he says. "That should be the mantra. The problem is that the majority of meetings are in passive mode," says Shore.
5 Ways to Tackle Meeting Bloat
He suggests five ideas that are often easy to implement in order to start to get a handle on reducing the waste resulting from meetings.
1. Block Out No-Meeting Periods
One idea for CEOs is to establish no-meeting zones. These consist of blocks of time, one day a week, of two hours, where no meetings can be scheduled throughout the organization.
2. Create Buffer Zones
Another idea is incorporating the notion of a transition time or buffer zone, between meetings. "You can move all one-hour meetings to 50 minutes," he says. "I guarantee there's nothing that can be done in a one hour meeting that can't be done in a 50-minute meeting."
The return on investment for that 10-miute buffer is that it allows people to return phone calls and email to move the organization along, he says. Obviously, the organization is not responding to customers when its workers are involved in meetings.
3. Train Meeting Leaders
One that may be a little more difficult to implement is the notion of privileging for meetings. In other words, in order to be empowered to call a meeting, one must have training in running them.
"We allow people to run meetings taking vast amounts of time and resources with absolutely no preparation or training, and no data to know how successfully or unsuccessfully they are doing it," says Shore. "We believe if you're going to use that many resources, you're going to need some training on running meetings."
4. Justify Your Meeting
That lack of training can lead to enormous variability in meetings—an obvious parallel to variability in clinical practice, another area of waste often targeted in healthcare organizations.
"They should give the business case for having a meeting, and justify the need for all the people who are there," he says, adding that through his research, he's discovered that in most meetings, at least a third of the people involved need not be there, don't know why they are there or why they should be there.
"86% of people we've surveyed have a negative feeling about meetings, while 14% see them as necessary or interactive," Shore says.
5. Consider Meeting Alternatives
Though it's not his idea, Shore advocates the use of lean huddles instead of traditional meetings. Such "huddles" last 15 minutes and usually tackle daily business within a defined department or area. "My lean huddle methodology allows for virtual huddles and was designed for that," Shore says.
"One CEO who came to one of my events says his use of huddles is liberating. He's the fourth CEO of this health system in 86 years. For as long as they can remember, they've had a three-hour management meeting every Monday morning. His management team sent him flowers when he canceled it."
To request a copy of the draft paper, contact David Shore.
Philip Betbeze is the senior leadership editor at HealthLeaders.