Streamline Your Business

By Laurie Kendall-Ellis, PT, CAE

Are we so focused on customer service or value propositions that we do not take the time to assess our operational effectiveness? Are we so outwardly focused that we forget to look inward? A powerful strategy for operational excellence is the pursuit of efficiency and streamlining.

As executive director, I recognize the fact that you compete in an expensive health care environment that thrives on redundancies and is process-heavy. I admire entrepreneurial cleverness, but I also reflect on how practices consume time, resources, and space. Developing lean practice design maintains or improves value with less work and waste. Small changes can add up to big savings.

In lean thinking, anything that does not contribute to value is waste. Practices can adopt what manufacturers, such as Toyota, have been doing for years. To find value and think lean, we need to define waste.

Overproduction: Holding unnecessary inventory or expanding office hours without enough patients to fill the time slots.

Waiting: The time an initiative takes before action, such as implementing that new public relations campaign.

Transportation: The time it takes to travel to a satellite office or a client’s home.

Motion: Gathering and taking inventory, processing client paperwork.

Inventory: Unsold products, stationery, marketing brochures, give-a-ways.

Overprocessing: When more work is done than required, such as when staff overdoes an event.

Defects: A program that is in place but produces no outcome.

Human Capital:

  • Suboptimization: Not using human capital to its full potential, such as the owner micromanaging whether a staff directory should be printed or digital.
  • Improper utilization: Using human capital for work that has no value and should not be done or should be done by an expert, such as payroll.
  • No utilization: Leaving human capital idle, such as not knowing your practice’s patient cancellation rate for proper staffing.

Once waste in your practice has been identified, the next step is to improve the process and create value. Four key steps:

1. Define value: This will require internal analysis. Challenge long-held assumptions and question the work flow of your practice. Change is difficult and will require your staff’s help, but in the changing marketplace, value needs to be redefined.

2. Identify the steps required to go from concept to delivery: Programs, services, or activities that have value require visualization, such as a diagram (value stream mapping) to show the step-by-step complexities.

3. Remove or improve steps that do not add value: Creating the value stream mapping (diagram) will result in opportunities to eliminate waste, such as the ability to accelerate a process (shorten the waiting time). Collaborating with staff for this step can be a strong team-building exercise.

4. Analyze the results and then start over again, continuously eliminating waste: It may take months to years to fully embrace and incorporate lean thinking into your practice, but embracing the concept of continuous improvement will represent savings (value).

PPS provides value and decreases waste in areas such as motion (stop trying to gather information through multiple resources versus accessing your section’s resources) and improper utilization of human capital (your section has the expertise) through our premier on-line and in-person business education, our excellent industry-focused magazine (newly expanded to a robust online format, weekly eNews articles on time-sensitive topics, our website ( and other resources that reduce your frustration and keep you informed through one investment (reduction of redundancy by belonging to the section). Your collegial community of peers participates in minute-to-minute discussions on the section’s Facebook, LinkedIn, and Twitter platforms, as well as the member-protected website message boards. Volunteer experts understand your business’ environment, providing real-life feedback.

Lean thinking applies to your association membership. Stop the waste and add value by connecting through one portal of excellence—PPS!

Respectfully yours,


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