This episode originally aired on February 13, 2022.
Bienvenue! Welcome back! We’re at the halfway point in our audio masterclass. By now you’ve heard three sets of stories and how-to lessons explaining why business infrastructure is important and how to build it.
If you haven’t listened to the first six episodes, then make sure you do that first. They’re like building blocks in that they contain foundational information that will help you follow along with this next story.
You’re about to meet two sisters who co-own a mental rehabilitation facility. Patients aren’t the only people drawn to them; regulators are too. Fines resulting from a failed audit forces them to contend with the way they manage paper files. Will they rise to the occasion or risk shutting everything down?
This is episode 241. Troubled Waters – The Story of the Benoit Sisters and the Expanding Medical Office.
***
Karen and Sharen Benoit are identical twin sisters running a mental rehabilitation facility with three locations. They’ve survived one disaster after another and, in the process, learned from a brush with the law the importance of protecting physical records at all costs. A recent audit exposed their lack of structural cohesion and transparency across their locations. Time is running out to demonstrate compliance.
Their business is only as good as the paperwork they can produce when requested. Another failed audit could result in a shutdown while opening the door to fraud accusations. Their consultant introduces them to the Paper Records Management element of the Kasennu framework to prove to the auditors their business operates behind-the-scenes as well as it’s perceived publicly.
***
It was 7:15 am on a breezy Monday in New Orleans, LA. There’s finally low humidity in the air, a fitting weather condition following a weekend of festivities as Karen Benoit and her identical twin sister, Sharen, celebrated their 40th birthday. It’s a miracle Karen is present at her Toastmasters club meeting, considering she only arrived home from partying a few hours ago.
She’s teetering between consciousness and unconsciousness, wondering why she chose to speak today. Her hands were trembling. Soon, a timer chimed – her cue that it was her turn to speak next. But first, the designated Toastmaster for the meeting introduced her.
[Toastmaster]: “Karen Benoit is a native New Orleanian. She recently celebrated her 40th birthday. This morning she will share with us her personal story – something that none of us are aware of. The title of her speech is ‘Weathering the Storms of Life.’ She has five to seven minutes. Please join me in welcoming Karen Benoit.”
The audience began clapping. Karen stood up and swallowed hard. Her heart was racing. As she approached the front of the room, she couldn’t believe how nervous she was. She had spoken publicly many times before, but this was different. She had to give a speech that required telling her personal story.
Although she’s previously shared tidbits of her past, she’s never shared the whole story. It was a defense mechanism. She had learned over the years how to hold back emotion, adapt to different environments, and press forward no matter the circumstances.
Now she faced a room of about 35 people. Before she uttered her first word, she noticed an old friend, Camille Soutien, whom she hadn’t seen in a while. They first met at this very Toastmasters club.
[Karen]: “Exactly 30 years ago, on a breezy, beautiful day, much like today’s, the trajectory of my life changed forever. Some call a breezy day the ‘calm before the storm’ and truer words were never spoken. Good morning, fellow Toastmasters and guests. Today, I will share with you three storms that I’ve weathered throughout my life.”
[Karen]: “The first storm happened when my parents were in a fatal car accident on their return trip home from Houston, Texas. My twin sister and I were spending the weekend with some friends. I’ll never forget when our friends’ mother delivered that most devastating news. The biggest question became, ‘Who will care for us?’ My sister and I had just turned 10 years old. We found out later that my parents went on this trip to surprise us with a new house. Unbeknownst to us, we were going to relocate, and our parents went to Houston to close on the new house. Their death was one hell of a birthday present.”
[Karen]: “We stayed with our friends and their parents for about six months until it got to the point where the financial strain of having extra mouths to feed proved to be a mission impossible. Both of my parents were only children, so we had no immediate aunts, uncles or cousins and all of our grandparents were deceased. No one seemed to want us and so we ended up in foster care. To this day, we’ve never bothered to look for any distant relatives. We figured, they never looked for us, so why should we look for them?”
[Karen]: “They say twins have a bond unlike any other and Sharen and I learned quickly that all we had was each other. We got lucky though, we were welcomed into a foster home when we were twelve. Although our foster parents never adopted us officially, we were able to stay with them until we turned eighteen and both enrolled at Xavier University.”
[Karen]: “Eventually, I became a social worker and Sharen became a psychiatrist. We both chose professions where we could specialize in helping children who either grew up in foster care or were adopted. By the time we were in our late twenties, we started our own mental rehabilitation facility to help these very children. Things were going well until the second storm happened – Hurricane Katrina.”
