Are Bottlenecks Bogging Down Your Practice

Are Bottlenecks Bogging Down Your Practice? September 12, 2019

Learn how to identify inefficiencies and streamline your workflow.

By: Jessica McBurney

Just about every one of us has experienced the following scenario; you’re driving down the highway and traffic is flowing nicely when all of a sudden you lurch to a halt and find yourself stuck in gridlock. It takes you about 20 minutes of stop-and-go when you pass an accident that has shut down the left lane leaving one lane open for everyone to pass through. This is a classic example of a bottleneck. Simply put, a bottleneck is something that either slows down or completely stops the flow of a process, and there are a few simple ways to identify them in your practice.

Identifying bottlenecks in manufacturing are pretty easy. On the assembly line, you can physically see the products begin to stack up and workers fall behind; think of the famous chocolate factory scene from the show, I Love Lucy.
However, it becomes more challenging in a complex system such as a medical practice or hospital system with multiple moving parts. Suddenly, people become your product, you’re heavily reliant on technology, and you are no longer following a widget down a straight and narrow assembly line.

Indications that you may have a bottleneck in your organization

Ask yourself these simple questions to start:

  1. Are there any recurring themes that you are hearing over and over again in your practice?
  2. Are you receiving any specific feedback from your patients that may allude to a workflow issue?
  3. Are your patients experiencing longer than normal wait times?
  4. Are you finding yourself constantly waiting for people or equipment?
  5. Do you often hear from your team that they just can’t get caught up on work?
  6. Are members of the team feeling stressed or overwhelmed?

If you answered “yes” to any of the above, you may have bottlenecks in your operational flow.

Discovering the Bottleneck

Process mapping can be an extremely valuable tool to help visualize and identify bottlenecks. Mapping out the entire workflow identifies all of the steps it takes to complete a process from start to finish and can quickly show you where opportunities for improvement may lie.

Have your team map the process as they believe it flows. This is an extremely valuable exercise. By doing this, you have the people actually performing the work showing you what their understanding of the process is. You’ll often find the process varies from person-to-person, and the degree of variation can be quite surprising. You may see redundant tasks being performed, missed steps, or deviations in how a task is performed. All of these lead to inefficiencies among your team and can quickly identify waste in your operation.

Classifying the Bottleneck

Bottlenecks typically fall into one of two common areas of inefficiency seen in the workflow; both equally impactful and potentially limiting the process.

  • Performer based bottlenecks – Any person (employees, or third-party vendors) involved in the process.
  • Systems based bottlenecks – Any technology, programs, or equipment that are part of the workflow.

Identifying Performer Based Bottlenecks

You know the old adage, “time will tell?” Well, it literally will when you are identifying a slowdown in the workflow. Gather information and have a basic understanding of how long a certain task will take. If the task is repeatedly taking longer than it should, you may have a performer based issue. Remember to take into consideration the skill level of the performer, and be sure you have training and development in place to support individual job functions.

Identifying System Based Bottlenecks

System based issues are often disguised as performer issues at first glance. It may appear as though a specific person or vendor is simply slow, but if you look a little closer, it’s often due to systems that are holding up the process. Look for key indicators such as long wait times. Listen closely for complaints from staff about programs or systems that are preventing them from moving easily through their work.

Next Steps

Once you have identified your bottlenecks, it’s time to resolve them. This may involve increasing the efficiency of a step by using automation, implementing a new tool or software solution, or even removing a step in the workflow all together to shorten the process.

Engage your team in problem-solving. Having faced the issue multiple times a day, it’s likely they have ideas for how to improve the process. Leverage their experience, and encourage them to experiment and try new things. Be sure to celebrate even the smallest success.

Finally, keep in mind this is a continuous process. Resolving one bottleneck can often lead to the identification, or creation, of another bottleneck.