What can you do to keep your production flow moving and your processes moving. At the end of the day, rather than waste your energy trying to straighten out the flow, focus your effort on flattening out the curves and minimizing interruptions as much as possible.

When I watch organizations, I am reminded of a swiftly flowing river.

Starting with raw materials at the river’s source and ending with finished products or services flowing from its mouth, overlaying processes flow into and onto one another. When everything is running smoothly, it is a wonderful thing to behold. But much like a river, no production runs perfectly straight and smooth. There are twists and turns where the flow must adjust and maneuver around obstacles that get in the way.

However, the “flow and process” is often broken by changes in policies or conditions in the delivery chain, employees that overlook important issues, and staffing arrangements that leave us waiting in endless lines. And that’s the reality. Companies of every size and from every industry contend with flawed process flow as energy and profitability slowly bleed away.

Managers at a large mid-western hospital were spending their days and weeks tearing out their hair, trying to figure out the source of unacceptably large numbers of no-shows and last-minute cancellations for medical tests.

At the end of the day, rather than waste your energy trying to straighten out the flow, focus your effort on flattening out the curves and minimizing interruptions as much as possible.

The problem was long in running. In some cases, patients were not receiving tests they needed therefore causing disruptions in the hospital’s schedules and lost revenue. To compound matters, staff time had ratcheted up as administrators and practitioners scrambled to stem the day-to-day scheduling problems and reschedule the canceling patients.

Management suspected that a major source of the problem was due to patients’ inability to obtain timely approval from their insurance carriers for the tests. We turned to our Listen methodology and asked staffers to call patients themselves. The subsequent interviews revealed that many patients had forgotten their appointments. Many others didn’t know which of the hospital’s many buildings they were supposed to go. Still others who remembered their appointments and managed to find the correct office, discovered at the appointment window that they had failed to follow pre-test preparations (e.g., fasting) and had to reschedule. Insurance, as it turned out, was of minimal consequence. It was clear to all that the patient preparation process was either non-existent or completely ineffective.

At my suggestion, managers examined best practices at other hospitals. They cataloged some common sense ideas for managing patient preparation procedures and paid special attention on departments in their own organization that seemed to be dealing with the situation better than other departments.

In a matter of a week or so, they had drafted two ways that the hospital staff could rectify the situation. First, patients must receive full explanations in print regarding their test, including a map that showed exactly where they had to go. Then, all patients received a phone call reminder for their appointment, plus a reminder (when applicable) about pre-test preparations. After the new patient preparation process was up and running, the hospital reported a 50% reduction in cancellations. The flow was fixed.

No company’s operations ever achieve total perfection. Among the companies that handle the twists and turns quite well, they move around the flow a seasoned sports team. Attentive members use strong communication between other members to assess changes quickly and make on-the-spot adjustments as situations require.

At the end of the day, rather than waste your energy trying to straighten out the flow, focus your effort on flattening out the curves and minimizing interruptions as much as possible. Work toward perfection, but don’t expect it to achieve it today.


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