What is Triage? The Importance for Business Process

keyboard with a key called "Buiness Processes"

Business processes frequently need to cater for extremely complex business situations. Well-designed processes, when combined with solid and well defined business rules, help organizations streamline operational decision-making whilst ensuring that customers receive a consistently good service.   

However, when we are assessing "as is" processes, we might find that they have been built to cater for the most complex and exceptional cases, and they may be inadvertently subjecting every single case to the same level of complex processing and scrutiny.  This is particularly true of processes that have 'evolved' organically, as opposed to having been consciously designed. We may find very busy teams frantically trying to keep up with a seemingly endless workload, there may be significant backlogs and even customer dissatisfaction. In these types of cases there may be an opportunity to streamline the process and save time and effort by introducing a triage step.

First let's define Triage. Triage involves carrying out an initial assessment, early in the process, to determine how the case will be handled. This allows us to build several routes through the process depending on the urgency or complexity of the particular case.  If you have ever injured yourself and ended up in the Accident and Emergency department of a hospital, you probably experienced triage first hand. It's likely that a triage nurse saw you first, assessed the urgency, and decided how soon you needed to be treated and what type of medical expertise was needed. If it was a small cut you probably had to wait a while for treatment. If it was chest pains, you may have been rushed straight to a specialist.

The triage meaning for business processes is slightly different. We can use similar 'triage' steps in our processes too. Imagine we are examining an insurance company’s claims process. It's likely that a huge theft claim, where valuable items were stolen worth tens of thousands of pounds, would need to be dealt with very differently to a claim for a policyholder who accidentally spilled paint on a carpet (so the carpet needs cleaning or replacing). An insurance company subjecting all claims to the same level of scrutiny would be missing a trick, we may well be able to 'shortcut' the simple cases and process them quickly and simply. Perhaps if a policyholder claims for £100 and they've never claimed before, we simply pay the claim. Carrying out any kind of investigation may be overkill. Therefore it would be beneficial to design several routes through the process depending on the complexity and risk associated with the claim. An initial assessment step ensures that the case is pushed down the correct 'triage route'.

Applying a triage step

Triage works when there are a clear set of rules defined. Clearly, having several routes through a process only works if it is possible to assess and define which route a particular case should take. The rules should be as objective as possible.  They should clearly and unambiguously define the criteria which are used to decide the route. These rules may be extremely complicated, but once they are defined they will assure consistency and efficient use of time and resources. Furthermore, if the rules are truly objective and measurable, then (depending on the technology used) this could be a good candidate for automation. Applying for a credit card online is a good example here. If you have a "good" payment record and your details can be found on the relevant credit rating agency databases, then perhaps the application can be automatically approved. If not, perhaps it needs manual intervention. Writing these rules may even lead to hard (but important) conversations about whether your organization wants certain types of business. If it is disproportionately expensive to process, then perhaps referring it to a partner could be a better option. Clearly there are much wider commercial concerns here requiring wider input and thought.

These triage steps help ensure that we are targeting our resources where they are really needed, and also ensure we are not holding up or delaying cases that don't need such a high level of processing or scrutiny. It can help reduce workload, backlogs, cost and if done well can increase customer satisfaction. The key to success is understanding the variation in demand, building the right routes through the process and ensuring a clear set of triage rules are written.

In summary: triage steps can be a useful consideration when we are aiming to improve processes, and are a useful tool in our armory.

Looking for more on business processes? Check out our 5 top tips for running a process improvement workshop