Improve staff communication with matrix reporting principles

May 22, 2012

Written by Madeline Hyden, MGMA-ACMPE web content writer/editor

Merging or integrating a practice with a larger health system or hospital means an increased chance for organizational silos and decreased collaboration. Matrix reporting structures, which involve employees reporting to more than one supervisor to provide more effective management, are a remedy for streamlining information and improving communication after integration. Although matrix reporting can help eliminate the miscommunication and inefficiencies that arise in larger, more complicated organizations, it isn't just for large systems; small and mid-size private practices can implement aspects of matrix reporting to enhance communication among staff and ultimately improve patient care.

Direct line supervisors vs. dotted line supervisors
Direct line supervisors are traditional supervisors who manage the performance of their direct reports and who determine job responsibility and compensation. Dotted line supervisors are horizontal connections between two staff members, and one may not technically report to another. Horizontal connections usually imply mutual reporting, with both people working together to achieve similar goals. Examples of horizontal connections could be two front-office staff members or two nonphysician providers. One doesn’t report to the other, but they’re accountable to each other to improve their areas.

Identify where dotted line supervisors reside in your practice. Direct line supervisors should be aware of their employees’ dotted line supervisors to understand the scope of their staffs’ workload and accountability.

Miscommunication and accountability concerns are common when staff members get direction and feedback from their direct line supervisor, their dotted line supervisors and other staff members. For example, your billing personnel may work regularly with the front-office staff on patient payment plans, but you, the administrator, may not know that.

They may each report to you, but they’re each others’ dotted line supervisors. Make sure they communicate to you the protocols they establish together. You can accomplish this through regular staff meetings, huddles, or one-on-one appointments between you and individuals.

Staffs of smaller medical practices are more to likely to have jobs that overlap with one another since there are fewer internal resources and staff members often have to cover for one another. In larger groups or integrated delivery systems, however, staffs tend to have more clearly defined positions and less opportunity to understand their colleagues’ roles. If time allows, have staff members train, or shadow, staff from other areas of the practice for a day.

By experiencing first-hand what their co-workers do every day, staff members may be able to identify new solutions for common problems and reduce interdepartmental misunderstandings. This could be especially true for schedulers and front-office staff to learn more about the clinical processes in a practice, and vice versa. It’s also a chance to see how their two jobs intersect and find out ways to work together more effectively.

For more information on matrix reporting structures, read “Gearing up for change” in the May/June issue of MGMA Connexion magazine. View a diagram of a matrix structure online on virtual Connexion.

What are examples of dotted line supervisors in your practice? Share in the comments section below.