By Ken Krivacic, OD, MBA
Storyboarding is a technique used in the movieindustry to isolate and arrange a series of scenes to tell a story effectively. Optometry can utilize this tool to improve office procedures by showing visuallywhere bottlenecks and delays occur in our everyday procedures.
In our office, we learned about how to apply this tool when we wanted toimprovepatient flow. We utilized theODLean in-office program to help us “storyboard” the patient experience in our office. The exercise of seeing in visual terms how our patients interact with our office was the first step to enhancing our in-office experience. We’ve been able to measure improvements in efficiency that translate directly to our bottom line. An initial $15,000 investment paid for itself in about a month–and more than tenfold in the course of a year.
The biggest change that resulted from the storyboarding exercise was in making the flow of our examination process for the patient more efficient. Prior to the change we tended to move patients from room to room on average five times during their exam process from the time they checked in at the front desk to the time they were taken to the front to either check-out or shop in the optical. As a result of the storyboarding process, we were able to either eliminate or combine several steps so that the patient now only moves from room to room an average of three times. This has led to greater efficiency, time-saving and a more pleasant patient experience.
A storyboard (above) was created by Dr. Krivacic’s practice staffto improve office flow by spotting bottlenecks–then finding solutions to be more efficient and profitable.
What is Storyboarding?
Storyboarding is a process that allows an organization to analyze a situation by mapping it out visually, and then make changes that meet the organization’s goals.
The process of visual thinking and planning allows a group of people to brainstorm together, literally placing their ideas together and then seeing as a group what can be improved. This process fosters more ideas and generates consensus inside a work group.
I measure the ROI for our storyboarding process in two ways.
One, did the storyboarding process enhance the patient experience in our office? The answer to that question is a resounding yes. Patients are not shuffled from room to room as much as they were before. I believe this leads to a less frustrated patient and an exam that can be performed in a timely manner, which should result in patients having more time to spend in either the contact lens area or the optical.
Two, did the storyboarding process enable the practice to benefit financially? As noted, the cost for the consultants was approximately $15,000. This sounds like a large sum for something that perhaps we could have done on our own. What was the resultant revenue gain? Since implementing the new process we have been able to easily handle one extra full exam patient per day per doctor. We have two full-time doctors, so we increased our monthly patient visits by approximately 40 (2 examsday x 20 daysmonth = 40 exams). Our average revenue per patient is $350. Therefore, our average increase in revenue per month is $14,000. This results in a yearly increase of revenue of approximately $168,000. That number sure softens the blow of shelling out for the consulting fee.
We looked at our revenue for the year after we implemented the changes, and we were up $131,000. That number is just short of projections, but still a great ROI. Also keep in mind that increase is not only for year one after the change, but for every year thereafter, as long as we stick to the process.
Visualize the Patient PathDuring Visit
For us, the storyboarding process helped analyze the path that patients took during their office visit. This was done using titles or descriptive words for each step of the process.
I believe storyboarding can have several uses in an optometric practice. It can be used to not only analyze and modify a current process you are performing in your office, but also as a means to set up a new process you plan to undertake. This can mean adding a new instrument, and seeing patient movement and times that it would take to perform the new test. Storyboarding also can be used to showhow you want contact lens products to be marketed to patients.
ODLean spent a full day observing and analyzing our current patient flow. They not only charted and storyboarded the flow of the patient through the office, they also timed the length of each encounter the patients had at each stop in their journey through our office for their eye exam. For example, they timed how long a patient took to check-in at the front desk, how long they waited until a tech greeted them to take them to the clinical area, and how long it took our staff to record a case history.
All these touch points were then written on Post-it notes along with their corresponding average times. Next, we arranged the Post-it notes on a large board in the order we were normally doing them. Then we stepped back and studied the board to see what stops were redundant or what stops could be moved or eliminated.
An example of a process we ended up changing after storyboarding was how we took retinal photos. Prior to our analysis, we would perform retinal photography after the patient had already gotten to the exam room and a majority of the exam was performed. In our storyboarding meeting it was suggested we perform the retinal photography while the patient was in the pre-test room that also housed the auto-refractor. This eliminated one stop and allowed for a more smooth flow through the office. In case you’re wondering, yes, occasionally we have patients whose pupils are too small to get a good photograph, and for those, we perform the photos after they have been dilated. This scenario results in that extra step and does slow the process down, yet our rule of thumb is: perform photos first whenever possible.
Allot Needed Time and Money
The storyboarding and consulting process required two full days. The first day ODLean analyzed our current process by observation and by interviewing a few patients about their experience in the office. For us, it was a business as usual day with a few extra people hanging out in our office with clipboards and stopwatches.
The second day we closed the office to patients. ODLean met with our doctors and staff to review their results and make recommendations. Part of the recommendation process involved setting up storyboarding for different parts of the office. They divided us up into front desk, clinic, contact lens and optical. For each department, storyboarding was used to show how the patient moved through that area and then each group brainstormed ways to make the process more efficient and a more pleasant experience for the patient.
The major cost was in the fee the consulting group charged. For our practice that was $15,000.
I believe an OD and his or her staff could perform storyboarding on their own. However, having a consulting company experienced in the process made it much better and more efficient. I do not believe we would have accomplished as much as we did in the timely manner that we did without the guidance and leadership of experts.