Six Sigma and Lean: The New Kids on the Orthodontic Block

Two of the ideas we’ve seen popping up in dental and orthodontic literature are Lean Management and Six Sigma Management. For those who aren’t familiar with these ideas, they are systems management processes for businesses. Lean Management focuses on eliminating waste (anything that doesn’t contribute to reaching your final goal) while Six Sigma focuses on eliminating mistakes by improving your systems. In our little sphere of the business world, Lean and Six Sigma are showing up in practice management applicationspractice building strategies and even in CE classes.

Obviously with what we do at MidAtlantic Ortho (design, manufacture and manage inventory) we are well acquainted with these efficiency and quality-assurance ideas. While these types of processes have a direct application to what we do, it’s worth considering if there are any ideas that can be extrapolated for the individual practice? For most practices, and really most businesses, the answer is a resounding yes.

Rather than get bogged down in the definitions of Lean and Six Sigma, we’re going to simplify the process into three steps.

In many ways, this is the most obvious, yet the most challenging step. You need to find a way to step outside yourself as the prime mover of all things in your practice and look at it as an outsider. Write down all the steps that happen during the patient’s journey. Consider all the patient experiences through their eyes. Question what you, and each member of your staff are doing and if those actions are necessary to reach your final goal. One great way to do this is to ask a friend to come in and do the secret shopper thing. Have them start with booking an appointment and then go through the whole process including the initial consultation. You aren’t looking to critique your staff so much as you want to critique your processes. You are looking to identify waste (as defined above) as well as points in the process where things go wrong.

Once you have an in-depth understanding of everything that goes into how your practice runs, start making changes. If your final product is a successful patient outcome, what can you eliminate from your current processes that isn’t contributing to that goal. Change or eliminate points in the treatment process where things don’t run smoothly. Don’t be afraid to experiment. Even if you make a change that doesn’t work, you’ve still added valuable data to your internal database of how your practice works.

After you’ve gone through the first two steps, it’s up to you to observe the result of the changes and respond accordingly. While the successful patient outcome is always your goal, don’t overlook the impact the changes you’ve made have had on your team, both positive and negative. You are looking for ways to empower your team to do more and get better. Think about what you learned from your secret shopper and the changes that might have inspired. Ask yourself questions like, do you need to reconfigure the layout of your practice, are employees being under-utilized, what elements of the patient journey are frustrating for the patient and/or their guardian?

That’s the processes in a nutshell. If you’re interested in digging deeper, there’s no shortage of articles on Lean and Six Sigma on the web. Harvard Business Review has lots of good information on both (disclosure, some of it is behind a paywall) but here’s a free one that mirrors our Look, Act, Learn approach. And as always, if you’ve dabbled in these kinds of approaches in your practice, we’re (always) curious to know what kind of changes worked for you.

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