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Why Tribal Knowledge Is Sabotaging Your Healthcare Contact Center


August 24, 2023

A healthcare call center in Seattle recently experienced a painful lesson when they lost three key employees: one to a competitor, one to retirement, and the other for medical reasons. With these staffers went the specialized knowledge and skills they had honed over decades, and which they had used to teach new employees the ropes. Despite the contact center’s best efforts, it is still recovering from the impact a year later. Errors are higher, wait times are longer, and providers and patients frequently complain about service.

Every time an experienced agent walks out the door, they take with them a wealth of information and skills. This uncodified, unwritten knowledge is known as tribal knowledge—and it’s a ticking time bomb. Tribal knowledge is a treacherous, uncontrolled, and unpredictable variable in an environment where consistency, accuracy, and compliance are paramount. 

To conquer your staffing challenges, you must overcome tribal knowledge. It is impossible to scale your organization without ridding yourself of reliance on tribal knowledge.

You need not be a prisoner to endless training and turnover of your most skilled and knowledgeable employees. It’s possible to reduce training from weeks to days. It’s possible for all your employees, even without specialized training and shadowing, to expertly handle every type of call. It’s possible to free your staff to focus entirely on patient-centered care. 

Drawing on decades of industry research and best practices, I've identified:

7 reasons why tribal knowledge poses a danger to your healthcare call center, & what you can do about it 

#1: Tribal knowledge is vulnerable to loss 

“Knowledge is like a garden: if it is not cultivated, it cannot be harvested.” – African Proverb 

Investment in your team is a necessity. And yet, tribal knowledge lives in the minds of your agents. When they leave, retire, or simply forget, that knowledge can be lost forever. This creates gaps in your service delivery and puts your remaining agents at a huge disadvantage.

#2: The “Documentation Nightmare” 

“Knowledge has a beginning but no end.” – Geeta S. Iyengar 

The dangers of tribal knowledge are often invisible until the damage is already done. It's the silent killer that undermines efficiency, effectiveness, and service quality. One of its most ruinous dangers is lack of documentation—what we call the Documentation Nightmare.

To prevent or escape the Documentation Nightmare, the first step is to document your processes, policies, and procedures. Create a centralized, easily accessible knowledge base where agents can quickly find the information they need in real-time. Regularly update this knowledge base and encourage contributions from all team members. 

This database should not only contain general information about the services provided but also specific scenarios, responses, and solutions that have proven effective over time.

This process is not a one-time project but a continuous endeavor that should be ingrained in your call center's culture. Encourage all team members to contribute to this knowledge base, which will foster a sense of ownership and commitment to the organization's collective intelligence. 

Remember, your team members each have their unique perspectives, experiences, and insights. So, while documentation can seem like a chore, frame it as an opportunity for each agent to contribute their unique skills to the team's collective knowledge and expertise. 

#3: Tribal knowledge impedes innovation & improvement 

“The secret to change is to focus all of your energy not on fighting the old, but on building the new.” — Socrates

Tribal knowledge creates an echo chamber, where outdated or inefficient methods persist simply because “that's how we've always done it.” This stymies advancement and growth—key factors in staying competitive in the rapidly evolving world of healthcare. 

Which is why you should encourage your agents to challenge the status quo and suggest improvements. Foster a culture where feedback is not just accepted, but actively sought. Use performance data and customer feedback to identify areas for improvement, rather than relying on tradition and intuition.

#4: Tribal knowledge hinders consistency & compliance 

"The only thing that guarantees consistency is a Standard Operating Procedure. Without that, you're relying on luck or magic." — Panos Athanasopoulos

In healthcare, consistency isn't just about good customer service; it's about compliance. If different agents provide different answers to the same question, it isn't just confusing for your customers; it can lead to serious legal and regulatory issues. 

Healthcare’s immense complexity demands nuanced knowledge about complex systems, specialized procedures, and regulations unique to every specialty, practice, and doctor—not to mention the industry itself.  