[Karen]: “I don’t need to tell any of you how absolutely devastating Katrina was. It caused physical, emotional, and psychological pain, a pain that binds every single one of us in the city together. A few months after Katrina, our facility was audited, and we failed. We failed, miserably. Not only were most of our patient records destroyed, but so was the facility itself. The auditing agency had little sympathy and we were fined severely. Had the levee not broken, we likely would have never received that tax. At least that’s what we told ourselves. But Sharen and I are resilient. The aftermath of Katrina led to a business expansion we couldn’t have imagined. Soon, we opened a new facility on the West Bank and extended our offering to all children suffering from the trauma of Katrina.”
[Karen]: “We were making such a huge impact that we opened a second location in Metairie and expanded our offering this time to children suffering from any type of trauma. As we gained more press and attention, we opened our third and latest location here in Uptown. As my sister and I weather our third storm, I’m learning that growth is good, but it can also be painful.”
[Karen]: “One thing I’ve learned is that there is the calm before the storm, the storm and then, the aftermath and clean-up. We’ve all weathered different types of storms. We may not be able to prevent the storm, but we can certainly take charge of our reactions to it. Our reaction is critical to whether we survive those storms. One thing I know for sure is that trauma is real. Pain is real. It’s okay to cry. It’s okay to release anger and frustration, but channel that energy into something that can grow and be productive.”
[Karen]: “I’ve lost people, material things and, at one point, I almost lost my mind. Yet I can stand here today before you and tell you that forgiveness is the greatest antidote. Laughter is medicine for your soul and life is for the living. Madame Toastmaster…”
Once the Toastmaster approached Karen to shake her hand, she walked back to her seat amid thunderous applause.
Following the end of the meeting, Karen was able to speak with her friend, Camille. They embraced each other tightly. Although they talked on the phone about once a quarter, two years passed since they last saw each other.
[Camille]: “Karen! Bonjour!”
[Karen]: “Camille! I’m surprised to see you! When did you arrive? I had no idea you were here!”
[Camille]: “Yesterday. I went to the club’s website and saw that you were scheduled to speak. I am here on a business trip this weekend but knew that I had to make time to see you. Happy Birthday! I was hoping to surprise you and Sharen, but my flight was delayed. I didn’t arrive until yesterday evening. I was so tired. So much for surprises. Where is Sharen by the way?”
[Karen]: “Oh, she left this morning for a short cruise to Cozumel.”
[Camille]: “Ooh, nice!”
[Karen]: “Yes, her husband and kids had to practically drag her away from the office. It’s only for a few days, though. She should be back before you leave.”
[Camille]: “Good. I’d love to spend some time with both of you. You mentioned a third storm, but didn’t say what it is. Is everything ok? Does it have to do with your business?”
[Karen]: “Yeah.”
[Camille]: “I hope I’m not prying. I’m asking because I wonder if it’s something I can help with.”
By this point, the meeting room cleared out and Karen motioned for Camille to walk with her out of the room. Now, she could let down her guard and speak more openly.
[Karen]: “Girl, look, we need all the help we can get! The sooner we can talk, the better. I can fill Sharen in when she returns. I know she won’t mind, considering the severity of this.”
[Karen]: “Look, I know it’s still early but maybe we can go to my office. I’d love for you to see it. I work from that location whenever we have a Toastmasters meeting since it’s not a far drive. Do you have time?”
[Camille]: “I will call someone at my next appointment to let them know to expect me an hour later, at around 10 am.”
[Karen]: “By the way, how did you get here?”
[Camille]: “I took the streetcar.”
[Karen]: “You can ride with me. When it’s time, you can take the streetcar to your next appointment. We’re only a block from the line.”
They walked to the parking garage where Karen’s car was parked. The drive to her office, though short, was a bit challenging because of all the commuters making their way downtown to go to work. Camille became nostalgic as she looked at all the restored and renovated old buildings and houses. She truly loved New Orleans and enjoyed comparing the city to her native Paris, France.
[Camille]: “It’s just the way I remembered it.”
[Karen]: “I hope that’s a good thing!”
Karen turned off a narrow, two-lane street and down a narrow driveway that ran between two houses now functioning as businesses. The driveway led to a small parking lot in the back of one of the houses.
[Karen]: “Welcome! Bienvenue!”
[Camille]: “Merci! Merci beaucoup! Ah Karen, is this it? Is this the new office? It’s beautiful!”
The house they parked behind was known as a shotgun double with a camelback – a popular style in historic New Orleans. The house had been converted into a mental rehabilitation clinic for children. The partially two-story building was painted in lime green with dark green shudders framing each window. There was ornate crown molding painted in white and, though there was little land around the building, the landscaping was picturesque.
They approached the back of the building and went up a few steps that led to a solid oak door. Unlocking and opening the door released a waft of fresh magnolias. Their office manager was already inside the building.
Camille took in the beauty of the building’s interior. The floors were terrazzo and stained in a beautiful bronze color complemented by various shades of green walls. She noticed a variety of plants placed strategically in the hallway and offices that they walked past on their way to Karen’s office.
