Staying connected to remote staff

Remote work is becoming the norm in many industries, and healthcare isn’t immune to the trend. Whether staff are remote full-time or have the option to work remotely on occasion, it’s transforming the way people think about work, from the physical space of an office to forging a team and building organizational loyalty. Offering the option to work remotely can boost staff retention and cut down on the number of missed workdays. It can also be a boon in today’s competitive job market, serving as an attractive perk and broadening the pool of qualified candidates an organization can choose from.

But setting up a remote work program isn’t as simple as handing employees laptops and sending them on their way. Remote work represents a fundamental change to the way staff and managers do their jobs and manage their relationship. It also presents questions, and challenges expectations and trust, in a way that working on-site rarely will.

Despite these challenges, many organizations are finding that the benefits outweigh the drawbacks and that clear guidelines and expectations can help staff thrive in a remote environment. Set your program up for remote work success by building strong communication, trust, and support.

Out of the office

Space is at a premium at most facilities. The lion’s share of real estate at a hospital will likely need to be dedicated to patient care areas, leaving office space to be squeezed into smaller and smaller spots. Cramped office areas aren’t ideal for tasks that require a high degree of attention and focus, such as auditing. Some organizations might opt to move departments such as finance or HIM to a separate building, but that can drive up costs. For organizations looking to save space and money, remote work can be an attractive solution. Remote staff can directly reduce overhead costs by eliminating the need for extra brick-and-mortar office space, says Gina Stewart, RN, BSN, CCS, CCDS, practice director for clinical documentation improvement (CDI) and coding practices at e4 Services of West Chester, Pennsylvania.

Getting away from the office can have other benefits, too. Although an office can be great for spontaneous brainstorming sessions and group projects, it can be difficult to set aside uninterrupted quiet time for intensive work when your colleagues know you’re just a cubicle wall away.

“Working in an office, you have to be more diligent about setting time to focus because it is more likely you will get pulled into meetings,” says Cathy Brownfield, MSHI, RHIA, CCS, vice president of operations at TrustHCS in Springfield, Missouri. “You’re more accessible.”

Remote work is ideal for quiet time, which is a huge bonus for staff who focus on complex, detail-oriented tasks like auditing, Brownfield says. However, collaborative meetings with remote staff require a little more legwork than simply heading into a meeting room, she adds. Technology can facilitate interactive, collaborative meetings with remote staff, but it comes with the same pitfalls and caveats that apply to conference calls. Login snags, dropped connections, or other technical issues can all occur and eat into meeting time.

Employee satisfaction

It’s no secret that most people enjoying having at least the option to work remotely. A 2017 study by Global Analytics Workplace found that 80%–90% of employees would like to work at home at least several days a week. The study lists some benefits, such as saving time otherwise spent driving and reducing the need to take sick days, that will be obvious to anyone who has faced a lengthy commute or been around coughing coworkers during flu season. However, it also points out other perks that might be less apparent, such as making it easier to stay fit and eat healthy, reducing greenhouse gas emissions from cars, and allowing staff to stay with the organization while caring for a family member. In particular, flexibility for caregiving can be a make-or-break option for many staff.

Stewart recalls running up against a similar concern with a previous employer. She was the only CDI specialist on staff for the hospital when she became pregnant with her son. Stewart planned to take 12 weeks of leave, but she knew an extended absence would have a significant impact on her facility’s CDI program. She spoke to her manager and offered to work remotely part-time for a portion of her leave but was told that wasn’t an option. When Stewart took a position at another hospital, to her surprise, she was immediately provided a laptop so that she could work remotely if the need arose. Stewart’s new manager explained that extending a remote work option was a no-brainer. Obtaining laptops for staff and crafting remote work policies did carry some cost, but it was cost well-spent—the manager knew her staff would be inspired to work harder in return. Rather than losing an entire day to a blizzard, the team could log on from home and complete a full shift.

“The flexibility it provided meant so much to me,” Stewart says. “It made the quality of my life better, and I still was able to get my work done. Just because I wasn’t sitting at a desk for eight hours straight in a cubicle doesn’t mean I’m not getting my work done.”

The view from the other side

Although remote work can decrease stress for staff, it can add worries for managers, Stewart says. Managers need to build a relationship with their direct reports, getting to know each person’s work style and understanding the management strategies that will help each employee produce the best results. A lack of face-to-face contact can make it difficult for managers and staff to develop rapport.

