In my practice, I can obsess over only one management area at a time. I may decide that I want the best optical or the highest percentage of annual supply of contact lens sales. I may put all my energy into giving the best exams in the most efficient manner. I might spend all of my time getting my accounts receivables to go down or diligently work on our processes and scripts to get my anti-reflective lens sales to go up.
This narrowly-focused obsession almost always brings good results. Yet this success typically comes at the expense of some other neglected area of the office. Inevitably, when we completely dive into filling our schedules, we fail to work on efficiencies in the office and our newly-filled schedule overwhelms us. When all hands are on deck for improvement of our meaningful use documentation, we drop the ball on following up on insurance claims that aren’t paid properly.
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True success comes from consistently giving attention to every part of the practice, not focusing all of your attention on one area at a time. This requires that you:
- Identify the zones of your practice
- Create a system to consistently evaluate and measure each zone
- Make small, daily improvements to each zone
While every practice is unique, most eye care practices can fit into these five zones.
Zone 1: Patient care
Often called “clinic,” most of this zone’s work is done in the exam room with the doctor’s involvement. But it also involves any communication involving the patient’s care. As we become more included into the healthcare system, our input to and from other professionals becomes more critical to the overall well-being of our patients. As managed care dictates what we say, who we say it to, and when we say it, checking it off the list is important. But we must not let the quality of the communication slip. Templates need to make sense and be helpful to all providers.
Zone 2: Front of House
This zone is the “public” area of your practice, typically the front desk area. This is the space that does not require special permission to enter. Most places of business have a front of house, and the rules are fairly universal. In our practices, the front of house includes the check-in area, the optical dispensary, and the check-out area. It is normal to find these areas competing for attention in this conflicted zone.
Related: Stop cheating your patients
Zone 3: Scheduling
This zone pertains to everything that controls the flow of patients into your practice. It includes—but is not limited to—appointment strategies, recall, reminders, communications with patients and all marketing.
Zone 4: Distribution
The term “lab” is outdated in most eyecare practices. An optical lab reminds me of where you would have had glasses and contact lenses made like my grandfather did. Some practices still do lab work, but many of us buy inventory, sort it, and sell it. This all falls under distribution.
Zone 5: Financial foundation
This zone continues to get more and more complicated, and many of the parties that we deal with want it to be complicated. For the overall health of our practices, we must stay in good financial health. We have to keep a keen eye on income and expenses and act quickly when something gets out of line.
Working the zones
These specific zones may not work for every practice, but something like them might. All that matters is that you identify four to six zones within your practice and group every activity that you do into one of those zones.
After each zone is identified, implement a process so that you will give some attention to each zone on a regular basis. Just saying you are going to do it will not work over the long haul—a system must be put into place. The system doesn’t have to be elaborate or perfect; it just has to be a system.
Related: Why you need a practice mission
Here’s how it works in our office.
We close the office every Monday at 1:00 p.m. for a one-hour staff meeting. We have been doing this for almost 20 years, and it is at the core of how our office is run. Getting together, face-to-face, once per week to discuss the practice has been invaluable.
At each meeting, we hear the five zone reports that give pre-determined measurements with a trend up or down. For instance, on the first Monday of every month, the Scheduling report includes a section on recall success rates, and we hear about marketing plans on the second Monday of each month. The Distribution reports share promise date percentages in Week One and returns percentages in Week Two. In Week One, the Clinic report shares the results from our EHR record audit (Revolution RevAssure) and our plans to improve our billing and coding , and Week Two includes current standing with meaningful use.
About every three months, we will have a fifth Monday. Those extra Mondays are reserved for topics that don’t need to be looked at monthly but can’t be forgotten or ignored. For Scheduling, every fifth Monday we talk about why our goal is to be booked at 80 percent rather than 100 percent. The fifth Monday Front of House report is a reminder about the value in our luxury lines of eyewear and why it is important that all patients see our best products. Rounding out our fifth Monday reports are Financial (cost of goods overview), Distribution (activity on our online store), and Clinic (overall net promoter score).
Small change adds up
In a culture where improvement is normal, there must also be an acceptance of less than perfect. If you are already perfect, then what is there to improve? An objective view of real data as a rule along with trending information is valuable when those reporting feel safe to share the truth.
By facing the facts as a group together on a routine basis, everyone sees their contributions to the team and understands that we all have room to improve. It also gives the leaders a chance to ask, “So, what are we going to work on this week to get better?” Before you know it, it is just what you do.