Eyeworld

OPHTHALMOLOGY BUSINESS 76 November 2017 by John B. Pinto, and Corinne Wohl, MHSA, COE Making the shift from memory to manuals the largest and hardest to get started with: the operations manual. One of your primal instincts as a practice leader should be to have ev- eryone doing things the same way, right? In business, this reduces costs and errors, and improves custom- er service. In ophthalmic practice, consistency saves vision and reduces malpractice exposure. Everyone agrees that "We should write stuff down" is a general prin- ciple for running the entire practice. When you come across something that's unsatisfactory, you should be asking, "What's our policy about this?" When there is a policy, you can follow it (or revise it). When there is no policy, you can develop one, with appropriate input from the rest of the practice's stakeholders. But you would be surprised at how few protocols and procedures are written down in the average practice—even in quite large practic- es. The main impediment is a lack of time, inertia and not knowing where to start. Here's a simple, six-step ap- proach to launch or enhance an operations manual for your practice. You don't have to do this alone. Even if you're smart, you don't come close to knowing the granular details of how each job is done in the practice. Instead, take this project by siege, over a matter of months, and turn to staff in the trenches to do most of the work for you. 1. Gather one department team, let's say the technical department, in a 60-minute meeting. Have a whiteboard or flip chart handy and hand out pads and pens. Ask everyone to write down at least 10 key skills one needs to master to be a competent technician in the practice. Go around the room several times, writing down what people say on the whiteboard. You will probably generate a list of 30 or more discrete skills, ranging from how to escort and interact with patients to how to assist in surgery. 2. At the same meeting (or a subse- quent meeting if you've run out of time) ask the techs to write a "B" "No man has a good enough memory to be a successful liar." —Abraham Lincoln T his month's column is ded- icated to those administra- tor and physician wizards whose profound memory skills allow them to keep everything about running their prac- tice in their heads. We'll get right to the point: Please quit it! A successful, growing practice will eventually overtake even the best memory skills. A practice may grow revenue and patient volumes linearly, a few percentage points a year. But the same practice's enterprise complex- ity rises logarithmically. A practice that doubles in size becomes four times as complex as it was. This leads to managing partners and managers who have been rely- ing on memory rather than writing hitting the wall, sometimes abruptly overwhelmed without warning as the number of moving parts and details swamps even their prodigious recall skills. Compare this to the rest of us. Over the years, people with mere-mortal memory capacity develop hacks to stay up with an ever-evolving, convoluting practice. These hacks include: • An operations manual used to me- morialize how everything is done in the practice • Naming conventions for computer files and passwords, rather than a random approach • Redundancy, so that critical in- structions are clearly understood by more than one person • The abundant use of labels on storage lockers and equipment boxes, and the posting of writ- ten instructions for each piece of equipment • Searchable word processing files containing "idiot sheets" for how things work • Rampant use of smartphone apps to serve as a portable brain • Laminated cheat sheets for techs to keep straight what each doctor and each presenting condition needs during a work-up Let's dive a little deeper into just one of these memory aids, albeit To the point: Simple practice tune-ups for complex times

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