By the time they settled in Karen’s office, it was getting close to 9:00 am. Camille knew she didn’t have much time to learn more about that third storm Karen alluded to earlier in her speech. But the situation seemed dire, so without hesitation, she expressed her condolences.
[Camille]: “Karen, about your speech…I am so sorry. I had no idea your parents died so tragically. I thought you and Sharen were adopted as babies. How foolish of me to make assumptions. I should have…”
[Karen]: “Please don’t be sorry! That’s exactly why Sharen and I don’t like sharing that part of our story. We don’t want people feeling sorry for us. If the effect of my speech was pity and sorrow, then I failed in my delivery. My intent in sharing our story was to evoke a can-do spirit and attitude. It’s important I get this messaging right as I plan to start doing more public speaking.”
[Camille]: “Ah, I see. Again, I hope I’m not prying by asking such personal things.”
[Karen]: “No, not at all. It’s so ironic that we own a mental rehabilitation facility but haven’t sought therapy ourselves. I guess we poured ourselves so much into our work that we saw that as our therapy.”
[Camille]: “Okay. May I ask, what is the third storm?”
Karen released a deep sigh, leaned toward Camille and, in a barely audible tone began to share.
[Karen]: “Girl, we were audited again earlier this month. The way we manage our paperwork has gotten us in trouble again. The deficiency was exposed when an auditor asked for a sample of patient files here at our Uptown location. The problem was there were different files for the patients across our locations. In other words, they’re not consolidated. Once he visited our other two locations, he discovered just how pervasive the file fragmentation really is.”
[Karen]: “The auditor concluded that we don’t have a cohesive records management system in place and he explained how this lack of cohesion could impede our ability to operate in an effective and compliant manner. In his final report, he made a recommendation to get a records management system in place within the next 90 days, or else he would have to report our refusal to comply to Medicaid. We’ve already received two citations in the past.”
[Camille]: “Oh, my goodness!”
[Karen]: “I know, right?”
[Karen]: “Lord, have mercy. I’m so rude. Enough about me. Girl, how have you been? And why exactly are you here?”
[Camille]: “Actually, I’m here to meet with the company I used to work for when I lived here in New Orleans. I want to introduce them to a framework I’ve been using with my clients. It’s called Kasennu and its used to build business infrastructure.”
[Karen]: “Oh, that’s good! How is business by the way? How does it feel to be an entrepreneur?”
[Camille]: “Great, thank you! It’s rewarding and challenging, but I love it! The travel is the most difficult part so far. I can do things remotely, but I want the hands-on experience first before I go 100% virtual. I’ve been working mostly with different small companies between Paris and Martinique to gain the experience of applying the framework. So far, everything has worked well, and the results are sustainable.”
When they walked through the front door of the facility, the office manager happened to be standing next to the receptionist. Karen made introductions.
[Karen]: “Justin, this is Camille Soutien. She’s originally from Martinique but spent her teenage years in Paris. She moved back to Martinique as an adult. We met 14 years ago when her company relocated her to New Orleans. She’s a dear friend of ours. Camille might be able to help us with our paperwork issue.”
As they got closer to the front door of the building, Camille noted the phrase, Laissez Les Bon Temps Rouler, painted above the door and smiled. It means, Let the Good Times Roll. It’s an expression unique to Louisiana that serves as a reminder to have a light-heartedness about you no matter the situation.
As Camille walked out of the building and down the street toward the streetcar line, she couldn’t help but think of everything Karen revealed. Even though Karen asked for no sympathy, Camille’s heart began to ache for everything she and Sharen have been through.
***
Camille called Karen later that night after her client dinner. As much as they talked on the phone over the years, they rarely discussed business.
Karen told her that it would be best to meet again on Wednesday. Her sister, Sharen was expected to return from her cruise the next day.
Karen also mentioned visiting Camille’s website to learn more about the Kasennu framework. In particular, she noted that the Paper Records Management element seemed to be the one they could benefit from. She asked Camille for more information.
[Camille]: “Sure. Basically, Kasennu is an operating system designed to help fast growing companies like yours scale in a repeatable and sustainable manner. In your case, the end goal would be to have processes that ensure regulatory compliance, a consistent patient experience regardless of the location visited, and satisfied employees who work for the collective good of the children. Does that make sense?”
[Karen]: “Yes, but I guess I struggle with why processes are needed in the first place. We’re not producing any tangible goods. We provide a service. Every therapist is different and has his or her own unique style.”
[Camille]: “That’s true, but there are certain government guidelines that all of your therapists must comply with. Proper recordkeeping is one of those guidelines. This is what the auditing agency has been trying to tell you. Yes, you’re attracting more and more business and you have beautiful and inviting locations that your patients and constituents love but, because you receive funding from the federal government, they need to make sure that the way you operate your business is up to code. That’s the real reason why you’re audited. You shouldn’t take it as a personal attack on you and Sharen, nor should you think of it as a curse. Instead, it could be a blessing.”
