Continuous Flow Front to Back Creates Patient Satisfaction

By James V. Anderson, DMD

This article represents a discussion of Principle #2 of the 14 Management Principles from The Toyota Way authored by Jeffrey Liker. Principle #2 talks of creating a continuous flow, adding value and eliminating waste from the production centers of your business. The principles illustrated in Toyota’s management systems can be applied to improving the efficiency in dental practice operations.

Many of us working in dental offices have learned to accept the waste of time and materials because “this is the way we have always done it” and the resistance to change that accompanies the statement. Instead, we should learn to produce the best quality care with the lowest material costs and shortest patient chair times.

The following is an all too common scenario in dental practice: A disgruntled patient approaches the front desk after his appointment and announces, *“This is the last time you will see me here so prepare to transfer my records. I have waited for the doctor a total of an hour and a half over the last two appointments, and I am “fed up with waiting.”

The situation is not just a crabby patient having a bad day but a severe problem with time management and patient care flow in your practice! If you only accept that delays in seating, delays in completion of treatment, frivolous interruptions, and unnecessary drama are all in a day’s work, you will never improve your practice and will continue to lose patients, reputation and necessary revenue.

When your goal is to provide a highly valued continuous flow experience for the patient from their first encounter with the practice to their checking out at the desk, problems within the systems will surface right away because of failures in current operations. How you resolve these problems will indicate whether you will improve the patient experience or not. Take a hard look at improving patient flow and ultimately improve patient retention and new patient referrals.

The following are samples of common upsets to time management that affect the patient’s positive experience.

  1. Why was the patient seated late? A. The assistant wasn’t notified of the patient arrival.
  2. Why was the *patients’ care interrupted while in the middle of treatment and left ten minutes with a mouth full of hardware? A. The doctor had to see an emergency patient.
  3. Why did the patient wait several minutes in another room for his examination after the hygienist completed the cleaning? A. The next hygiene patient had arrived, and the doctor was late getting into the room to do the evaluation.

What is truly valuable to the patient in all of these instances? Is it getting attention on time with respect and professionalism? Realizing the goal is to keep the patient from waiting we observe the lack of available staff to assist.

From the Toyota Way, the key is measuring Operational Availability and the other is measuring Process Capacity. Operational Availability (OA) is a measure if ALL your resources are available to be used productively. Process Capacity is a measure of how MUCH of your resources are currently being utilized. The goal would be to always have your OA 100% and Process Capacity at 85-90% If your OA is 100% and your capacity each day is 85-90%, then you can respond to walk-ins, do an unplanned filling after a prophy, or utilize your other expensive specialty services, all at the time of service, exact when the patient is in the chair. The Toyota Way are systems designed to provide tools for continuous improvement in the workflow. Creating the right process will produce the right results according to the author, Jeffrey Liker.

Dental software such as Dentrix and Eaglesoft have patient arrival systems built into the computer appointment book, but the problem is that the monitor in the treatment room or nearby must be on that screen to see the arrival of the patient.

Light signal systems such as Comlite, have been available for decades but are limited to visual access to the light panel. In some practices, the receptionist or business staff must walk to the back of the office to alert the patient arrival. Creating a continuous flow of patient care by keeping up with the latest improvements to redesign work processes is essential for the victorious team.

New technology from Simplifeye – Dental communication technology offers product “Flow “, to keep your team in the loop with instant notifications that pop up on their smartphones or watches and” DEXvoice”, a product that will instantly pull up patient records, x-rays, charts, and other information– all with your voice–you would not have to leave the room to unglove and use the keyboard.

Patient satisfaction can be elusive if you are not aware of how you can improve their experience. Combining a caring, thoughtful attitude and newer and better technology will give you the combination for successful patient experiences.

Originally published in The Dentist’s Network


James Anderson, DMD was an entrepreneur before becoming a dentist. His leadership and business presentations offer dentists the essentials needed to achieve the practice and life of their dreams. His speaking programs help dentists realize their full practice potential by combining dental clinical skills with excellent business skills to create a profitable and enjoyable dental practice career.

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