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Quality Matters blog from Workflow Diagnostics

We know that quality matters to you, and your customers, so we're offering this regular blog on topics related to process improvement, waste reduction, problem solving and Lean Six Sigma quality methodology. Your feedback is welcome. Comments can be submitted using our contact form.

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(September 2010)

Will you get your EHR incentive in May 2011?
By Mark H. Davis, President & Senior Consultant, Workflow Diagnostics

In just eight short months, the federal government will begin making its first incentive payments to practices that have successfully implemented an EMR/EHR. To be in that first group of adopters, all you have to do is:

1) Register your system with the federal government in January.

2) Claim 90 days of "meaningful use" in April.

3) Receive your payment in May.

Sounds easy, right?

Wrong.

If you want to receive a payment in May, you'll have to have your system implemented by January. That's only four months away, with Labor Day, Thanksgiving and Christmas holidays in-between.

Get the picture?

Even in the best conditions, implementing a new system can take several months. To be ready for January, the time to launch your EMR/EHR initiative is no longer tomorrow, it's today.

Contact me today to discuss your EMR/EHR implementation. I'll show you how you can be "live in five (minutes)" with Practice Fusion, a free, web-based solution that is taking the healthcare industry by storm. Then, I can help manage your implementation to ensure you're in that early group of adopters. This will not only maximize your incentive payments, but help you gain immediate efficiency by eliminating paper and the associated costs and limitations.

For a high-level overview of Practice Fusion, use this link: http://www.practicefusion.com/takeatour.

If you like what you see, you can sign up using this link: http://www.practicefusion.com/ccn/WorkDiag.

To your success,

Mark H. Davis, CLSSBB
Workflow Diagnostics

 

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(August 2010)

How ya doin'? How do you know?
By Mark H. Davis, President & Senior Consultant, Workflow Diagnostics

One of our favorite phrases in America is “how are you doing?” Because we say and hear it so often, we rarely listen to the answer or give one that is meaningful. It’s just a way of acknowledging mutual existence, a recognition that another human has passed our way.

In our personal relationships, “how are you doing” is simply a polite gesture. Sad to say, it doesn’t really matter if we know the answer. In business, however, we have to know how we’re doing. And the simplest, clearest indicator of how we’re doing is how our customers think we’re doing.

All too often, we take solace in silence and assume we’re performing well. “No complaints, no problems,” we naively believe. The flip side can also be true; we sometimes grade ourselves on the only feedback we get, and that typically is a complaint rather than praise. Unfortunately, people are more likely to give unsolicited complaints than compliments.

But neither of these sources is a valid indicator, simply because neither provides a representative sample of our customer base – which points to a key function a learning organization must have: an effective means of gathering valid performance data.

In the old days, a business would put a suggestion box in a waiting room or lobby and wait for the ideas to roll in. Notice I said “in the old days.” We can’t afford to sit around and wait for feedback anymore. Ever see anyone put anything in one of those boxes? Better yet, ever see anyone come and clean it out? At the end of the day, it’s just a lazy way of acting like you care. People will give you their feedback by going next door to your competitor.

If we really care about our customers, we’ll continually ask them how we’re doing. We’ll solicit their feedback without fear or repercussion. We must make it clear that we care about the answer. We must take no offense, but receive the feedback as constructive criticism, a customer’s contribution to our ongoing enrichment.

There are many different ways to collect useful performance data:

  • Train sales staff and service people to ask for feedback in non-leading ways.

  • Ask for feedback after every customer engagement or product/service delivery.

  • Ask, “What would have made your experience better?”

  • Communicate the areas we are grading ourselves on. Ensure they match what our customers are grading us on, e.g. timeliness, responsiveness, effectiveness.

  • Make performance standards measurable. We should ask, “How quickly do you need that?” Then we should measure how quickly we provide it on a regular basis.

  • Formalize data-gathering in the form of surveys, questionnaires or written comment forms.

Most importantly, we must then do something with what we learn. Read the comments. Take them to heart. Affinitize them to identify areas of focus. Communicate the learnings to our teams. Assign owners to different indicators. Form teams to address problems. Let our customers know what we’re doing.

The company that is able to take negative feedback and turn it into positive change is two steps ahead of its competition: 1) it’s asking; 2) it’s doing. It may be a risk to ask for feedback, but the rewards come in the rich relationships with loyal customers and a business that reflects the heartbeat of its clients.

 

   

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(July 2010)

Watery workaround: Waste-buster or waste-maker?
By Mark H. Davis, President & Senior Consultant, Workflow Diagnostics

In a previous blog entry, I wrote about the workaround I created to deal with a leaky shower faucet. Rather than fix the real problem – worn out seals on the cold water side – I created a nifty workaround to capture the dripping water and transfer it to a nearby toilet tank after the occasional flush.

The system of stewardship I created was the result of much thought, study, innovation and industriousness. Today, I am proud to say, it has taken on a life of its own. Not just a temporary fix, it has become quite an elaborate process, complete with its own set of rules, tools and procedures, and has become a permanent part of our daily routine.

