The health care field has become increasingly competitive over the past few years. The need to increase quality of care and decrease costs has left most health care providers struggling to find new methods for survival. One such approach is through merging with another health care provider. The following article details one such organization's approach to merging and how it impacted mail operations.

Scottish Rite Children's Medical Center and Egleston Children's Hospital, two predominantly pediatric health care providers in the Southeast, merged their operations over a period of two years beginning in 1998 to become Children's Healthcare of Atlanta. The Mail Services department was involved in the merger process from the very beginning, thanks in part to mail employees developing reputations as mail consultants.

Don't have an identity crisis

Our first step was to inform the United States Postal Service of the hospital's new identity. Table 1 displays a checklist of important responsibilities for the mail supervisor during the transition time. One of our most critical responsibilities at the hospital was verifying that no changes would apply to our USPS Nonprofit status. Complications arose during our merger process concerning our status. Originally, it was mandated that we simply file another PS Form 3615 with updated information, but eventually, we were required to reapply altogether. You should allocate at least three months to prepare for the possibility of such an occasion.

Suddenly you have 2,500 new friends

Before the merger, both mail centers were offering 24-hour delivery of internal mail and two to three business days for US mail. At the beginning of the merger, each of the mail centers became overburdened with new mail. Entire departments and individual employees moved from one campus to another. Some individuals had offices at up to three locations. The result was a doubling of internal mail, fliers, large mailings and even junk mail. Before we knew it, the standard delivery time had increased to five days in extreme cases! With Children's offices located in 32 different ZIP Codes with two huge hospitals miles apart, it was becoming apparent that a central location was necessary to tie all the loose ends. Customer satisfaction was decreasing and  costs were skyrocketing. Our main goal was to decrease costs by eliminating duplication of services, equipment and staffing. The next step was to combine both hospitals' mail centers into one identity. To do so, a project plan needed to be developed based upon cost savings data associated with the time it took to receive, process and deliver hardcopy communication (mail). The delivery time of the mail is what sold the idea to merge the operations. 

Of course, the decision to merge both operations was not without controversy. It was necessary to explore outsourcing the services. The added expense for third-party management, up against an already proven mail model in both mail services prior to the merger convinced the majority to keep mail services in-house, thus immediate mail consolidation planning began.

What now? Now what?

When determining the structure for our new operations, it was decided that a "wheel and spoke" method would work best as we had two main hospitals, one corporate headquarters and numerous satellite offices. A wheel and spoke method can best be understood by how it sounds, a central hub, branching out to various points. We wanted to bring all the mail "in" to one location and out right away.

After determining the structure of the new mail center, a location for the new centralized service and floor plan was chosen by the mail center supervisor and a team of architects. The architects required specific answers about machine voltage outputs. For this reason, we had a good indication early about what equipment was to be purchased. Roughly 75% of our equipment was pre-owned and the remaining items were purchased in advance.

Once the mail center was designed, the next step was to create a service package for each employee in regards to mail services. We started by communicating to all employees the types of mail (US and inter-company mail) and when they could expect service for each category. Next, service · levels were selected for each location consisting of mail center staff, USPS or courier services. Services performed by the USPS were to have a turnaround time of two to three days for First Class mail some next day in Local Delivery Zones (LDZ), call your local post office for a list of your LDZs. Services performed by mail center staff would have a one business day turnaround to selected service locations and two to three days for non-priority service locations. In order for a department to be considered a selected service location, the following criteria was considered: location, number of employees, revenue generated, urgency of mail received or sent, volume of mail and type of department.

The next part of the project plan consisted of determining production levels and acquiring staff to facilitate service agreements. A Mail Flow Planning System (MFPS) was developed to manage the service agreements between the mail center and our customers (hospital staff). The MFPS consisted of four staffing levels. The first level was comprised of a distribution team whose task was to deliver to the customers. The second and third level consisted of a sorting and metering team. The last team's responsibility was to manage all of the shipping needs for the organization. The metering and shipping team also assisted the distribution team with deliveries early in the day. All of the teams had time allotted during their days for cross training, preventative maintenance and housekeeping duties.

Is it working?

Once the two departments were successfully consolidated, the last part of the project plan (quality assurance) was put into place. Internal and external quality assurance plans were implemented, the following are a few examples:

Internal: Measure sort rate, benchmark 1,000 pieces per hour with no more than three errors per hour. Measure meter rate, utilizing manufacturer software capable of identifying user and processing times.

External: Periodically survey customer. Seed mail to measure route effectiveness.

The mail services consolidation plan was simple in its approach, but very effective. It has become the backbone for our decision-making process and has helped us keep our customers' needs first. To date, we have been successful in increasing the level of service quality and decreasing costs.

Tony Flash is the mail services supervisor at Children's Healthcare of Atlanta. He also serves as vice president of Education for the new Atlanta Mail Systems Management Association. He can be reached at 404-929-7496 or email tony.flash@choa.org.