Too many Cooks Spoil The Broth

Processes fail and suboptimise often because clarity of roles and responsibilities is missing.

Too many cooks can indeed spoil the broth. A process where many different parties feel that they are responsible often pull in different directions, result in wastage of resources, damages to relationship and worst of all the customer (or Patient in healthcare) suffers.

A useful framework is RASCI:

Responsible - Who makes it happen?
Approve - Who needs to approve this?
Support - Who provides the expertise?
Consult - Who can add value?
Inform - Who needs to know?

There should only be one person Responsible, and any more than one Approver can be troublesome and for me raises alarm bells. For the other roles it is perfectly fine to have more people.

I have been thinking about how to streamline certain roles in the hospital for better effectiveness and have found the framework to be very helpful.