[Karen]: “A blessing? Have you lost your mind?”
[Camille]: “Not at all! Quite the contrary. I say it’s a blessing because had this citation not happened, you would be in real danger of losing credibility if, God forbid, you all open even more locations without a centralized and formalized records management system.”
[Karen]: “Interesting. Listen, our number one mission was, is, and will always be to help children suffering from trauma. We measure our success by the number of children who mature into fully functioning adults and thrive, not by how much money we make and certainly not by the piles of paper we keep.”
[Karen]: “With the increased intensity and frequency of these natural disasters, we’ve received even more exposure, especially when we were featured in a piece in the New York Times.”
[Camille]: “You have 90 days to resolve this matter, yes?”
[Karen]: “Yes. Problem is, neither Sharen nor I have the time to focus on this. We realize we’re going to have to make the time. We don’t want to lose what we’ve worked so hard to build for the past 12 years. We’re cash flow positive, have no debt and are set to have our best gross revenue ever at $23 million.”
[Camille]: “Karen, think about this. Many lawsuits are lost daily all because people cannot provide proof. Your recordkeeping is like your insurance policy. Just as you have insurance for your business, your home, your car or even your life, think of recordkeeping as your insurance against lawsuits. It won’t prevent a lawsuit from happening, but it gives you the protection needed to defend yourself and your business practices.”
[Karen]: “You know…I never thought about it that way, but you know what? You’re right. I tell you what, I’ll fill Sharen in on our conversations. We have a meeting at Tulane University Wednesday morning. We usually walk across the street to Audubon Park afterwards to debrief. Can you join us? We can leave straight from there and go back to the office so you can ask more questions and gather any additional information you may need to help us.”
Sharen returned her sister’s call on her ride home after arriving from her cruise. As a psychiatrist, she was skillful at listening without interrupting and therefore took great care to absorb every word Karen said as she gave the highlights of her conversations with Camille.
Sharen also confirmed that she was available to meet with Camille after their meeting at Tulane.
***
The next day, Karen and Sharen walked from the campus of Tulane University directly across St. Charles Avenue to meet Camille in Audubon Park at 1:00 pm. Sharen gave Camille the traditional French greeting with a kiss on each of her cheeks. Camille was genuinely happy to see them.
The trio was now complete. They got a kick out of being seen together publicly. All three of them were 5’2” and of similar caramel complexion, except Camille had shoulder-length curly black hair and the twin sisters had wavy, light brown hair. It seemed like yesterday that Karen introduced Camille to Sharen after meeting her in Toastmasters.
They began walking the 1.8 mile paved path around the golf-course that rested in the center of the park. The majestic oak trees formed a maternal-like canopy over parts of the path as if protecting the runners, joggers and walkers. The gentle breeze through the trees made the weather all the more appealing. As they walked, they began to catch up on personal matters before moving on to business.
Camille learned that the sisters were both ready to travel more, but with three locations they had been busier than ever. Someone suggested they apply for membership at Tulane University’s Family Business Center. It has since proven to be instrumental in helping them understand the value of succession planning and processes. As they continue to expand, they told Camille it was important that they keep the business ownership within their family.
[Sharen]: “We didn’t grow up with cousins, aunts and uncles, so family is everything to us. And Karen and I know we can’t do it all. Attending regular meetings at the center has helped us realize that our business is really like a house of cards built on a sand foundation – it’s fragile. This latest audit was a real wake up call. Frankly, as a physician, I’m embarrassed. I know fully well the importance of maintaining patient records.”
Once they completed a revolution around the park’s paved path, the three of them headed to the Uptown location.
***
When they walked into the waiting area of the facility, the sounds of local, but famous jazz greats like Wynton Marsalis and Kermit Ruffin were playing softly in the background. There was a lot more activity in the waiting area today compared to the first time Camille visited. There were a few teenagers, each donning large headphones, listening to their own music, and a few younger children, some of whom were reading books and others who were playing together in a large sandbox on the floor.
Karen walked into her office to begin returning phone calls while Sharen asked Camille to follow her to visit Justin, the office manager. Eventually Sharen left the room, knowing that Justin would do a far better job explaining their records management system.
Camille was struck by Justin’s warm personality. Although she knew little about him, she could already tell why they hired him. From what she heard so far, he was friendly and worked really well with the children and the staff.
It wasn’t quite cold enough to wear longer sleeves, so he had on a short-sleeved, buttoned up shirt revealing his tattooed forearms, a complete diversion from the twins’ dress codes. They were always dressed sharply. As a matter of fact, Camille couldn’t recall a time she’s ever seen them in blue jeans.
Camille asked Justin how long he’d worked there. He went on to tell her he’d been there for two years and how he works as a drummer at night. He was instrumental in getting the Uptown location opened ahead of schedule. He started working on centralizing the records management system across all three locations, but ran into resistance from the other two office managers.
