5 Characteristic Effects of a Poorly Designed Schedule

A poorly designed patient schedule template or a schedule that has no design at all but gets filled as you go, can have disastrous effects on how long patients wait, how effectively patients are handed-off to your dispensary staff, and many other things.  Below are 5 characteristic effects of a poorly designed schedule. If any or all of these apply to your Optometry Business, then you should probably take a closer look at your strategy for how you fill your patient schedule.

  • Your mornings start slowly – For example, you schedule your first patient for 8:00 am but you don’t see them in the exam room till 8:20 or 8:30. You stand around and wait while you wonder what’s taking so long to bring the patient back.
  • Patients arrive in waves – If you were to stand behind your reception area, you can see patients arriving two or three at a time, followed by a lull of no patients at all for a while. If you have a practice with more than one physician per day, this may be more pronounced.
  • Morning and afternoon humps – Your office begins to get fuller and fuller until you are over run with patients around mid to late morning and then the process repeats itself around mid to late afternoon every day.
  • Your exam rooms fill up and then empty out – There are times when you walk out of your exam room and you look down the hall way and all the doors are closed because there are patients waiting for you in every room. Similarly, there are other times when you walk out of your exam room and all of your rooms are empty but there are patients waiting in the waiting room.
  • You have mixed success handing patients off to your dispensary staff – Sometimes you can hand a patient directly off to your dispensary staff either in the exam room or the dispensary.  At other times you try to hand a patient off and no one responds to your call.

If any of the 5 characteristics above apply to you, you’re not alone. Scheduling issues are so prevalent in fact that in the hundreds of eye care businesses we have worked with across the U.S. and Canada, we have never left without redesigning the schedule!

If are working in these conditions, then it’s time to take a closer look at your schedule design.  You are missing out on an opportunity to improve patient flow, increase capacity for more patients, and dramatically improve capture rates and revenue per patient in your dispensary. 

Here’s what we offer with our Scheduling Optimization Program:

  • A discovery session with your Business Advisor to discuss scheduling issues and identify specific goals for your eye care business
  • A thorough analysis of your current model for scheduling including your templates, phone call, and appointment confirmation process
  • A report providing you with specific root causes within your current schedule that impact patient flow
  • A new customized schedule template for your eye care business
  • An implementation plan for how to put your new schedule to work, while managing pre-appointments and other patients that are already on the schedule


You can try to design your own schedule, but why not receive support from the most experienced scheduling experts in the industry.  We are here to support you.  Through our Scheduling Optimization Program, our team of highly skilled analysts will review your schedule, provide recommendations, and build a customized schedule template for your office.

Starting at $1800, its more affordable than you thought, and the real question you should be asking yourself is – How can you afford not to do it?

For more information on our Schedule Optimization Program click here to contact us and learn more or give us a call at (904) 701-3084.




Tony has utilized Lean Management concepts to help foster a culture of employee driven continuous improvement at more than 400 Eye Care practices across the United States and Canada. His approach has generated significant revenue growth, cost reductions, and operational efficiency within these practices, while also improving staff accountability and engagement.

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When you make an appointment, how likely are you to keep it?

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The acts of making and attending a doctor’s appointment are becoming disconnected in today’s world.  Most of us have good intentions, but sometimes life gets the best of us.  That appointment we made 2 months ago for 4pm tomorrow now conflicts with our kid’s soccer practice, volunteer work, work trip, meeting that we feel is now WAY more important. Or we ACTUALLY FORGOT, even though they emailed and texted us 2 days ago to remind us. Whatever the reason no-shows happen all the time!

So, how can we change this behavior? How do we keep the appointment and intention connected, how do we keep the Patient engaged in our practice?  The answer may very well be as simple as using good customer service to create senses of responsibility and loyalty in our patients.  Putting effort into making personalized reminder calls, or taking notes to remember specific things about patient’s personalities/likes/activities.