The solution is to reduce this complexity into one Simple Standard. A Simple Standard offers clear, concise, and easy-to-understand guidelines. Creating one Simple Standard that ensures a uniform approach to all calls makes it easier for employees to understand diverse tasks. Staff can then quickly learn and adapt to new responsibilities.  

A Simple Standard allows you to replace tribal knowledge with standardized training and resources. You’ll ensure every agent has the same foundational knowledge and access to the same up-to-date information. This way, regardless of who picks up the phone, your customers receive consistent, accurate, and compliant information. 

#5: Tribal knowledge slows down onboarding & training 

“Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime.” — Chinese Proverb

When new hires must rely on existing team members to learn the ropes, it weighs down the onboarding process and burdens your seasoned agents. It also leads to inconsistencies in training, because different agents may have different ways of doing things. 

Perhaps the biggest benefit of creating a Simple Standard, then, is that new employees are trained and ready to go in less than 3 days. This frees up your experienced agents to focus on what they do best: serving your patients. 

#6: Tribal knowledge creates dependencies & bottlenecks 

“The strength of the team is each individual member. The strength of each member is the team.” — Phil Jackson

When certain agents become the “go-to” people for certain types of inquiries, then these agents become “experts” in that specialty, and many organizations start segmenting their workforce accordingly. The “Surgery Scheduler” becomes a different role than the “Patient Navigator,” and so on. 

But this specialization of employees creates vulnerabilities. It makes your organization inflexible, as it is harder to adapt and change workflows. Critical knowledge, once stuck inside a silo, usually stops advancing. This increases training costs, and it can bring your operations to a standstill. 

Cross-training is the solution to this problem, but cross-training can be expensive. To make it less expensive and easier, and to enhance quality, you should develop Modular Templates. More on that below.

#7: Continuous training & cross-training 

“The best way to predict your future is to create it.” – Peter Drucker 

The last piece of advice is arguably the most important: Create a system for continuous training and cross-training. The more each team member knows, the less dependent you are on one person's tribal knowledge. 

Cross-training is particularly important as it allows for flexibility within your workforce. If an employee with specific knowledge is unavailable, it is reassuring to know there are others who can step in without causing a significant disruption to your service. 

Simple Standards and Modular Templates facilitate cross-training by providing a consistent framework and approach for various tasks and processes within an organization. Here's how they contribute to effective cross-training: 

  1. Simple Standards: By establishing clear and straightforward standards, organizations can create a common language and understanding of processes across different departments and roles. This makes it easier for employees to learn and adapt to new tasks or responsibilities, because they are already familiar with the basic principles and guidelines.

  2. Modular Templates: These templates serve as interchangeable and easily customizable components for various tasks and processes. They help break down complex tasks into smaller, manageable parts, making it easier for employees to learn and master new skills. Modular Templates also promote consistency in the way tasks are performed, ensuring that cross-trained employees can deliver the same level of service as their specialized counterparts.

The bottom line

Together, Simple Standards and Modular Templates foster a more efficient and flexible workforce by making it easier for employees to learn new tasks and responsibilities. Tribal knowledge is not inherently bad. In fact, it is a rich source of information that can boost your call center's performance. However, the dangers lie in the over-reliance on it without having appropriate systems and practices in place to manage it.

Every call center's journey to excellence is unique. But achieving mastery begins with one universal key: conquering tribal knowledge. Take that critical first step, and transform your current contact center struggles into a future of possibility. The rewards for both your organization and patients will be well worth the effort.

To learn more about the biggest issues facing patient access and call center staffing ==> 

Explore Staffing Resources Vault

Posted By

Stephen Dean

Stephen first built his career in information technology, working as a developer for Hewlett-Packard and several start-ups. He received his MBA from Duke before co-founding Keona Health, where he manages all facets of finance, marketing, and operations.

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