According to Justin, they were envious of the fact that he was hired as an office manager with no previous experience when they had to work their way up to the position. But soon Justin realized he’d spread himself too thin trying to stand up a new location and take on such a large project. Sure enough, the audit caught up with them.
Justin offered to show Camille where the archived records are kept. As he began to walk out of his office, she quickly removed her tablet and stylus from her shoulder bag so that she could take photographs and record notes.
The archived records were in a small room, stored in several black, steel lateral filing cabinets purported to be fireproof and waterproof. Each had five drawers. Justin expressed frustration as he recalled telling Karen and Sharen how, despite being fireproof and waterproof, these cabinets wouldn’t help them survive another storm like Hurricane Katrina.
Camille used her tablet to take photos and jot down notes, taking into account the office location and the number of files. She asked that Justin unlock and open each drawer so that she could assess just how many files were contained in each. Each drawer, with the exception of two, was stuffed with files.
[Camille]: “My goodness! You’re already running out of space in this location!”
Justin agreed and then offered to drive her to see the files at the other two locations in Algiers and Metairie.
Listening to the names where the other offices are located reminded Camille that Karen and Sharen’s original location in the Gentilly area no longer existed. The building containing the suite they rented was destroyed during Hurricane Katrina nine years earlier.
***
At each location, Camille met most of the staff and took more photos and notes. When they returned to the Uptown location, she thanked Justin for driving her around. She then went into Karen’s office. Sharen had left earlier to go home and finish unpacking and recuperating from her cruise.
[Karen]: “Ok, what do you think? Is there hope for us?”
[Camille]: “Absolutely! I’ll need some time to prepare a proposal for you, considering the other work I have to do while I’m in New Orleans, but please expect to receive something from me by the beginning of next week.”
[Karen]: “Okay, that’s fine. Can you do me a favor though? Promise me we can go out for old time’s sake before you leave. You’re in the Big Easy. It’d be a shame for you to be here and not get a chance to party.”
[Camille]: “Oui, Madame. I promise.”
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Hey there, it’s me Alicia Butler Pierre! At this point, you might be wondering, how on Earth is Camille going to help her friends? Well, you’re about to find out. But keep in mind, we can’t include all the details – if we did this episode would be several hours long. But you’re in luck because you can get all the details in my book, Behind the Façade: How to Structure Company Operations for Sustainable Success. That’s where this story comes from and its where you’ll discover how you can build business infrastructure to scale your fast-growing organization without the chaos. Get your copy today on Amazon or wherever books are sold online. Click the link in this episode’s description to buy your copy today!
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It was Saturday and Camille was back in the tropical paradise of Martinique. She was proud of herself. In one week she gained two potential new clients: her old job that has an office located in New Orleans and the Benoit sisters. Her eight-hour flight to Martinique afforded her time to review carefully all of the information Justin and the other two office managers shared with her.
She also reviewed the auditing agency’s guidelines. From her online research of the agency, Camille learned that they exist to ensure quality care in providing health and human services. They are an independent resource that analyzes certain tools to assess the quality of care. Those tools include documented processes, job descriptions, an organizational chart and records management systems. They even look for a documented service delivery process as part of their audit – literally every element of the Kasennu framework that Camille learned over a year ago!
Once Camille settled in at home, she spent the majority of Sunday preparing proposals, first for her former employer and then one for Karen and Sharen. She emailed her proposal to the twins early Monday morning, a few days before Halloween.
***
While Karen was at her weekly Toastmasters meeting, Sharen had been in her office since 6:30 am. She had a day packed with appointments and she was still trying to catch up after taking a short vacation last week. She happened to be on her computer when the email from Camille arrived. She opened the email and began to read it.
In it was a summary of Camille’s discoveries – a recap of her meetings with them and the office managers. She also saw a summary of the Paper Records Management solution. It read…
Physical or paper records are a vital proof of original documentation. It’s important that staff know where to find information when they need it in order to perform their jobs well. Unlike electronic records, paper records are tangible and therefore more susceptible to compromise. Thus, they must be handled with utmost care; without a scanned counterpart, disaster recovery is impossible, as you’ve learned the hard way. Paper Records Management is one of the elements of the Kasennu framework. It’s a system that links together the processes, technology and people needed to create, name, categorize, store, and purge physical data in an organized, consistent and transparent manner.
Sharen continued reading.
The scope of your Paper Records Management system will focus on creating a centralized archival repository that considers that the business and its existing locations all operate in a flood-prone region that is seven feet below sea level. We will leverage your existing organizational chart as the foundation for organizing records to archive across all locations. These records include patient, legal, accounting and personnel files. We will assess the optimal storage solution and document the process for converting a record from active to inactive.