Here’s the case for having a staff member conduct personalized phone calls reminding patients to attend their appointments. A recent study by the American News Medical Journal “suggests that patients may be more likely to show up for their appointments if they get a telephone call from the office — a call from an actual person, not a machine. Approximately 23.1% of patients who received no reminder call missed their appointments. The number went down to 17.3% if patients were contacted by the HouseCalls automated appointment reminder system offered by TeleVox Software Inc. in Mobile, Ala., the system used for the study. But the no-show figure went down further to almost 13.6% if an actual staff member made the call.”

A few reasons for the decrease in no-shows are patients feel more responsibility when speaking to another human being additionally it allows them to not only speak up and say they can’t make the appointment but immediately schedule another one instead of just canceling.

Perhaps your staff is too busy to make personalized phone calls, there are other ways to create good customer service or invoke a feeling of loyalty. Upon meeting with your patients be sure to engage with them personally, ask them what they are doing for the weekend or comment on a sports team shirt they are wearing and then make a note in their file to remember for next time.  I can recall bringing one of my younger children to the doctor’s office with me for one appointment and the staff have never forgotten.  To this day when I have an appointment they ask me how she’s doing and it keeps that connection and sense of loyalty going. As a doctor or staff member you only have a few moments to engage with the patient while they are in the office, so make the most of them to invoke a connection

In our hurried society of flat communication, it’s nice to talk to people who recognize us, who greet us warmly, and who show good intentions toward us.  Treat your patients as you would want to be treated.

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Should you schedule dispensing appointments?



Many eye care businesses are reluctant to setup dispensing appointments for their patients.  Naturally, eye care business owners worry about creating a situation where they are not offering the utmost flexibility to patients.  In this Practice Management Tip of the Month, we will discuss the benefits of dispensing appointments and why you might want to think about doing this in your practice.

In a previous Practice Management Tip of the Month, we discussed the impact of dispensary walk in traffic patterns on your ability to hand off patients effectively to your Opticians.  We also provided a downloadable tally sheet that enables you to identify what the specific “walk-in” traffic pattern looks like for your practice.  Knowing this “walk-in” pattern is a vital aspect of developing a well-planned schedule template that enables optimal patient flow and likelihood that your patient will reach the dispensary on the day of their exam.  Visit this link for a copy of our previous month’s Practice Management Tip of the month.

Before we talk about the virtues of setting up dispensing appointments, let’s spend a little bit of time walking through the typical process we see.

  1. Patient selects a frame / lens options and check’s out.
  2. Optician tells the patient that the glasses will be ready in 7 – 10 days.
  3. Patient leaves the dispensary.
  4. Patient calls back on day 5 to find out if their glasses are ready yet, hoping that they might be ready early.
  5. Patient calls back on day 7 to find out if their glasses are ready yet.
  6. Optician receives glasses from the lab on day 9.
  7. Optician calls the patient and leaves a message to let them know their glasses are in.
  8. Patient calls back because they never listened to the message and the receptionist has to figure out why the patient is calling.
  9. Finally, the patient gets in contact with the Optician and finds out that their glasses are ready.
  10. Patient “Drops in” to pick up their glasses.
  11. Patient has to wait because the Optician is with another patient.
  12. Glasses are finally dispensed.

That’s a lot of steps to dispense a pair of glasses.  There are three reasons why this process is less than ideal:

  1. Calls from patients to inquire about the status of their glasses (“Are my glasses ready?”) make up the second highest volume of incoming phone calls into most Eye Care Businesses.  This reason for incoming phone calls is only second to scheduling an appointment.  Incoming phone calls inquiring about the status of glasses is only magnified when Opticians call and leave messages for patients letting them know that their glasses are ready, because many patients don’t even listen to their voice messages.  They just call back.
  2. Patients coming in for a dispensing will arrive at the practice at a time that is convenient for them (which is usually not convenient for you.) Most dispensing visits will occur around the lunch hour when the patient can take a break from work, or towards the end of the day because the patient left early from work.  The lunch hour is tough because this is usually a time when part of your staff is out to lunch.  These heavy dispensing times also happen to coincide with times when people come in for repairs and adjustments, frame selections from a previous day’s appointment, etc.  At the same time, the Optometrist is trying to hand-off patients from the exam room into an already busy practice.  Eye Care Businesses that are open on Saturdays also have heavy dispensing visits during this time.  This is prime “Selling” time that you don’t want to clutter with dispensing visits.
  3. When patients show up for dispensing appointments unannounced, Opticians have to scramble to get the glasses ready for dispensing. You might argue here that the glasses should have already been cleaned, prepped and kitted previously.  The reality is that this just doesn’t happen all the time.