With this workaround, I not only displayed a penchant for process, but I achieved an even nobler goal: I have saved an estimated 1,000 gallons of water!

But being a hero hasn’t been easy. Here are just a few of the issues I’ve addressed as I’ve worked to perfect this clever workaround:

  • When I first started, a mop pail was sufficient to capture a day’s drips. Over time, the drip worsened and sometimes the pail overflowed before it could be emptied. To compensate, I began emptying the pail more often. This might sound like more of a chore than a rewarding waste-buster, but I know it’s for a good cause and that keeps me going.

  • I don’t know how you handle this at your house, but at ours, I don’t flush with every use (“if it’s yellow, let it mellow,” as they say). With all this extra water lying around, I’ve started flushing more. Otherwise, the pail will overflow and I’ll waste the excess. Can’t have that! While this may feel counterintuitive (aren’t I just trading water down one drain for water down the other?), I’ve chosen to ignore that. The goal is to save that dripping water and use it somehow. I have to accomplish that goal, come Hell or high water, so to speak. So, I’ve adjusted our flushing patterns to keep up with the escalating waste.

  • The workaround system requires regular attention. What if I am gone all day and the pail doesn’t get emptied? Maybe I can hire a neighbor to empty the pail while I'm gone? This seems a little overboard, not to mention embarrassing. So on those days, the extra drips go down the drain. I’ll just to have live with that until someone volunteers to toilet-sit.

  • Lately, the drip has gotten so bad I’ve had to upgrade the catch mechanism to a 5-gallon bucket. This takes all day to fill, requiring only one emptying per day (usually in the a.m.). But a full bucket is downright heavy. I have to be careful not to spill the water. It has happened a few times, to my chagrin. I keep an extra towel handy just in case. I also try to wait until the very last second to re-fill the tank, so I don’t have to hold the heavy bucket for too long.

  • Which brings me to another point -- my wife doesn't buy in to this whole scheme. She'll just flush away without using the bucket. Or she'll leave the bucket somewhere else. The whole system breaks down when she's in control. Maybe she can fix the seal? (She'll have to figure out how to remove the handle, which is firmly rusted in place.)
  • Sometimes I also forget to replace the bucket. I hate it when I do that. It’s really frustrating to realize a whole day’s drips have been lost. When this happens, I take a moment to stare at the sparkling drops of wasted water on the floor of the shower, pondering what could have been. This moment of self-chastisement motivates me to do better.

  • Other times, I flush and forget to grab the bucket. What a waste! I guess nobody’s perfect.

  • Now, I’m not sure what I’ll do if the toilet tank starts leaking… Guess I’ll cross that bridge when I come to it.

If you’re impressed and want to implement a similar system, below is a basic workflow diagram to get you started:

wkaround jpg

I’m also available for consultation as you develop your own system. Feel free to contact me here with any questions. Just remember: I’m a process engineer, not a plumbing engineer.

Finally, as you see waste around you at home or at work, don’t let that waste go down the drain. Build your workaround today and be a good steward!

(Note: This blog is intended to expose the folly of workarounds, as well as our tendency to use them. I invite you to share your thoughts concerning how this phenomenon relates to your business environment.)

   

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(June 2010)

Systems thinking helps to sanitize the “waste”
By Mark H. Davis, President & Senior Consultant, Workflow Diagnostics

McDonald’s recently tore down one of its first restaurants in our area and replaced it with a brand new, hip and stylish eatery. The layout and furnishings are sleek and clean, there are flat-screen TV’s strategically located throughout the dining area and a convenient wi-fi network so you can surf while you scarf. (I’m not really sure if the menu is new; I pretty much stick with the $1 value offerings. Cheap but filling.)

The progressive design flows all the way to the restrooms, where the latest sanitation systems are on display. The urinals are touchless; just step away, and away it goes. The sinks are also touchless; just place your hands underneath the faucet, and a perfect amount of water automatically cascades down onto your hands. Drying your hands is a sanitary cinch – just wave your hands underneath a powerful wall-mounted dryer, and you’re done in seconds.

Reinforcing this emphasis on sanitation is a comforting sign that reads, “Employees Must Wash Hands.”

While that’s certainly a warm-fuzzy, there’s just one problem: employees could wash their hands all afternoon, but they wouldn’t be clean when they got back to the grill. They have to grab the door handle to get out. Imagine if the previous guy didn’t even stop by the sink on the way out – an employee would pick up all his germs (and more) when he grabs that handle. And he’d carry it all the way back to the grill or register and pass it along to everyone he serves.

Yuck. Make that “McYuck.” Germ-X anyone?

There are actually several lessons in systems thinking here:

1) This marvelous system of sanitation collapses because the design was not thought-through all the way to the end. Individual components may have been optimized, but the effectiveness of the overall system was overlooked. As a result, the system failed to meet the goal. So much for all those great fixtures.