The final paragraph highlighted the specific steps for creating their system as well as a breakdown of how they’d complete the work. There were a total of 75 file drawers filled with archived records and a total of 30 file drawers filled with active records across all three locations. The work would be divided into four remote sessions before the 90-day window from their audit review expires. Those four sessions would be spread over the next two months to allow them time to work around their busy schedules as well as the upcoming holidays.
***
When Karen arrived at her office, she found that Sharen was already there waiting. Sharen told her sister about Camille’s proposal before forwarding it to Justin. Although she had a hunch of what Karen’s answer would be, Sharen asked her anyway and then called Camille.
[Camille]: “Bonjour!”
[Sharen]: “Bonjour, Camille, it’s me, Sharen. Karen and Justin are also in the room. We saw your proposal. When can we start?”
[Camille]: “Does next Monday work?”
[Sharen]: “Next Monday it is!”
The day of the first remote Paper Records Management session arrived. Karen, Sharen and Justin logged into Microsoft Teams from their respective offices.
Before them appeared a screen with a grid on it. Once Camille confirmed that they could each see the screen, she began to explain what they saw.
[Camille]: “Before you is a grid of rectangular blocks. The top row of blocks contains the names of your departments: Management, Clinical, Accounting, Administration, Public Relations, Human Resources and Quality Assurance. I extracted that information from a copy of the organizational chart that Justin gave me. Does this look correct?”
Karen slowly replied, yes. Even though the proposal mentioned leveraging their organizational chart, she still wondered what this had to do with their paperwork issues.
[Camille]: “Stay with me Karen! I promise it will soon make sense. Back to the grid. The remaining blocks of the grid are empty. The first thing we will do is assign a color to each of these departments. After that, I will explain how you will populate the remaining blocks with information about your physical files. The reason we want to assign color is because it aids in memory retention and, in the future, will decrease the amount of time spent in locating files. Once you know the meanings of colors, you can choose a color that best represents each department or grouping of paper files.”
Camille then clicked on a button on the top menu of the business infrastructure software containing the grid. The button revealed a pop-up window containing a color chart. As her mouse hovered over the primary colors first, the meaning or significance of each color appeared on the screen.
[Camille]: “As you can see, the color red represents action, energy and foundation. The color blue represents communication and loyalty, and the color yellow represents joy, confidence and attention.
[Camille]: “I suggest that you use the color most closely associated with your business as the color for your core department. In your case, the core department is the Clinical Department. Since your company’s logo is green, I would choose that color to represent it. Green is associated with health, balance, prosperity and safety.”
Camille continued to hover over the remaining colors. Sharen and Justin learned that orange represents relationship, dark blue represents wisdom, and purple represents ascension. Now that they knew the symbolic meanings of these colors, they could assign one to each of the remaining departments.
Karen, Sharen and Justin began to talk among themselves and instructed Camille on which color to assign to each department. Camille changed the color of the rectangular blocks containing the name of each department as follows: Management (blue), Clinical (green), Accounting (black), Administration (purple), Public Relations (orange), Human Resources (yellow), and Quality Assurance (red). Their reasoning for choosing black instead of green (a more traditional choice representing U.S. dollars) for the Accounting Department was because they want to stay “in the black.” They chose red as the color for the Quality Assurance Department to indicate its “red hot” importance. After all, compliance can make or break their business.
Camille saved a copy of the grid and converted it into a document compatible with a word processing program. She emailed the copy that included additional instructions to all three participants. The next step was to fill in the blank, white rectangles on the grid with the names of the different types of files based on each employee’s paper file inventory. She opened the page containing the instructions and read each aloud.
Sharen expressed concern about how long this exercise could take. She was doubtful it could be completed in less than 90 days. Camille assured her it was possible.
[Camille]: “It really depends on how many types of files you have and the amount. The therapists may complete this inventory in one to two hours since most of their files will be patient records. But Karen’s inventory may take longer considering she probably has file types associated with each department. I think you need to give yourselves about two weeks to get this done.”
[Camille]: “Let’s move on. Save a copy of your completed grid. Justin, please distribute copies of the blank grid and instructions to everyone at the Uptown location. You’ll also need to send copies to the office managers at the other two locations and ask them to distribute accordingly.”
[Camille]: “I recommend working in four-hour increments. Depending on the amount of paper in a person’s office, this exercise can be daunting to take on in one day. Besides, you won’t have time if you do this during a workday.”
Justin responded letting Camille know that they could ask their teams to come into the office on Saturday mornings and over the Thanksgiving break when the offices are closed.
Camille then wrapped up the session.
***
Learning that they might have to work during the week of Thanksgiving was a strong motivator. Everyone in all three locations worked hard to get all physical records inventoried and logged into the grids in just one week.
Justin emailed a file containing 32 grids to Camille. It encompassed all offices and spaces containing physical records across all three locations. She uploaded the file into her business infrastructure software in preparation for the second remote session. Doing so revealed 85 unique file types, each categorized and color-coded by department.