All of the issues listed above present good reasons why scheduling dispensing appointments can actually improve your productivity and enhance the patient experience in your practice.  Dispensing appointments may sound less convenient to the patient, but in reality they offer an opportunity to ensure that Opticians are available when the patient comes in for their dispensing.

Dispensing appointments help to drastically reduce incoming phone calls with inquiries about the status of glasses.  Patients who receive an appointment time and date for dispensing, have a concrete expectation of when they are supposed to be back to pick up their glasses.  This will eliminate the incoming phone call because a specific time and date has been set.  Appointment reminder technology can then be leveraged to send patients confirmations / reminders about their upcoming appointment.  Delays from the lab do occur from time to time.   Because of this, a process has to be put in place to verify that glasses have arrived prior to the dispensing appointment so that the patient can be rescheduled if an issue occurred.

Another virtue of dispensing appointments is that they help shift dispensing patients into less busy times of the day.  If your Optical is less busy around 10:00 am for example, this might be a great time to setup a few dispensing appointment slots for each Optician so that you can leverage your optical staff better during that time.  That also helps reduce traffic during other more popular times of the day so that you have a higher likelihood of finding an available Optician when you want to hand-off a patient at the end of your exam.  Dispensing appointments help you level load patient arrivals into your dispensary so that your Opticians can handle a larger number of patients throughout the day.

Finally, dispensing appointments help your staff prepare for the dispensing visit ahead of time.  Having a reasonable expectation of when a patient is supposed to arrive will enable your staff to prepare the dispensing kit ahead of time so they aren’t hunting down cleaner, cloths, and cases while the patient is in front of them.  This will help make the visit more efficient and enable your Optician to provide a high level of service while moving on to the next patient in less time.

Just like with scheduling eye exam appointments, scheduling dispensing appointments involves developing a robust process for how to handle different situations like glasses not being ready, Opticians being out of the office, etc.  For more information on how to setup dispensing appointments in your practice, please email us at:  info@practicecopilot.com, or call at (904) 701-3084.  We are here to help.

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Zulu Raises the Bar With Staff Communication at Gee Eye Care


Missouri City, Texas Dr. Kevin Gee, owner at Gee Eye Care, is no stranger to the technological advances that the Eye Care Industry is constantly experiencing. From writing a technology column for Optometric Management, the leading how-to guide for optometrists, to lecturing on a national circuit about the importance of vision care products and services, he is fully in-tune with all aspects of the Eye Care market. “I am always looking for ways to stay on top of the latest optical trends and technologies to ensure that my patients receive the best care and products available. It is important to be open-minded to new innovation because many times it can add tremendous value to your business by increasing efficiency and productivity you did not know could be improved,” said Dr. Gee. With this philosophy, it is no surprise Dr. Gee’s practice is an early adopter of an innovative new office communication platform called Zulu. Zulu creator Practice CoPilot, a company specializing in lean practice management consulting as well as products that enhance high quality patient encounters through cutting edge technology, is revolutionizing communication between staff and doctors.

Dr. Gee’s enthusiasm for Zulu was apparent from the start after his first consultation with Practice CoPilot CEO, Tony Milian. “When I learned about Practice CoPilot’s Zulu platform, I knew our office had to have it! The pager system that we were currently using was not satisfying our office’s needs anymore and I knew Zulu would be the ideal solution.”