2) Technology (in this case, fancy fixtures) alone doesn’t guarantee a certain result. It may be fun to install the latest toys, but an effective process is a lot more fun – especially for the customer.

3) This also points to the power of the value stream for the customer. Every point along the way should be designed to add value. Missing the mark at one step can ruin the whole experience.

Inevitably, we find workarounds to compensate for badly designed systems. In this case, my workaround was my sleeve. I’d much rather have had a swinging door. And then, maybe a small fry. To go, of course. And cooked by somebody who has never used the restroom.

   

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(April 2010)

"What are your motivators? You need to know -- Your business depends on it!"
By Mark H. Davis, President & Senior Consultant, Workflow Diagnostics

As complex as the human brain is, the things that motivate us are actually fairly easy to identify.

As I analyze my own business behavior, I see that in my weaker moments, I am motivated by four main elements: 1) pride; 2) selfishness; 3) fear; and 4) greed. These character traits may sound self-protecting, but ironically, if left unchecked, they actually have the potential to ruin my business.

Let’s start with pride. I define this as “having something to prove.” This is the trait that tells me I’m always right, I’m too good for a certain job or task, or I’m just going to wait for the other guy to call me this time. Pride may be as American as apple pie, but it is also a dangerous sin, in personal relationships and in business. The Bible tells us that “pride goes before destruction,” and I have certainly found this to be true in both areas. How many contract negotiations have failed due to pride, thereby ruining the chance of success for both parties? Too many to count, I’m sure. And when a business is new, the worst thing you can do is thumb your nose at jobs or clients that are “too small.” On the contrary, doing a small job on the cheap to generate positive word-of-mouth can be a boon to your business. This could be called “humility” – which I define as “having something to share” – and it is great business practice.

How about selfishness? Paradoxically, prioritizing oneself above others is a recipe for self-destruction in business. Remember the old days when just telling people how great you were was the essence of successful marketing? Not anymore. When I look back on my first business presentations, I see this flaw in all its shameful glory:  a picture of me – I wonder why, since I was making the presentation? – followed by details on my education, experience, capabilities, goals, advantages, blah blah blah. All me, nearly all the way through. Needless to say, I didn’t make many sales with that one. But I did make a lot of people yawn. To counteract this, I now try to focus on service, which puts the customer in the spotlight. How well do I understand their needs? What problems can I help them solve? Again, great business practice, and quite rewarding for everyone involved.

Then there’s fear … fear of failure, embarrassment, poverty, shame and so forth (but not public speaking – that one I actually enjoy for some reason). I either make rash, hasty decisions when I’m motivated by fear, or I make no decision at all, which is actually the worst decision. Fear tells me not to bother that potential client, that I can’t handle that large project, that the other guy is smarter than me (maybe he is, but that shouldn’t matter). It tells me to put my head down and pout – basically, to give up. While we’re told that fear is a protective instinct, I’ve found it to be the death-knell for business growth. Instead, I try to focus on faith. As a Christian, my faith tells me that “the Lord is my shepherd, I shall not want.” This gives me boldness to move forward and keeps things in perspective. I know the source of my provisions, and He is faithful. Standing on this assurance, I have confidence to take risks and innovate.

Now let’s talk about greed. With all of the money-making schemes at our fingertips nowadays, how do we avoid falling into this trap? Money is the first motivator that comes into everyone’s mind. After all, we all need to eat , pay bills, buy more things, buy a  bigger house, build wealth and retire early, right? But come on – is materialism all that really motivates us to get up every day, provide optimal service to our clients, put up with various complaints and annoyances, attend pointless meetings, pay numerous taxes, make cold calls, etc.? Surely, we are not that shallow, are we? I have found that when money is my primary motivator, I make bad decisions. I leave my strengths and may even abandon my principles. My judgment is clouded and my head spins around. I entertain deals and make offers that aren’t prudent or within my business plan. While I do need to be profitable to stay in business, I can’t simply ignore my ethics and betray my character for the sake of a buck. Eventually, who would want to do business with a guy like that? Not me. As the Bible tells us, “the love of money is the root of all sorts of evil.” It may still seem like the root of good business, but I’m going against the grain here and telling you it’s the rot of good business. So I’ve learned to not let love of money be the motivator. (And somehow, I’m still in business.) In good times and bad, I try to focus on giving, instead. Again, we are told in the Bible, “He that giveth unto the poor shall not lack.” By making giving a habit, I am able to defuse greed and keep my focus on others, particularly my current and potential customers. The more I give – in terms of useful information, insights or helpful resources – the more I become a trusted and valued partner in their eyes.

As business owners, if we don’t identify our motivators early on, we could easily make decisions that lead to the premature demise of our promising ventures. So, what are your motivators? Are your current motivators leading you down the wrong path? Are your decisions driven by pride, selfishness, fear or greed? I encourage you to spend some time answering these questions, to be honest with yourself and to connect your motivators with your business behaviors. Make whatever adjustments are necessary to avoid the pitfalls of these destructive habits and character traits. Your business will grow, and your customers will thank you.

   

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