The Lean Practice Coach » Uncategorized

Wall of Fame

Paul Blossom — Thu, 04 Feb 2010 21:58:13 +0000

All of us would like to build our referral base. One idea for that is to have a “Wall of Fame”. It seems to me that this would encourage current referrers, and perhaps encourage those who have not yet referred. It certainly acts as a reward program for those who do refer. The picture below shows one office’s “Wall of Fame”. This wall of fame is located in an alcove in the waiting room where patients can see it easily. This doctor adds a new member of the wall of fame each month. The doctor is happy with the increase of referrals from the program. The doctor also reports that there have been a number of positive comments about the wall. The negative comment was that one of the most prolific patient-referrers was disappointed that they weren’t first on the wall.

It’s a process, not an event.

Paul Blossom — Mon, 01 Feb 2010 14:59:37 +0000

It’s a process, not an event. Dating is a process. So is losing weight and building a practice. On the other hand, putting up a trade show booth is an event. So are making an appointment and having surgery. Events are easier to manage, pay for and get excited about. Processes build results for the long haul. Lean focuses on processes, putting in place a framework of continuous improvement to ensure efficiency and effectiveness over the long run. All, of course, aimed at and oriented to customer/patient satisfaction and quality improvement. Lean is process improvement.

The 5 Why’s

Paul Blossom — Fri, 29 Jan 2010 19:46:15 +0000

Many times in life we are presented with a problem for which we need to get to the root cause. One technique for arriving at the root cause is called the five why’s. If you ask the question “why” repeatedly you will come to the root cause. The number five is a good rule of thumb for the number of times you will need to ask “why?” to arrive at the root cause. This is a very simple tool to use, one that does not require a data collection plan, and it easy to complete without any statistical analysis. I recommend that you follow these set of steps to utilize the five why’s method.

Write down the problem. Grading down the specific problem helps you to describe it completely; it also helps the team to focus on the specific problem.
Asked why the problem happens, and write the answer down below the problem.
If you have not identified the root cause for the problem you specified in step one, ask why again. Write that answer down.
Repeat step three until you or you and your team agree that you have arrived at the root cause. This may take more or less than five why’s to accomplish.

Problem Statement: You are on your way home from work and your car stops in the middle of the road. (I borrowed this example…)

1. Why did your car stop?

– Because it ran out of gas.

2. Why did it run out of gas?

– Because I didn’t buy any gas on my way to work.

3. Why didn’t you buy any gas this morning?

– Because I didn’t have any money.

4. Why didn’t you have any money?

– Because I lost it all last night in a poker game.

5. Why did you lose your money in last night’s poker game?

– Because I’m not very good at “bluffing” when I don’t have a good hand.

As you can see from this example, using the five why’s has allowed the team to arrive at a root cause that can be acted upon. It is much easier to work on root causes than it is to work on symptoms.

Eliminating Waste – Walk Time

Paul Blossom — Mon, 25 Jan 2010 16:38:46 +0000

One of the main objectives of leading practice management is the elimination of waste. There are several types of waste that have been identified: over-production (making too much), motion (of doctor, patient, assistant or machine), waiting (of doctor, patient, assistant or machine), conveyance (movement of people or objects), inventory (materials), and correction (rework and scrap). Today’s post focuses on the motion of doctors and patients.

Recently, I was in a doctor’s office where the treatment rooms are located in the corners of the office, as far away as possible from the front desk. This Doctor had the habit of walking each patient back to the front desk while talking to them. A quick back of the envelope calculation indicates that the Doctor walked about a mile every day escorting patients back to the front desk. This translates to 20 or 25 minutes of walk time. As it turns out, the office could be rearranged quite easily to reduce the walk time to nearly zero, thus saving the Doctor and the patients time and effort. This is an example of inefficiencies that are “built in” to a practice. If you look, these inefficiencies are everywhere.