What is Zulu? Zulu is an application specifically designed for efficient office communication through the use of a messaging platform. Zulu allows staff and doctors to know what is going on at all places of the office, at all times with the click of a button. Zulu’s pre-scripted messaging feature reduces the need for typing in lengthy phrases every time communication is needed which makes it even faster to signal the doctor when a patient is ready. If there are any updates that a team member needs to let another staff member know, they can use Zulu to send a quick message to keep everyone updated. Before, staff at Gee Eye Care would have to slowly scroll through both short and long messages and then find a computer in order to send a response over to another teammate. Instead of staff having to be intrusive by walking in and out of exam rooms or have someone come in while seeing a patient, Zulu gives staff a quick pop-up message based on what the other team member needs. When you need broader communication, Zulu has the ability to message entire groups. Zulu can be completely customized via the Zulu admin panel to fit your specific business needs. With Zulu, you can send messages from your desktop computer to an employee’s mobile device and vice versa. This feature enables employees that need to be mobile to not have to be glued to the computer to send and receive messages.  With Zulu, all you need is a wireless connection!

The implementation of the Zulu platform on iPods was welcomed with open arms from the Gee Eye Care staff. “Zulu did not disrupt daily workflow and was easy to tap right into. I could see an immediate improvement from the pagers we previously used. I would choose the convenience of Zulu over the pager system any day,” said staff member Jimmy Huynh. Unlike the pagers, Zulu allowed staff to do more than just signal the doctor. With a few clicks, Zulu gave staff the ability to ask quick questions without stepping out of a room. By reducing the time it takes to notify the doctor that a patient is ready and enhancing communication abilities within the team, Zulu allows for increased patient efficiency. With Zulu, patients can get in and out in a timely fashion.

At Gee Eye Care, internal advancements are also evidenced by better time management, communication and flexibility which allows for the office to run on time to generate a more efficient and productive business.

Milian declared, “The staff is conditioned to expect direction on where to go from Zulu; that’s how reliant the practice is on this communication tool. Dr. Gee even synced Zulu to his Apple watch so he can see push notifications on his wrist and know exactly what is going on around the office. The positive impacts of Zulu can truly be seen throughout the practice. ”

Although many forms of communication systems are readily available, not many practices actually use these systems. “I would estimate that only 10% of all eye care practices have a formal form of communication like exam room ID flags and pagers. I believe the eye care world is missing a huge opportunity to improve not only internal efficiency, but patient efficiency by integrating Zulu into their practice. Zulu is the communication tool all eye care practices desperately need, but do not know it yet. Many practices have a “fear factor” for new advanced technology. They believe that the Zulu platform is only for the technologically advanced; which is the farthest from the truth,” declared Dr. Gee.

The perk of Zulu compared to other traditional communication systems is that it is an all-inclusive platform. In addition to sending pre-scripted messages, Zulu provides status reports, clock-in abilities, and better record keeping and data collection for later reference. In addition to these features, Zulu displays a running thread of messages that shows who responded to what rather than just paging one person and assuming they responded and they did not. Staff can use the iPod as a credit card terminal as well which allows for the convenience of one device to be used for payment and Zulu access.

Dr. Gee continues to be a big proponent of the Zulu platform, even mentioning Zulu recently when lecturing about the difference that efficient communication can make in a practice. “Since the institution of Zulu, the improvement to our workflow and communication has been so tremendous, our office has not looked back since. Zulu is a powerful communication tool that can take your practice to the next level.”

To Download the Apple or Andriod Version of the Zulu App please click here.

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The Self Perpetuating Cycle of Missed Hand-offs


Eye Care practices today have no shortage of competitive pressure.  This is especially true on the dispensary side of the business.  Internet sales, brick and mortar competitors down the street, you name it.  They are all anxiously waiting to receive your patients and your prescriptions so they can sell them a pair of glasses.  This is why, it’s a delight to see patients you saw in the exam chair a couple of days earlier, back in your dispensary shopping for a pair of glasses.   This is a testament to patient loyalty and also to the patient’s perception of your dispensary selection right?  Well sort of, these return visits present a double edged sword.  They are a great thing, but they are also an indicator that your patients are running out of time on the day of their exam to visit your dispensary.  They also represent an opportunity to improve scheduling strategy.

