As a rehab therapist, you already expend a lot of energy on optimization—optimization of your patients’ physical, occupational, or speech capabilities, that is. You help your patients be their most perfect, most functional, and most effective selves. But what about your business? Are you working to ensure your practice is as perfect, functional, and effective as it could be? In other words, are you optimizing your clinic—or are there gaps that are frustrating patients and staff and impacting your bottom line?

If you’re leaning toward the latter, you’re not alone. But there are several things you can do to change that—and you can start right now by taking a page from the Toyota Production System playbook. See, we here at WebPT want you to embrace your inner car manufacturer. Just kidding. But we do want you to start trying out some lean principles that Toyota pioneered in the 1930s in order to optimize its production line. In the book Lean Thinking, authors James P. Womack and Daniel T. Jones distilled the principles of lean manufacturing into five points (which we’ve adapted from this source and this one):

  • Value: Pinpoint the value your customers want to receive from you.
  • Value Stream: Map out the entire flow for each product—all steps from start to finish. Then, pinpoint wasteful steps (i.e., those that do not provide value).
  • Flow: Ensure the service or offering flows from start to finish without being interrupted by waste.
  • Pull: Change the focus from pushing a service or offering to pulling, which means performing work based on customer need, thus avoiding unnecessary effort.
  • Perfection: Aim for perfection to inform a culture of continuous improvement.

Mapping the Value Stream

The Profitable Practice, a blog from Software Advice, has a great article about how to apply lean principles to a physician’s office. We’re going to adapt those how-tos here so they apply to rehab therapists. First, though, a few clarification points:

  • As a physical, occupational, or speech therapist, your product is the treatment you provide to your patients, and the value patients receive is functional improvement (or maintenance, as the case may be).
  • If you provide entirely different services (e.g., aquatic therapy, therapeutic massage, or gait analysis), you can map the value stream for each offering individually.
  • To identify value in any stream, look for anything that a patient would be willing to pay for; steps that do not create value are waste.
  • Get your whole team involved—two heads (or thirty) are definitely better than one when it comes to optimization.

Now that we have the basics covered, let’s dive in.

Current State

The very first step in mapping a value stream is to identify a process as it stands right now. To begin, create a very high-level flowchart that describes a typical patient’s experience interacting with your clinic. (We drew up a super simple one below using Excel; you also could use software like LucidChart or sticky notes on a wall.)

From there, you’ll want to fill in all of the missing steps—and we do mean all of them. Your Current State Map should account for every second of a patient’s experience as well as all of the steps you and your staff must take to create that experience. Even steps that might seem like one step—such as a patient scheduling an appointment—can be broken down into smaller ones, such as calling the clinic, being placed on hold, and/or receiving an email appointment confirmation. You also should include steps that aren’t meant to be part of the process but regularly are, such as leaving the treatment room to find a hot or cold pack or calling patients who are running late.

After you’ve completed your first pass at the Current State Map, start collecting data to confirm it actually matches a real life patient’s experience. To do so, shadow your patients. In addition to taking notes on every step that occurs from the moment a patient calls to schedule an appointment to the moment he or she is discharged, you also may want to time each step using a stopwatch. That way, you can begin to calculate averages and spot lag times. Some experts recommend adding a symbol to the chart for any time a patient is waiting.

You’ll also notice junctures in the process where patients take different routes based on specific criteria (e.g., whether or not the patient has insurance). You can represent these forks on your map with a decision tree, like this one:

Waste

Once you have a complete Current State Map, it’s time to go looking for waste, which, if you remember, is any step that does not provide direct value to your patients (i.e., it’s not something a patient would pay for). According to this definition, documentation, billing, continuing education, and insurance verification are all waste. However, these things are necessary for you to run your practice and get paid; thus, they provide value elsewhere, which means they stay. Steps like patients waiting to receive treatment or your staff performing double data-entry because your EMR doesn’t talk to your billing software are waste with a capital W, which means they’re ripe for elimination—or at least change. Think about what a drain these things are on time, energy, and money, especially when repeated again and again and again.

Perfection

At this stage, you and your team get to let your imaginations run wild, drop all constraints, and put together your perfect map. In an ideal world, what would the process look like? Go crazy. After you know what perfect is, take a step back and create a plan that you believe is attainable within the next year or so. This is your new goal. Now, it’s time to brainstorm ways you can transform the current process into the future one. Often, small, incremental changes have the most positive, lasting long-term effects. While perfection isn’t actually achievable, aiming for it will keep you motivated to track your progress and continue to identify new ways to improve the delivery of your services.


For some great examples of how real life healthcare professionals have benefited from implementing lean principles, check out the Profitable Practice article in full here. (Hint: benefits include reducing patient wait times, saving money, leaving work at a reasonable hour, minimizing stress, and improving teamwork and camaraderie.)

Sounds pretty good, huh? Have you experimented with lean principles in your clinic? Tell us your experience in the comment section below.

