Wound Centers Should Be More Like Southwest Airlines!
Our CFO, Rylan Smith, and I were sitting in the San Jose airport today waiting for our flight back to Burbank watching the Southwest flights come and go. We both commented to each other how expiditiously, efficiently, and effectively (the 3 E's) each plane was turned around. The passengers were loaded quickly while the crew joked with them and greeted each passenger. The fueling and bag loading was like ballet. Trucks and cars coming and going right on cue. Everyone lined up according to their number with no mad dash or elbows to get on first. Then there was the invisible item, the vibe. That's right, I said vibe. The overall feeling in the terminal and on the plane that emanated from the Southwest employees. I fly, a lot. I am on a first-name basis with half of the Delta and American flight attendants! With all of that familiarity, I still have yet to find any other airline besides Southwest that has such a consistently happy, helpful, and fun staff. Expectations are clear, getting on and off the plane goes quickly, and the flight is usually easy. Doesn't that sound like the way a wound center should run?
If you have read any of my blogs, you already know that just about everything reminds me of wound care centers. It's a sickness. However, in this case, there is a point!
As I visit centers around the country that have asked our team to come in and get them back on track, regardless if they are run by a GIGANTIC management company, or operated on their own, the first thing I notice is that their flow is horrible. It is not OK for patients to wait hours in the waiting room. Having patients wonder if they were forgotten in an exam room is simply not acceptable. If every clinic you run, no matter how many patients you see, is a six to eight hour ordeal, you will lose physicians, patients and referrals. Take a page from Southwest and build a better plan. By doing this your flow will improve, your team's moral will be better, you will have more time for your patients, and the "vibe " of the clinic will be exceptional. The vibe comes from your team and affects every patient you treat.
Here are two quick tips:
#1: One Train Wreck At A Time! -
Rank your patients by acuity, then make sure no more than one most-difficult ranked patient is seen at a time. For instance, you may want to use a scale of 1-3.
A 3 denotes the most time consuming patients: A new patient that has not been seen before, a patient with several difficult wounds, a patient that might be difficult to deal with on a regular basis, (I am sure you don't have any of those!) or a very large patient that takes a great deal of time and effort to get in and out of the chair.
A 2 may be a little less time consuming, however they may still need more time than a 1: A patient that needs a wound VAC placed, a difficult area to reach, a very sensitive patient who needs a little extra time, or a patient with multiple wounds that may not be as extreme as a 3.
A 1 may be an established patient who knows the routine, possibly a diabetic foot wound which is generally quick and easy to treat, basically the quickest patients you have.
Once you have separated patients into these categories (I suggest doing this during your morning meetings with the whole team, and please don't tell me that you don't have a morning meeting) set up your schedule with no more than one #3 in a 30 minute or one-hour period. This will depend on how many exam rooms and team members you have. With 5 exam rooms, you might have one 3, two 2's and two 1's.
Tip #2: R.A.T.E.D.
I will give away one of our best trade secrets here: Once you are seeing a patient use a simple system. We have developed an approach over ten years called RATED: Room, Assess, Treat, Educate, and Discharge. We have a full system, training videos, and algorithm just for educating our clinical team to this approach. It's that important. By identifying team members for each component you can run your center as smooth as a Southwest flight.
Just don't give the attendants a hard time when they are pointing out the exits. Trust me on this one.