During this second session, she presented a matrix with attributes in the top row representing the lifecycle of a physical record from creation to retirement or destruction. Those attributes included: Full Access Rights, File Name, Active Location, Retention Period, Archive Location, Purge Cycle and Destruction Type. They would identify this information for each of the 85 unique file types.
Camille explained that during this session, she’d describe how to fill in each attribute’s column and that they’d work together to populate the matrix for a few file types. Then, the teams at the three locations would be responsible for filling in the remaining information.
The first file type they began populating information for was “Patient Record.” Camille typed into the cells on the matrix so that everyone could see the proper way to fill in each attribute for a patient’s record.
Once she filled in the matrix with attribute data for a few more file types, she downloaded the matrix into a spreadsheet file. Then she emailed a copy to Justin and asked that he upload the spreadsheet to a cloud-based shared drive so everyone could update the same spreadsheet in real time. This would prevent hours of merging data from their 23 employees.
90 minutes passed. Before wrapping up, Camille asked whether they’d found an offsite document management vendor. Sharen told her they anticipated making a final decision and signing a contract with the new vendor by the end of the week. Camille congratulated them and confirmed the date of their third session.
***
Before uploading the matrix to the cloud for real time collaboration, Justin went about the work of carefully reviewing the auditing agency’s guidelines for patient record retention.
Rather than box and store older files remotely, they would have the offsite storage vendor use their proprietary technology to scan and catalogue all files that surpassed their retention period.
Armed with this information, Justin, Karen and Sharen selected the vendor they thought could best serve their needs. Justin then ordered several banker’s boxes from an office supply store and had them delivered to each location. These boxes would store the files that would be scanned and/or archived initially at the vendor’s offsite facility.
***
The third remote session with Camille began during the first week of December, 2014. Prior to starting this session, Justin emailed her a copy of the completed matrix in the form of a spreadsheet. In the body of the email, he mentioned that he developed instructions to follow in identifying and boxing records to scan and/or archive in preparation for the vendor to pick up. Although Camille had a few days to ponder the information in the matrix, she developed some immediate recommendations to give them.
This session lasted less than an hour as Camille’s primary objective was to give some recommendations before they arranged for the offsite storage vendor to pick up the boxes of archived records.
[Camille]: “It occurred to me that you all do not have a designated ‘headquarters.’ I’ve given this a considerable amount of thought and I can’t help but wonder if this is why the back-office operations became so fragmented and siloed.”
This came as a shock to Sharen.
[Sharen]: “Headquarters?”
[Camille]: “Yes. By identifying one of your locations as the official headquarters, you can centralize much of the management activity into one hub. That hub can disseminate all information that each location must adhere to. I think your Uptown location should be the new headquarters location. Think about it. Your H.R. manager is physically located there and so is the Senior Accountant. They service all three locations and play an integral part in establishing management protocol.
[Camille]: “Also, Karen and Sharen, although you have offices at all three locations, you seem to spend most of your time at the Uptown location. I also foresee Justin becoming an internal compliance officer. I say this based on the initiative he’s taken in implementing this project, as well as the work he’s done in the past to consolidate and standardize the efforts of all office managers. Since all of you play a proactive role in management, it makes sense that the Uptown office become the headquarters. What do you think?”
After giving it more thought, Sharen, Justin, and Karen unanimously agreed.
[Camille]: “Then it’s settled! But first, we need to discuss a critical part of your Paper Records Management – getting some of the records ready for archival. Justin, you mentioned you created some instructions for this. I’m going to give you control so that you can share your screen with us.”
Justin gained control of Microsoft Teams, shared his screen, and began reading the list of instructions he created. It was comprehensive and included information specific to the teams at all three locations. It accounted for scheduling work around the upcoming holidays until the end of the year as well as quality assurance checkpoints. All of this would ensure a positive and smooth experience with the document management and storage vendor.
This third session ended with Camille reminding everyone to reach out to her if they had any questions along the way. She was proud of the progress they were making. In fact, they were ahead of schedule.
Since they were ahead of schedule, Camille used the time originally slated for the fourth remote session to present her final report with recommendations.
It was Monday, December 21, 2014 just a few days shy of Christmas. Karen, Sharen, Justin and the other two office managers all logged into the fourth remote session with Camille. Camille shared her screen, and everyone saw what appeared to be a cover page of a report. This, Camille told them, was their official Paper Records Management system. It was a 22-page document that included their completed matrix, along with specific procedural steps for creating a new physical file using the new color-coded labeling system.
Other steps included the protocol for: 1) working with the offsite storage vendor to pick up new archival records, 2) scanning documents, and 3) testing and updating the new Paper Records Management system.