Cashing In on Private Pay: The PTs Guide to Going Out-of-Network - Regular BannerCashing In on Private Pay: The PTs Guide to Going Out-of-Network - Small Banner
  • Evidence-Based Marketing Strategies from the Pros Image

    articleSep 27, 2016 | 4 min. read

    Evidence-Based Marketing Strategies from the Pros

    This special guest post comes from Gene Shirokobrod, DPT, co-founder of UpDoc Media , and Ben Fung, DPT, MBA, chief content officer of UpDoc Media . As physical therapists, we use evidence-based reasoning to provide the most effective care for our patients. Why, then, do many clinics resist using evidence to inform other areas of their businesses—like marketing? There is a tremendous amount of information available on how to use marketing principles effectively—and yet, few clinic leaders …

  • 6 Icebreakers for New PT, OT, and SLP Patients Image

    articleFeb 16, 2018 | 6 min. read

    6 Icebreakers for New PT, OT, and SLP Patients

    While beginning a new patient’s first appointment by asking why that patient is seeking your services may be the most efficient route to developing his or her treatment plan, such a direct approach can leave your patients feeling brushed off. Now, more than ever, patients want to feel connected to their healthcare providers, and that requires excellent patient communication skills on your part—communication skills that you’ll need to apply before you jump into the clinical stuff. Think …

  • Common Questions from Our Stalled Patient Progress Webinar Image

    articleFeb 7, 2018 | 9 min. read

    Common Questions from Our Stalled Patient Progress Webinar

    Earlier this week, Dr. Heidi Jannenga, PT, DPT, ATC/L, the president and co-founder of WebPT, teamed up with Charlotte Bohnett, WebPT’s director of demand generation, to host a webinar on common barriers to patient progress —and strategies for overcoming them. During the question-and-answer portion of the presentation, we received quite a few audience questions on the nuances of fostering patient engagement and moving patients toward their therapy goals as efficiently as possible. We’ve compiled the most frequently …

  • Knock Out Patient Dropout: 8 Ways to Increase Retention and Revenue Image

    webinarFeb 12, 2018

    Knock Out Patient Dropout: 8 Ways to Increase Retention and Revenue

    In one corner, we have a highly skilled rehab therapy provider known for delivering amazing clinical outcomes through noninvasive, movement-based treatment. And in the other corner, we have a discouraged, disengaged patient whose quality of life has taken a major hit due to musculoskeletal pain and dysfunction. [video://fast.wistia.net/embed/iframe/d11isduky2]   If you’re a rehab therapy provider, you’ve probably seen this battle play out more times than you can count—and we’re betting that more often than not, your therapy …

  • Clean Break: How to Fire an Employee Image

    articleJul 27, 2016 | 11 min. read

    Clean Break: How to Fire an Employee

    There’s no easy way to let someone go—it’s a difficult conversation that no one actually wants to have—but at some point or another, every manager, director, and practice owner will have to figure out what to say when firing an employee. It’s an inevitable part of running a business. No matter how exceptional your hiring practices are, not every candidate you bring on board is going to end up being a perfect fit. Unfortunately, there’s no script …

  • Accounting Tips To Keep Your PT Business Running Smoothly Image

    articleJun 28, 2018 | 6 min. read

    Accounting Tips To Keep Your PT Business Running Smoothly

    Healthcare business owners tend to wear a number of different hats to keep their businesses going. Many have to learn to juggle patient satisfaction , employee performance , and overall clinic success. And while most PT providers focus heavily on the clinical side of things (i.e., providing top-notch patient care), they can’t continue helping patients if they don’t keep their finances in order. With that in mind, here are seven tips to help you overcome one of …

  • Reactivate Now! How to Get Past Patients to Come Back Image

    articleJan 17, 2019 | 7 min. read

    Reactivate Now! How to Get Past Patients to Come Back

    Goodbyes shouldn’t be permanent—especially when it comes to discharging patients. In fact, should those patients ever need to return to therapy, your practice should be the go-to for all their PT needs. That’s why it’s crucial to integrate a patient reactivation plan into your overall healthcare marketing strategy. What is patient reactivation? But, first things first: what do we mean when we talk about patient reactivation—and why is it important? In a nutshell, patient reactivation refers to …

  • 4 Creative Ways to Leverage Online Patient Reviews Image

    articleMar 15, 2018 | 5 min. read

    4 Creative Ways to Leverage Online Patient Reviews

    If you’ve been reading the WebPT Blog for any amount of time, you’ve most likely come across a post or two about the importance of cultivating a plethora of positive online reviews. After all, online reviews provide prospective patients with the social proof they may need to choose your practice over another. They also set a baseline for the patient experience—and help improve your findability online. While you could certainly glean a ton of great benefits from …

  • FAQ: The State of Rehab Therapy in 2019 Image

    articleJul 19, 2019 | 14 min. read

    FAQ: The State of Rehab Therapy in 2019

    Earlier this week, WebPT’s fearless leaders, Dr. Heidi Jannenga, PT, DPT, ATC, and Nancy Ham, CEO, revealed the results of our annual State of Rehab Therapy survey and discussed the national trends that affect rehab therapy professionals on a daily basis. The presenters didn’t have enough time to address all of the thought-provoking questions we received from our audience, so we compiled an FAQ for y’all to read at your leisure. Can’t find the answer to your …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.