Management Tips: Streamlining Your Process

By Emily Smolak, MS

Creating and maintaining a well-oiled, profitable, quality-care practice is no small task. We all struggle with managing inefficiencies, from payment models to workflows to communication and beyond. Unfortunately, those inefficiencies are not forgiving in this challenging, reimbursement-driven environment and create a sense of chaos even in the most calm of personalities. That is why fine-tuning your processes—i.e., streamlining—is more crucial now than ever.


An essential first step in streamlining is stepping back and taking stock of your practice’s brand and productivity as a whole and comparing it to others within your demographic, setting, and client population. As a manager, this twofold process allowed me to reflect on my department’s operations, as well as identify opportunities for improvement and growth.

To reveal these operational strengths, I asked questions related to what was working well and who was driving the success. These are the aspects of your practice you want to build upon and duplicate. Conversely, I learned about the slow, disjointed processes and the ineffective, unnecessary ones. My team and I analyzed these weaknesses and either improved them or eliminated them. Behind all operations are the policies and procedures that will either support your methods or bog them down; it’s important to keep these up-to-date and relevant to your current practice model.


To identify programmatic growth opportunities, I prioritized networking with professionals through some of these means:

  • Being an active member of my professional organization and joining listservs
  • Reacquainting myself with past colleagues and expressing my earnest interest in keeping the lines of communication open
  • Holding recurring meetings with fellow managers of similar facilities
  • Building relationships with academic institutions and programs across multiple disciplines

The professional resources I’ve fostered have been invaluable in assisting with the review, restructuring, and development of my organization. These professionals regularly share tools and advice that have saved me time and effort, a benefit that cannot be overstated.

The next step I took as a manager was reviewing the referral process, including origin of referral, personnel involved, transmission of order, and basis for referral. Due to reimbursement requirements, heavy documentation loads and high productivity standards are necessary burdens. So how is your practice intaking new clients, documenting the source of referral, and communicating with outside referral sources?


Implementing a streamlined information-sharing process offers many benefits, including the following:

  • Streamline the referral process. Set up a system with one-to-one communication between your clinic and your referral sources.
  • Encourage electronic record-sharing and communication between practices. Utilize such platforms as encrypted email, portals, HIPAA-compliant file sharing, and electronic health records systems to save you time and manpower.
  • Ensure the most appropriate medical diagnoses are indicated on documents, especially for billing purposes.


Another top priority for streamlining my organization’s therapeutic process was gauging client outcomes. Success in the therapy world means providing quality, research-based interventions to yield timely and measurable progress toward goals. Not all methods and modalities are created equal, so it is critical to ascertain which one work best.

Review your clinicians’ specialties and how they fold into your practice model. Determine whether those specialties are well applied in treatment and attracting new client referral sources. You may dissuade your clinicians from using outdated, less empirically supported interventions by conducting article reviews as a team at regular intervals.

Find the areas where you may expand your program or practice based on client need and request, potentially outside of your typical reimbursement structure. Your clients may be willing to pay out of pocket for specialty care not readily offered elsewhere. For instance, my team now boasts a myofascial massage therapist who focuses on pain management and who works through a different lens to address the musculoskeletal needs of our clients. On the other hand, trim any services that are both not readily reimbursable by insurance and not appealing or effective for your target population or setting.


All things considered, a streamlined therapy process is one that takes time, patience, and ongoing revision. Begin by reevaluating your program’s processes to validate that they’re running smoothly and resourcefully. Cut out the ineffective functions and replace them with quality, cost-effective ones. Lastly, stay engaged with your colleagues and your community to ensure the long-term success and continued growth potential of your practice. 

Emily Smolak, MS

Emily Smolak, MS, is the habilitation services manager at The Verland Foundation, Inc. in the Pittsburgh area. She may be reached at

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

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