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By Root 3153 0

Effectiveness means a deliberate action of focusing on the correct product mix segments by servicing only the select group of patients. Efficient means that number of patients seen in a given time increases without affecting the quality of service. Frequently decisions about effectiveness are made based upon fees for a particular procedure like a dental implant. Most of the time various other factors, like precious doctor time, investment costs, truly variable costs, and opportunity cost where we must forgo doing restorative work in order to do this implant procedure, are not considered in decision making. The formula to make a decision of product mix (which procedures to focus on) is usually simple: Throughput (T)/Constraint Unit or Doctor Time. When comparing one group of procedures versus others or when considering referring patients to specialist versus learning to do the procedure in house, the above formula will help make the decisions. The efficiency of doctor time increases when we are careful about not wasting the precious doctor time on tasks unrelated to patient care.

a. Total kit concept where everything is ready for the doctor to treat the patients. This includes equipment, tools, laboratory work, radiographs, and information about the patient from other specialists or practitioners including the physician’s medical clearance, if necessary.

b. Equipment and tools have preventive maintenance programs so that there is no surprise breakdown of equipment.

c. A standardized flow sheet similar to Basic Life Support or Advance Cardiac Life Support that outlines all the treatment steps is used. This helps the whole team know exactly what is expected in the next step.

d. Workplace organization ensures that everything has a place and everything is in its place.

e. Supplies are always available when the doctor is working; they never expire or run out. On the other hand, the supplies are not ordered excessively because this will increase OE.

f. Emergency equipment and supplies are always updated and checked on a periodic basis.

g. Workplace is meticulously clean and welcomes everyone to come to work.

h. Quality of work is important because time is wasted in redoing the procedures instead of doing a new procedure that we could have done.

i. Health care has a lot of surprises like patients coming late or arriving early, patient’s expectations change, patient and staff personality and communication styles, and the procedure can have some unexpected delays or complications. The staff, who helps the doctors offload their work, might be absent or unreliable. If the staff changes the new staff might not have the requisite skills. It is important to have protective capacity (capacity to accommodate Murphy and maintain patient flow) of the staff to ensure that the doctor time is never wasted. The protective capacity is the extra skill sets or extra staff, who might at times appear to be standing around, but they actually help to protect the precious doctor time.

5. Subordinate everything to the above decision: The challenge is to control this environment where every patient is unique and there is never a predictable time to get things done.

a. Understanding that there are two goals, one to protect the doctor time and second to ensure that the patient is not unnecessarily waiting too long, which can result in the patient’s dissatisfaction and through blockage can cause loss of throughput.

b. The time prior to the patient seeing the doctor is considered the doctor buffer. The patient might be present prior to the doctor finishing the proceeding patient. Most dentists work at least two or three chairs. This means that the time it takes to register the patient, take an x-ray, or have laboratory work ready for the patient must be done and the patient is ready in the second chair prior to the dentist finishing the first patient. If the dentist takes a long time to complete the first patient, there must be a signaling system to inform the check-in person so that the staff does not make the patient wait