Our studies while working with hundreds of eye care businesses across the country show that in the best eye care practices, only 50% of patients that walked out on the day of their exam come back to the dispensary at a later date to shop for a pair of glasses.  In a glass half full kind of way that’s a great thing, but the flip side is that the other 50% are going somewhere else with their prescription.  Another interesting statistic is that these patients spend about 25% less on average in the dispensary than they would have on the day of their original visit.  That makes a lot of sense when you think about it.  The recommendation that you made in the exam room happened a few days earlier.  It doesn’t carry nearly the amount of weight that it did when the patient was handed directly to your Optician.  On these return visits the process typically starts with frame selection instead of lens selection, another contributing factor in the lower revenue per purchase result.  We have a really great infographic that provides some statistics on patient flow and how it affects revenue.  Here is the link.

Furthermore, the patients that do come back to shop are coming back at a time that’s convenient for them, not necessarily for your Opticians.    These patients are no longer being controlled by the schedule.  We normally see typical increases in return patients during the lunch hour and from about 3:00 pm to 5:00 pm. This causes yet another challenge because your Opticians are completely occupied with patients from previous days so you can’t make an effective hand-off of the patient you have inside your exam room.  We call this the self-perpetuating cycle of missed hand-offs.

Walk-ins are going to happen irrespective of how efficiently your patients flow through the office.  Because of this, it’s important to take daily dispensary walk in patterns into account when developing your schedule template.  Build a tally sheet (or download ours) for your Opticians so they can keep track of when patients “walk in” to your dispensary throughout the day.  The tally sheet should be divided into hours so you can count how many patients walked in each hour of the day.  Use the tally sheet to keep track of patient walk ins for a period of a couple of weeks.  That should give you enough information to establish what the typical daily pattern looks like.

Once you have an established pattern, use that information to make adjustments to your schedule template.  Let’s say for example that you have a high “walk-in” rate from 3:00 pm – 5:00 pm.  You should offset this by reducing the number of “Glasses” patients you put on the schedule from 2:15 pm – 3:30 pm to help your Opticians keep up with incoming demand.  You can book more medical patients or contact lens patients during this time to alleviate the congestion in optical.  The flip side is also true.  You can schedule “Glasses” patients more heavily during times when your dispensary is experiencing lighter traffic.  Counteracting the typical daily walk-in pattern with sound scheduling strategy will help you reduce those occurrences when you try to make a warm hand-off to the Optician but fail because your Optical is full of patients.

Developing a schedule template that takes dispensary “walk-in” traffic into account will help you increase your dispensary capture rate and revenue per patient by ensuring that patients have a great chance to receive one-on-one service from your Opticians.  Go out and capture that extra 25% you are leaving on the table, by trying this technique.  Let us know how it goes.  We love to hear your success stories.

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Winging It is for Birds – Prep and Thou Shall Be Successful


Don’t be the person that is stranded on a raft in the middle of the Ocean and can’t set off the flares when the big cruise ship comes by, because they didn’t read the instructions. There are just some things you do that you want to be really prepared for, because you only get one chance. If you are lucky, maybe a couple of chances.

Rapid improvement events are one of the best ways to leverage the power of concentrated team effort to improve something within your business. These events are not absent of risk however. An event that doesn’t go as planned, or doesn’t product the results desired by the team can rapidly reduce the enthusiasm for future improvement work. You will start to hear things like, “We did a lot of talking and planning, but nothing really changed.” Rapid improvement events are an investment. They require significant staff time, effort and costs. Don’t take this responsibility lightly. A rapid improvement event may only last a day, but proper preparation should start weeks in advance. Typical rapid improvement events that we run start with a three-week prep timeline and end with a three-week sustainability timeline. Here is a list of things you should consider before every rapid improvement event to increase your chances of success:

Team selection: Carefully think through who should be involved in your rapid improvement event. You need the right mix of subject matter experts as well as a few people from outside the process that have very little knowledge of what’s going on. These folks usually ask all the questions that everyone else is afraid to ask. Thoughtful team selection is critical for the success of the event, but it also helps you align resources to cover for the team while the event is taking place. Nothing is worse than an event that is constantly interrupted by people stepping out to fight fires.

