Silos: Help or Hinder?

Do the silos in your healthcare organization need to be broken down?

One of my observations almost on a daily basis is that there are silos in every workspace, and we constantly hear the phrase that silos need to be broken down. I will get to that in a minute. Where does the silo concept come from? The reality is that silos are everywhere, and they are not necessarily totally bad, but where does that silo mentality come from?

Surprisingly, the silo concept gets implanted in our minds very early on in life which may be a surprise to most of us. It was to me. Remembering back to our childhood days, grammar school tended to be one teacher, multiple subjects, all in the same classroom. The silo process starts later in the upper grades with each subject having its own teacher, with different styles, different rooms, homework assignments, and allotted times. In addition, most of the time each student had their own desk, their own locker, books, and equipment.

This is just one area where it starts, but it was the beginning of compartmentalization or, more simply stated, silos. Each subject was independent of all the others. This concept is subliminally implanted in our minds, so why would we not carry it through to our work environment, ours being healthcare.

According to Corey Moseley there are three types of silos he discusses. These include the following:

  1. Organizational – this is division within the department according to different types of people and skill sets often making them operationally autonomous entities focusing on specific goals leading to little interaction and information sharing. There may also be a financial component to this silo when comes to individual budgets.
  2. Information – this can be secondary to #1 where information remains trapped within the department
  3. Silos of the mind – these are ingrained thought patterns that influence everyday decision-making within teams. They’re the result of departmental biases and information hoarding

These are all found in clinical revenue cycle.

Let’s return to the previously mentioned statement that silos need to be broken down. This is probably very true, but silos cannot be left that way. Silos need to be rebuilt and here are several thoughts that come to mind:

  1. Knowledge-sharing – information cannot remain trapped in one department; think about the disparate platforms utilized by a department that don’t communicate with others
  2. Cross-functionality – every person should understand how other departments function, not necessarily in detail, but in overall knowledge
  3. Cross-pollination – ideas/actions from one department may be beneficial to another
  4. Standardization – using this concept across an organization helps keep everyone on the same page
  5. Accountability – from the CEO, to leadership, to managers, to team members, everyone should be accountable for their actions

In conclusion, are there silos in your department or organization? Make sure they work for your benefit and success.


John Zelem, MD, FACS

John Zelem, MD, is principal owner and chief executive officer of Streamline Solutions Consulting, Inc. providing technology-enabled, expert physician advisor services. A board-certified general surgeon with more than 26 years of clinical experience, Dr. Zelem managed quality assessment and improvement as a former executive medical director in the past. He developed expertise in compliance, contracts and regulations, utilization review, case management, client relations, physician advisor programs, and physician education. Dr. Zelem is a member of the RACmonitor editorial board.

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