Allergy and Respiratory Center
Health Care

Dr. Given credits success of the Allergy and Respiratory Center to the concept of Kaizen, a Japanese term for continuous gradual improvement in work processes, and a visit to Disney World fifteen years ago. “My children enjoyed the rides and the Disney characters. I appreciated how investment, planning and careful execution could result in such a high level of efficiency and professionalism of the entire customer experience.”

From that point began the practice of weekly office meetings with both business staff and patient care personnel. In an atmosphere of mutual respect, they focus on providing quality patient care and respect, managing each step of the patient experience from the time the patient walks into the office until the time he or she leaves. A sampling of these steps include filling out forms, telephone contacts, payment arrangements, medical interview process, medical education, patient communication techniques, medical record keeping, prescription writing and scheduling appointments. “Through the analysis process, improvements can come in a number of ways – first, a step in the process may be no longer necessary, second, it could be done better, third, it could be done more easily, forth, it could be done by another worker, thus freeing a higher paid or more skilled worker to focus elsewhere or fifth, it could be a process that may lend itself to automation. By continuously reviewing our processes, we find improvements in all these levels,” says Given.

Patient care is quite different in his office. The entire office works on a Microsoft Windows NT network and utilizes a computerized medical program to create, store and retrieve patient medical records. Each nurse works from his or her own exam room equipped with PC workstation and printer. “In the field of allergy, there is a need for a lot of discussion between care giver and patient. We know that it is important to spend as much time as needed with each patient and yet, for me to do that by myself with every patient is just impossible.” Their response has been to invest in a high level of training for nurses. Equipped with this knowledge, technology and support, the nurses perform much of the interview and education processes. Dr. Given and his Nurse Practitioner are then able to focus on those elements of the evaluation – physical examination, clarification of diagnosis and treatment issues, prescribing of medications and whatever else may require their special skills or knowledge. An approach seems to be working “Everyone seems to win with this approach Patients appreciate the unhurried atmosphere and the emphasis on listening and explaining, nurses enjoy the face to face time with the patient and Joe (Nurse Practitioner) and I enjoy the role of teacher and supervisor” says Given.

“We began working on this in 1996 when there were no electronic medical records! We were flying by the seat of our pants but it was fun! It was very costly but the result has been a program that really fits our needs and our style of practice.” Given points out benefits to automation of medical records such as reduced cost of medical transcription, reduced needs for storage of paper charts, reduced errors and improved overall efficiency.

Asked for advice, Dr. Given answers “There is no one rule but some points that have proven helpful to us are to determine what makes your product or service unique or superior. Hire as many smart people as you can afford. Constantly analyze and improve your business or production processes. Share knowledge with employees and encourage them to move up their levels of responsibilities. Look for applicants with a good attitude, natural intelligence and a willingness to learn. When business processes are broken down into well-defined segments, individuals who may not have completed an advanced degree can become excellent employees.

Dr. Given considers himself very fortunate. “I’m happy to have a job I love and people with whom to share it.”