Our Approach

Our approach can be summarized as a combination of Todd’s unique ability to facilitate groups, his use of humor and team approach to change management with proven methodologies such as:

  • Lean & Six Sigma
  • Assess, Diagnosis, Treat, Prevent
  • Measureable Results
  • 5 S (Sort, Straighten, Shine, Standardize & Sustain)
  • Patient Centered Medical Home


The Lean journey is like healing a patient
The Lean journey is similar to the treatment of a patient. It requires people and support from various departments and ancillary staff to effectively apply Lean concepts and tools.  As the treatment of a patient is individually tailored, Lean must also be tailored to the facility, department, and/or process in which it will be used.  To this end, we have followed the model below to assess the current state and provide solutions to improve the patient experience at your office.

Common sense approaches to solving your problems while striving for process excel

Adherence to the ADTP (Assess, Diagnosis, Treat, Prevent) methodology will allow for improved throughput, increased patient satisfaction, and leverage of existing resources to promote efficiency.  Lean is about applying common sense approaches to solving your problems while striving for process excellence.  If you keep that in mind, as well as these four phases (Assess, Diagnosis, Treat & Prevent) you will have a successful Lean journey.  Additionally, the principles of Lean and ADTP can assist in transforming the traditional Physician Clinical Office Practice into a Patient-Centered Medical Home.

Every physician wants their practice to work well for their patients, their staff and themselves.  They want to deliver high quality care at a reasonable price and meet the needs of their patients.  But there are multiple challenges facing practices today including Medicare payment reductions, increasing financial pressure and managed care organizations, rising cost of office operations, and increasing pay-for-performance models.

Those issues along with patient wait times, gaps in the schedule, the correct data not available for the visit, etc. impact the patient experience.  Improving patient flow and reducing errors will allow for improved throughput, increased patient satisfaction, and leverage of existing resources to promote efficient office practice.

More on Assess, Diagnosis, Treat, Prevent

assess diagnosis treat prevent


This is the most critical step in Lean Clinical Office Practice. In medicine, professional skills are used to assess and evaluate a patient. In Lean, similar assessment skills are used to evaluate an area or process and prepare it for detailed analysis. This involves teamwork and management involvement from the beginning.


Just as a stethoscope, oxygen saturation monitors, blood work, etc. assists in determining a diagnosis of a patient, Lean tools are similarly used to identify and gather information to further analyze a process. This involves continued reliance on teamwork, as a diagnosis is often reached using a multi-disciplinary approach, thus allowing for a statement or conclusion to be drawn concerning the nature or cause of the area or process requiring attention. This will provide the bridge from assessing an area (previous phase) to ensuring the correct treatment (next phase) is taken.


This involves the application of a Lean tool to a process or area. In medicine, the ultimate goal is to make the patient well. In Lean, the goal is to attain a state of process wellness that allows for continuous improvement.


The old saying “An apple a day keeps the doctor away” is analogous to maintaining a healthy (i.e., Lean) process once it has been improved. In medicine, often rehabilitation, life style change, continued medications, yearly checkups, etc. are used to ensure that the ailment the patient experienced does not reappear. In comparison, this applies to process improvement. This is achieved through controlling the improvements implemented in the previous phases through effective measurements, visual controls, Total Employee Involvement (TEI), and reward and recognition from management.