Our Methodology

Coleman Associates founder Roger Coleman, who created Patient Visit Redesign™ in 1993, talks about its origins:

In January 1993 I read two books that forever changed my thinking about health care delivery. The first was Michael Hammer's Reengineering the Corporation. The second was The Wisdom of Teams by two former McKinsey consultants. I was so excited by this stuff that I immediately sketched out a training program that fused these two concepts of reengineering and self-managing teams.

"I wanted an alternative to the consulting approach which generated invoices and impractical recommendations but rarely solutions. I wanted a program that would build within the organization an internal capacity for patient-focused change. By trade, I was a manager, not a consultant. It was important to me to develop something I would have been excited about as a CEO.

In May 1993, we trained our first redesign team in Austin, Texas: The Phoenix Team. This team successfully redesigned the adult primary care visit in a city health department facility. The excitement among managers, team members, and staff was palpable, and the results profound."

Coleman Associates has been honing our work process design training programs ever since. Our method has magic to it because we train the redesign team to focus like a laser on the needs of patients. This focus reignites the passion for patient care that most staff members initially brought to their jobs but have often lost over time. Team members put their own needs aside and openly work together to create a patient experience that's truly satisfying. This work is intensely serious and exciting.

That's why our method works.

Within two weeks of their initial training session, redesign teams conduct their first Rapid Redesign Test (RRT). For three hours they see patients using the redesigned patient visit process. Teams often say after their first clinic test: "This stuff works!" Indeed it does.

How does our method work?

The Twelve Key Elements in our Clinic Redesign and Patient Visit Redesign™ Collaborative programs are what make it happen:

1. Top managers sincerely and genuinely commit themselves to radical redesign and dramatic change. Commitment means saying publicly: "Failure in redesign is not an option. Period." There can be no wavering of commitment in the face of other priorities.
2. Five stellar reengineers are selected by you to form your redesign team. We will let you select only staff members who possess the characteristics of successful reengineers. Redesign teams typically are a mix of managers and line staff. Larger organizations may need multiple teams.
3. Top management guarantees redesign team members four hours per week "offline" from their regular responsibilities to do redesign work for the entire duration of the program. That is six months. Almost half this "offline" time is spent in redesign test clinics.
4. We teach team members to track and map patient visits, so they see firsthand what it's like to be a patient in your setting. This work is the foundation for truly understanding the current visit process. It is magnificently revealing.
5. In a 1.5-day Learning Session, your team learns how to radically redesign the patient visit and how to test the new redesign.
6. During the eight-week Action Period that follows the Learning Session, redesign teams conduct eight Rapid Redesign Tests (four-hour clinic sessions with one or two Patient Care Teams). Patients are thrilled with "the new way" and let you know it. We coach your team through this Action Period.
7. In a second 1.5-day Learning Session, the team learns how to implement the model across the site, and how to train and coach other staff.
8. The team and managers now work closely together to finalize the redesign and run final test clinics.
9. Using our Economic Impact Analysis methodology, you determine if the redesign model is economically viable. If viable, the team presents the final redesign model and results to top managers.
10. Top managers determine whether the redesign will be implemented site-wide.
11. The redesign team and managers proceed to orient, train, and coach all staff to work according to the new model.
12. The team and managers participate in a final one-day Learning Session. Participants learn to troubleshoot remaining barriers.

Strong evidenced-based didactic material. Fun learning sessions. Passionate coaches. Twelve years of experience. And an 80 percent success rate. That's why we're the national leaders in Patient Visit Redesign™.

On average, redesign teams reduce patient visit time by 33% and increase productivity by a corresponding amount. Our top quartile teams slash patient visit time by over 50% and increase productivity by a similar proportion. We've seen this happen in organizations of all sizes, from clinics with seven staff to hospital OPD behemoths. Our Patient Visit Redesign™ methodology is so successful that we've applied it to increasing financial performance (RevMax Collaboratives) and social service redesign.