Managers must take a leap of faith when it comes to remote staff, Brownfield says. In an office, a manager can stop by for a chat and see that a staff member is hard at work. Although software and apps can help managers monitor activity, a manager of a remote team must trust that staff members will conduct themselves professionally even when out of sight.

“If you don’t have that level of trust—if you manage by suspicion—you’re not going to be a very happy manager when you have remote people,” Brownfield says.

In a positive working relationship, trust goes both ways. However, developing trust between managers and remote staff can be difficult. When Stewart took on her role at e4 Services, she had worked her way up through the organization’s CDI ranks and had already established professional relationships with her team. But when new staff join the organization, Stewart must build trust and communication from scratch. “They know me over the phone, but they don’t know me personally,” she says. “I think the biggest challenge is developing that rapport and developing that relationship with them.”

To counteract that, e4 Services holds mandatory virtual monthly meetings. During the meetings, managers and directors provide education and update staff on any changes or news from the organization. Stewart also makes a point of setting up in-person meetings with her team whenever possible.

“In the event that I go to a client site or there’s a conference in a certain area, I’ll reach out to people who live in that area or are working at that client’s site and we’ll go out to dinner,” Stewart says. “Any time we’re in the vicinity of each other, we try to do something.”

In addition, e4 Services hosts a yearly retreat for all full-time employees. The retreat is an all-expenses-paid trip that combines company meetings and development opportunities with more casual socialization.

If a company retreat isn’t in the cards, don’t undervalue the power of simply hearing someone’s voice. “We encourage our managers to not rely totally on email communications and on some type of frequency you reach out by phone and actually listen to a person’s voice,” says Bill Wagner, CHPS, chief operating officer of KIWI-TEK in Indianapolis, Indiana.

Establish open communication with clear guidelines and expectations. Managers should be clear about what method of communication they prefer, says Sarah Humbert, RHIA, coding and compliance manager at KIWI-TEK. Providing contact guidelines, times available, and an expected time frame for a response will help staff feel more comfortable and confident getting in touch.

There’s a wide range of technology that can keep managers connected to remote staff. Cloud services, video conferencing, and remote desktop apps make it easy to set up meetings and share screens. “If a coder has a question, we can jump right on a remote session and we can be looking at the same chart at the same time and talking through it,” Humbert says. “They don’t have to email all the details of a chart. We can simply jump on together and walk through the question they might have.”

Setting expectations

An organization’s remote work policies should lay out clear expectations for remote staff regarding scheduling, performance evaluations, and other needs. Managers must be able to use the organization’s policies to develop guidelines specific to their department.

“From a management perspective, you need to have those expectations set about what is expected of them when they’re working remote,” Brownfield says. “Are they expected to be online and available from 8 to 5? Or is that flexible?”

One of the perks of working remotely is the ability to step out for an hour during the workday while causing minimal disruption. A remote staff member can arrange to be out for an hour during the afternoon and then make up that time by working an additional hour at the end of the day, while on-site staff might need to be out the entire afternoon, Brownfield says. However, remote staff can’t simply step out during the day without giving their manager notice.

Remote work can also be appealing for a staffer that wants to work outside of typical business hours, Wagner says. KIWI-TEK has found that dictating a set, uniform schedule to all remote staff doesn’t yield the best results. After all, flexibility is one of the main attractions of remote work, and remote staff might be spread out across time zones, making a single start and end time impractical. A staff member with young children might prefer to start work early in the morning, break to get the children ready for school, resume work through the morning and afternoon, break again to bring the children home, and then wrap up the day with another hour or two of work. Other staff members might be caring for elderly parents and will need to build a schedule around trips to the doctor.

But flexible doesn’t mean unknown. Managers should be kept in the loop regarding scheduling needs. “They determine their work schedule and work it out with their manager. If their work schedule changes or if there is a temporary interruption to the work schedule, they’re required to communicate that to the manager as soon as they know about it,” Wagner says.

Hitting the mark

A manager who has experience working remotely will be better equipped to manage remote staff, Humbert and Wagner say. A manager new to working with remote staff might face a learning curve, but it’s not impossible to establish guidelines and workflow that are suitable for everyone involved. Clear, consistent guidelines and performance standards, along with communication and trust, can make a remote work program a success.