Resource Alignment: You want to make sure that you prepare backups for your team members so that they can be fully focused on the improvement event. Aligning with other managers if your team members report to others, is a critical part of the process. You might also have to align resources that are external to the team actually engaged in the event. For example, you might have to have an IT contractor at the ready, in case your team determines that they have to move a couple of data lines so they can lay out a space more efficiently.

Crystal Clear Objectives: Be very thoughtful about what you are trying to accomplish with the event. How are you planning on measuring success? Your team needs to have absolute clarity about what they are trying to accomplish. They need to know this well in advance of the event so that they come in with the right mindset. If your objective statement has any “and’s” in it, you need to rethink your objective. Try to accomplish one or two things during a rapid improvement event and you will set yourself up for a higher likelihood of success.

Tight Scope: It is as important to know what is out of scope as what is within scope. In fact, be explicit about this. Write down what is not within the scope of your rapid improvement event. Scope creep is the absolute worse event killer. It’s a distraction and a temptation that a lot of teams get into. If you don’t have a clearly defined scope and more importantly know what’s out of scope, you will likely walk

out of the event with a vague sense of accomplishment. Keeping the scope tight allows you to define clear measures for success.

Measures of success: Know how you are going to measure the success of the rapid improvement event objectively. How do you know the event was a success? Does it just feel successful or can you objectively measure success? At the end of the event, you should know whether you accomplished the action items you sought to complete during the event. After the event, you should know whether the event was successful through metrics you put in place. These can be financial, operational, etc.

Understand the current state: Prior to making changes, you need a clear baseline. That’s the only way to know if you have made an improvement after the event. It’s also the best way to keep your team from spinning out of control and speculating on how bad or good something really is. If you have done your homework and collected critical data prior to the event, you will not only give your team greater confidence, you can get to the fun work of improving a lot faster.

Project Charter: I saved this one for last but it should really be the first thing that you do. A project charter is a one-page document that provides clear and concise information about the rapid improvement event. It outlines the problem statement and objective, measures, scope, team members, dates, etc. A charter document forces you to think critically about what you are preparing for. We have personally cancelled many rapid improvement events because the project leader didn’t have a properly prepared charter. It is that important.

Read your instructions, and have your flares ready for when that cruise ship comes by. Consider every rapid improvement event as an opportunity that isn’t available to you every day to get something really great done for your business. Prepare, and thou shall be successful.

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Is your continuous improvement strategy off track? – 3 telling indicators

The vast majority of healthcare institutions today are actively engaged in some form of improvement journey. A well designed and structured continuous improvement strategy is imperative to developing a transformational culture that drives sustainable improvements in safety, health care outcomes, and process efficiency. All of these things ultimately lead to better business performance. Success is possible only when employees in the trenches “get” what your leadership team is trying to accomplish. Here are three indicators that help you know whether you are on the right path, or whether it’s time to re-evaluate your strategy.

1. The One Reason: Do you have one reason above all others for why your employees should be actively engaged in continuous improvement? If so, can they articulate what it is? Walk the floor and ask any employee directly engaged in patient care why they are being asked to participate in a specific improvement activity. Every employee should be able to articulate the one reason why the improvement work they are engaging in is important. If you get a bunch of different answers, this is an indicator that your mission isn’t clear enough. Paul O’Neill the former CEO of Alcoa, the largest Aluminum company in the world chose to make safety the one reason to continuously improve. As a result, Alcoa has a track record as one of the safest companies in the world to work for. Significant financial performance improvement naturally followed as a result. The one reason needs to be something that everyone in the organization can rally around, no questions asked.

2. The Outcome: Every employee needs to see that the effort they made to improve actually generated the outcomes expected. Are you measuring the method instead of the outcome? For example, if you develop a standardized rooming process for patients to ensure that depression screening is completed on all patients in a certain age range, measure the depression screening results, not whether the standard work is being followed. If you aren’t getting the results you expected, then revisit the method. Many organizations focus on auditing the method and don’t look closely enough at the results. Employees lose interest because they can’t see how the work they did clearly ties to an outcome measure. Improvement feels like busy work, instead of being tied to an outcome.

