Adequately resourcing administrative staff
Lois Margaret Nora, MD, JD, MBA
When a former colleague and I had lunch recently, we began discussing an issue that has long challenged medical education leaders: Insufficient administrative support. As my colleague discussed her own perspective at a business organization, I recognized that this issue is widespread and has consequences for the quality of our work and for the well-being of our teams.
Skilled support personnel such as office reception staff and administrative assistants are critical to the function of any leadership team. It’s difficult to overstate the importance of their assistance with scheduling, planning, document preparation, and representation of the team within and beyond the institution. These individuals can also be a wonderful source of advice and institutional knowledge, and they may offer a safe space for discussion of and counsel on sensitive issues. Such professionals serve a pivotal role in identifying issues that need to be addressed, getting work done well and on time, and networking across the institution.
While it may be appropriate for administrative support professionals to function as a shared support system for a team, I have noticed that administrative support professionals are increasingly assigned to multiple senior leaders who have significant responsibility in an organization. In recent years, there has been a dramatic expansion in many schools of career advising, academic advising, and CQI functions, all of which require administrative support systems. While these changes appropriately include new decanal staff, I am not convinced there has been a consistent and commensurate expansion of support staff.
A few consequences can result. Administrative support professionals who answer to multiple leaders may be forced to prioritize among those they assist, setting the team up for possible conflict when time is short and deadlines are approaching. Overworked administrative professionals may struggle to maintain the quality of their work, hurting perceptions of customer service, not to mention the outcomes of the work itself.
These issues can also contribute to a sense of isolation and difficulty taking time off, creating a potent well-being challenge for administrative support personnel. The whole team inevitably feels the strain. Others on the team may have to set aside work that only they can do to meet administrative needs, adding to inefficiency across the office. It’s difficult for senior leaders to be as effective as possible if they are frequently pulled into administrative tasks that do not require their expertise, and their well-being may suffer, as well.
Blending my medical education accreditation work with my role as a change-maker coach for the National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience, I have been working to identify intersections between well-being and accreditation. While the LCME does not explicitly set requirements for administrative support staffing, Element 2.4 sets an expectation that staffing will be adequate for supporting the mission of the school. In addition, the LCME expects offices such as Medical Education and Student Affairs to be accessible and for those professionals to be aware of and responsive to student concerns. In my experience, student dissatisfaction often relates to limited administrative support and/or rapid turnover in staff, rather than any lack of diligence or caring among the people in those offices.
For the health of the team as well as optimal accreditation outcomes, I advise professionals to spend some time examining their administrative support staffing levels to ensure adequacy. Questions that may help stimulate this discussion include:
Has your team’s workload grown? Consider how your class size and/or program load compares with 10 years ago.
Has the size of your support staff grown concurrently with the expansion of middle management?
Have people been promoted to middle management without shedding their administrative support roles? Internal development and promotion are things to celebrate, but some new managers may need additional support to meet the expectations of their new jobs.
Are people across your team working at the top of their expertise, or are they handling tasks that take time away from their most important work?
Are there staffing guidelines available for your area of work? Some organizations, such as the National Association of Student Financial Aid Administrators, set benchmarks for staffing that may be helpful. When considering such benchmarks, keep in mind that issues faced by medical and other graduate students can have unique complexities that may influence staffing needs.
Review your results from the AAMC GQ and any annual student surveys your school is conducting. If you are maintaining your DCI regularly as we have suggested, you can start by reviewing the latest information there. If scores related to the availability and responsiveness of staff in areas like career counseling, academic advising, and financial services suggest there are problems, consider whether the teams in those offices are overextended and could benefit from enhanced administrative support.
Hopefully, these conversations will spark meaningful ideas for supporting your full team and the work they do. These discussions will also likely inspire ideas for supporting administrative support professionals themselves. Here are five that I think are particularly important:
Ensure adequate staffing: As discussed above, inadequate administrative support staffing puts a strain on everyone, particularly administrative support professionals themselves. These colleagues often manage entry points to our offices; if they cannot function effectively, we can expect concerns about accessibility.
Keep an eye on compensation: It’s worth looking at benchmarks for salaries across your team, especially as workloads expand. Administrative support professionals who have not received promotion-related compensation changes may warrant particular attention. Make sure pay reflects the value these professionals bring to the team and the school.
Engage the full team in planning: The institutional knowledge and perspectives of administrative support professionals bring unique value to goal setting and strategic planning. Meaningful inclusion of these professionals in such processes is critical to maximizing results.
Encourage professional development: Growth is not just about promotion. Ensure your administrative support staff has access to professional development opportunities — and your full support for taking time away from day-to-day work for these activities. The whole team will benefit from this investment in professional skills and satisfaction.
Celebrate your team: Recognizing contributions across the team is a tenet of good leadership. Be sure your administrative support staff has the same opportunities as others to celebrate your office’s achievements, and be sure to acknowledge the great work these professionals do every day.
It’s not difficult to imagine how administrative support professionals become overloaded with work. The most skilled of these professionals make balancing many complex tasks and priorities look easy. However, real problems can result when these colleagues are stretched too thin. As accreditation professionals work to address problems that may link to the effectiveness of senior leaders, ensuring staffing adequacy and appropriate attention to the needs of administrative support professionals may be a helpful place to start.
