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A bottleneck in a business refers to a point in a process or workflow where the flow of work is constrained or slowed down due to a limitation in resources, capacity, or efficiency. It’s like the narrow neck of a bottle that restricts the smooth flow of liquid. Bottlenecks can hinder productivity,  impact overall operational efficiency, affect team culture, and limit your ability to grow your business..

There are two important things to know:  

  1. Your business is only ever as good/fast/profitable/effective (pick your word) as your bottleneck.
  2. Every business has a bottleneck.

Bottlenecks are most commonly thought of in production and in terms of an assembly line but are just as relevant to your chiropractic practice. Though the same thought process can be applied to all areas, here is one simple example:

Your office has an average of 25 new patients every month, but your overall monthly patient visit average isn’t increasing in accordance.  Somewhere between the first visit and overall patient retention you have a bottleneck.  

Here’s how you can identify a bottleneck in your business:

Key Performance Indicators (KPI’s): Monitor various performance metrics related to your processes. Beyond the basic numbers of new patient visits, patient visits, services & collections, there are KPI’s within each process that determine those final numbers. If you notice that certain metrics, such as patient flow, over-the-counter collections, customer service response times, or procedure follow through, are consistently lagging behind or not meeting expectations, it is most likely indicative of a bottleneck.

Workload Imbalance: If you observe that some team members or departments are consistently overloaded with work while others have idle time, it might suggest a bottleneck. A bottleneck often occurs when work isn’t evenly distributed. That being said, remember there is a difference between being busy and looking busy. Unless you have KPI’s in place, it can be hard to identify the difference.

Queues and Delays: Long queues or delays at specific stages of a process can signal a bottleneck. For example, if there is not a clear communication process throughout patient flow, you could have a new patient waiting in an exam room for 15 minutes before being seen by the doctor and/or clinic assistant.

Dependencies: If certain tasks or stages of a process have dependencies on others and one task is consistently causing delays, it could be acting as a bottleneck for the entire process. For example, if patient’s are consistently waiting long periods of time for their turn in therapy you potentially have a bottleneck.

Capacity Analysis: Evaluate the capacity of various resources, such as machinery, personnel, or technology, at different stages of your workflow. If one resource has significantly lower capacity than the others, it might be a bottleneck.

Process Mapping: Create a visual representation of your workflow, including all the steps and handoffs involved. Analyze the map to identify areas where work might be getting stuck or delayed. Determine KPI’s for the tracking of these processes and then re-evaluate every 30-days. Once established, review them every 90-days.

Feedback from Team: Encourage your team members to provide feedback on their experiences with the workflow. They might be able to pinpoint specific areas that are causing frustration or slowdowns, as well as contribute new thoughts and processes to test..

Data Analysis: If you have access to data related to your processes, you can analyze it to identify patterns of slowdowns or inefficiencies. Most commonly you will utilize reports in your software to help with this step.  

Once you’ve identified a bottleneck, it’s important to address it. This might involve reallocating resources, optimizing processes, investing in additional capacity, retraining a team member, redesigning workflows and/or taking an honest hard look in the mirror. Keep in mind that addressing bottlenecks is an ongoing process. As your business needs and dynamics change over time, your practice grows, technology advances, and so on, evaluating your bottlenecks is imperative to maximum success.

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