Article Date: 1/1/2008

It's Time to Get Rid of TIM WOOD
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It's Time to Get Rid of TIM WOOD

Here are seven steps to a leaner, more successful practice.


If you want to begin 2008 by eliminating unnecessary activities in your practice, you might want to consider adopting "Lean Six Sigma," an approach billion-dollar multinational corporations have used for more than 20 years.

Lean Six Sigma relies on you and your staff to identify and eliminate waste in your practice, leaving only those activities that the patient cares about and is willing to pay for when done right the first time.

This lean methodology focuses on seven types of waste found in organizations, which you can remember by the name TIM WOOD. (This is big business — there had to be an acronym.) Below, I'll explain what TIM WOOD stands for and provide some basic examples.

Transportation. Movement of products or information from one place to another adds time to activities. For example, the minute or two it takes to retrieve a pair of trial contact lenses for a patient may not seem like such a long time, but in a high-volume practice where a doctor sees 10 or more patients in an hour, two minutes represents as much as a 33% increase in time. Also consider the time involved in moving paper prescriptions, orders, etc. and how you can eliminate these things through practice-management software and/or electronic medical records.

Inventory. Whether it's contact lenses, frames, or office supplies, excess inventory can cost practices tens of thousands of dollars a year.

Motion. Poor ergonomics can lead to extra movement, as well as contribute to strain and muscle pain (see "Optometrist: Heal Thyself" in the September 2007 issue of OM.)

Waiting. Aside from patients who often detest long waits in the reception area, delays in other areas, such as processing insurance claims, can reduce cash flow.

Over-processing. Do you have staff members who check the work of other staff or vendors — sometimes two or three times? Can you remedy this problem by implementing a process that ensures correctness the first time?

Over-production. Extra copies of documents, ordering too many supplies or products all lead to waste in the practice.

Defects/rework. A defect, whether it's the result of staff, a vendor or equipment, costs not only staff time, but patient satisfaction.

The first step toward ridding the practice of waste: Meet with the staff. Ask them not only about waste, but about processes that add no value to the patient's health or their satisfaction with the practice. With persistence, you can expel TIM WOOD from your office. OM

Optometric Management, Issue: January 2008