Justin reported that the document management vendor would pick up the file boxes of information that required scanning. He said that all other file boxes to store were labeled. They took pictures of all boxes and he, Karen, and Sharen even planned on driving the five-hour distance upstate to Shreveport where the vendor is located. Since this was their first time ever doing something like this, they wanted to make sure everything went off without a hitch. Karen chimed in.
[Karen]: “Yeah Camille, this is a little scary for us. But I keep reminding myself that our system is not only going to look good, it will be good! It only took us 12 years to get it right. But, better late than never!”
Sharen then expressed her enthusiasm, remarking on how comprehensive the new system is and how it ties together the efforts of all of their locations. It also provides a foundation they can use when they open additional locations.
[Camille]: “That’s so wonderful to hear! I’m glad you now understand the value. You should share this new Paper Records Management system with everyone. Let them know the expectations for complying with the maintenance of your company’s physical records. As you continue using this system, evaluate whether you should invest in developing your own official document management solution. It should include scanning, indexing and classifying more of your records in an electronic format. This is a more expensive option, since the solution would be customized to your company’s specific needs, but it will significantly reduce your liability in storing active physical records onsite.”
Camille closed the document describing the new system and thanked everyone for all their hard work and the opportunity to work with them. She emailed a copy of the Paper Records Management system to all of the session’s participants and hinted that she wanted to have a separate conversation with Karen and Sharen.
***
Later that night, Sharen called Camille and Karen on three-way to discuss more of the final recommendations Camille hinted at earlier.
[Camille]: “I think you should consider adding two new roles: a compliance officer and a community liaison. As I told you before, I foresee Justin advancing into the role of compliance officer. This role would enforce and manage the activities of the Quality Assurance Department for all locations. Right now, you have no one specifically working in that department, which is probably another reason why compliance was low in certain areas, despite best efforts. If Justin is promoted into that role, then the current receptionist can be trained and promoted to replace him as office manager of the headquarters location in Uptown. I suspect it’ll be much easier to hire a new receptionist than it would be a new office manager.”
[Camille]: “The community liaison is a new role that would help field questions from the general public and media. If the publicist you’ve hired does a good job, then Karen’s time will be spent mostly in business development and making media appearances, not in fielding questions. It’s time for Karen to function as a true Chief Administrative Officer while Sharen remains the CEO and medical director. Sharen, as the business continues to expand, you may also be faced with choosing between being CEO and serving the role as medical director. Just something to think about.”
Karen and Sharen offered no objections.
[Camille]: “Here’s what I think we should do as next steps. First, pass the audit check-in next month! Then, I can start working with Justin to teach him the rest of the Kasennu framework.
[Camille]: “By the time you start applying those first few elements of the framework, the timing should work well to attend a process identification and documentation workshop. It will take place next year in April in Atlanta. You really should attend, especially as you start adding more locations.”
Sharen didn’t need convincing to attend the workshop.
[Sharen]: “If this exercise has taught us anything, it’s that processes help bind and stitch our operations together. It gives everybody the same compass to direct our workflow. Plus, it ties into the succession planning work that we’ve been learning about at Tulane. Camille, we can’t thank you enough!”
***
The following January 2015, Karen made her first international news appearance a few days after receiving confirmation they’d passed their audit. All that practicing at Toastmasters paid off. Telling more of her personal story was helping to bring more attention not only to the plight of children growing up in the foster care system, but also to children suffering through trauma in general.
Karen’s phone rang constantly, but there was a phone call one day that took her by complete surprise.
[Karen]: “Hello, this is Karen Benoit.”
[Stranger]: “Hi…Karen? My name is Lisa Benoit Aucoin. I recently read an article about you in the Times Picayune newspaper. I’m…I’m your cousin. Our grandfathers were brothers.”
Karen’s heart raced, much as it did when she last spoke at her Toastmasters club. She was speechless. She vaguely remembered Lisa.
[Stranger]: “Hello? Karen?”
[Karen]: “Yes, I’m here.”
[Stranger]: “Can we talk?”
_________________________
Thank you for listening. We hope you enjoyed this episode as much as we enjoyed creating it! Please leave a five-star rating and a review to let us know what you liked best. While you’re at it, go ahead and subscribe wherever you’re listening to this podcast.
The story you just heard is based on Chapter 5 of the book, Behind the Façade: How to Structure Company Operations for Sustainable Success. A link is available in this episode’s description wherever you’re listening.
Coming up in the next episode I’m going to explain how you can create a compliant and audit-ready Paper Records Management system for your organization.
A special thank you to Equilibria, Inc. for making this masterclass possible.
This episode was written, produced, and narrated by me, Alicia Butler Pierre. Audio editing by Olanrewaju Adeyemo. Voice acting by Sylvie Soudin. Original score and sound design by Clarence Levy III with Sabor! Music Enterprises.
This is the Business Infrastructure – Curing Back-Office Blues podcast.
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