3. Finder to Fixer Ratio: True north for developing a sustainable culture of improvement is when the finder to fixer ratio approaches 1:1. Naturally, this is indicative of an organization that is very mature in its improvement journey, however you should be able to see indications of this in your organization. During meetings, how often do employees present issues without accompanying solutions? How often do you see people in your organization taking it upon themselves to solve problems that affect their daily work? This is one of your best gauges of whether your employees “get it” or not.

Spend some time evaluating your strategy based on these three indicators. If any of these three indicators are off track, then it’s probably time to reevaluate whether your continuous improvement strategy needs some continuous improvement.

For more information, contact us here:

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Start Your Day Off Right – Conduct a Daily Huddle.

Conducting a daily huddle is not a new concept, but unfortunately what should be common practice isn’t so common in many of the healthcare settings I visit. Starting the day off the right way provides you with a better opportunity to make sure you end the day the right way. A lot of things can happen in between the beginning of the day and the end of the day, but making sure everyone is well informed and ready prior to seeing patients certainly improves your chances of success.

I routinely show up 15 – 30 minutes before the first patient arrives at many of the offices I work with. This is an opportunity for me to see how the day gets started. Often times I observe staff showing up only a couple of minutes before the first patient. They walk in half jogging to their post. They scramble to turn on their computer or pull the covers off all of the diagnostic equipment right as the first patient is walking through the door. Even more strikingly, many doctors time the arrival of the first patient coming into their exam room with their own arrival. They walk into the room as they are putting on their coat and begin fumbling through the chart. From a patient perspective, this leaves a less than perfect impression of your practice. Those patients that schedule the first appointment of the day with your practice are typically the most sensitive about good patient flow and coordination within your practice.
A morning huddle helps you prepare for your day in a couple of ways.

1. A huddle helps increase the likelihood that everyone will be there on time.
2. It is an opportunity to review the schedule and anticipate challenges. You can annotate special requests like specific diagnostic tests so that these are performed before the patient walks in the exam room rather than after. (This causes a lot of patient flow issues.)
3. It gives you and your team a chance to reflect on what worked and didn’t work from the previous day so you can begin to create a culture of learning and continuous improvement.
4. Finally, it keeps reminding the team that they are a team. It shows everyone that the role they play is an integral role in the care of the patient.

Huddles don’t have to be long; five to ten minutes tops. They don’t have to happen in the morning either, although I recommend that they do because it’s a great way to ensure that everyone shows up on time. A lot of practice owner’s don’t like to do huddles because they require some degree of overtime pay every week. From experience working with many practices across the country, the productivity gains you will make through better coordination will outweigh the cost of overtime.

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Plan, Do, Check & Act


The best and most successful businesses look at improvement as a standard operating activity, not something viewed as done every several years or dreaded. You’ve probably heard it said, if you’re aren’t getting better, you’re falling behind. To ensure long term success and business health, you must constantly be seeking what is and isn’t working for your business and trying to improve. Plan, Do, Check, Act it isn’t rocket science, it’s continuous improvement. The beauty of it is that most solutions you will develop won’t cost you a dime and if they don’t prove beneficial can be easily reversed.

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I Can’t Have My Technician Do That!


Really? No successful, growing business has ever thrived with one person doing everything. But it’s quite common for business owners to struggle letting go of control. Delegation can be difficult, but when done correctly, makes us all better and more productive as a team.

Do only what only you can do! We talk to practitioners about this all the time. There are aspects of your business you really can’t let go of, perhaps it’s the refraction, or maybe it’s DFE, but you should pressure test these ideas from time to time. When you do only what only you can do, you empower others around you to raise their game.

Now, it’s not done blindly of course. If you want your techs to check pressures, you have to train them to check pressures. And training isn’t one and done. Take the time to ensure staff fully know how to do what it is you want them to do and then periodically check for consistency and accuracy of the task.

I realize it isn’t easy, delegation is tough at best. But in several hundred practices, I’ve yet to see the first truly successful practice where the doctor does all the work while the staff sits idle doing only minimal tasks.

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