Roles and Responsibilities Chart

One approach to defining, understanding and addressing the construction of an organization is the well-known Roles and Responsibilities Chart, (R&R chart). An R&R chart shows the actors of an organization, (people, groups, divisions), and the actions they perform. A simple R&R chart for a practice might look like this:

Role/Responsibility	Receptionist	Medical Assistant
Answer Phones	X
Collect Copays	X
Schedule Appointments	X	X
Room Patients		X

This is obviously a very, very simple R&R chart, but it does the basic job of identifying what the responsibilities of the receptionist and medical assistant. It also highlights problems that might develop due to overlapping responsibilities, such as with “Schedule Appointments” above. As both the receptionist and medical assistant have this responsibility, how should this be handled? Can the receptionist have everyone schedule with the medical assistant–or vice versa?

R&R charts can include additional information regarding the interaction between actors by using different letters to denote actions, such as responsibility, coordination, input, notification and approval. In this chart, the practice identifies the relationship between the actors and the responsibility

Role/Responsibility	Receptionist	Medical Assistant	Provider
Answer Phones	R1	R2
Collect Copays	R1	R2
Schedule Appointments	R1	C	A
Room Patients	R1	N

The receptionist now has the primary responsibility—the “R”—for all of the tasks listed, but the medical assistant has secondary responsibility to help with answering phones and collecting copays in support of the receptionist. The receptionist is responsible for scheduling appointments, which the medical assistant coordinates (“C”) with the the provider, who is responsible for approving (“A”). The chart reflects that when the receptionist rooms the patient, she will notify (“N”) the medical assistant.

R&R charts can break down the construction of large organizations by focusing on departments, then groups and then the individuals within those groups. They are helpful in determining process flow required by the interdependent layers of an organization. Staff may have input on a supply order that has to be approved by an office lead who must coordinate the total cost of the order with someone responsible for the budget, which could look something like this:

Role/Responsibility	Staff	Lead	Finance
Order supplies	I	R	A

The staff gives input (“I”). The lead is responsible (“R”) for ordering supplies, but they can’t do wo without the approval (“A”) of finance. Using R&R charts is a good way to conduct an appraisal of an organization.