In the early days of my rehab practice I knew exactly what to do and how to do it. I solved problems as they arose, and it was all so easy because there was only one person – me.

As my practice grew and I started employing people, life started to get more interesting. Things would go wrong, staff members would panic, and stress and strain became a daily part of all our lives. I thought this was all part of running a business. I had not learned yet that delegation, processes and systems are integral to a smooth-running operation and can make daily life, if not exactly a breeze, certainly a lot more enjoyable.

Being the Center

The trouble was that I was the center of all activities, the one who knew every task and made all the decisions. It was exhausting having to orchestrate each day’s activities; always having to be the one with the solutions to every emergency. I realized that if I did not delegate some responsibilities, they were going to be mine – and I had far too many.

I realized how central I was to every task the day I went into premature labor and, without warning, my staff found themselves floundering, alone with no direction and totally ill-prepared to take over my functions. They had roles and responsibilities, but I had never documented the roles precisely or updated them as things changed. As a result, even after I got back to work there was cross-over of staff members’ roles, with many roles going unfulfilled. Naturally, when there were jobs that no-one felt responsible for, they fell to me. It was really a ‘flying by the seat of your pants’ approach, and not very efficient or much fun.

Systems are Essential

I quickly learned that I needed to get out of the position of kingpin in the middle, learn to delegate responsibilities, and develop efficient systems.

If we don’t have systems, we create extra work for ourselves. Some of us are too busy to work out efficient systems, and we’re over-busy partially because we have not worked out an efficient system; a typical catch-22 situation.

The only way to build something that has the potential to grow bigger than oneself is to put into place systems and processes, and then delegate responsibilities and tasks. We cannot remain central to every process. If we do, we become the limiting factor to our business’s growth.

I learned the systems and processes that I needed to run the business more efficiently, and now I could not run my practice without them.

Write it Down

Most of us have some idea of a system and the processes we need to run the business; the problem is, it’s all in our head. We have to get it down on paper. Writing it all down forces you to think through every detail clearly; to imagine eventualities and come up with processes that accommodate those eventualities.

Documented systems also:

  • streamline procedures
  • optimize your time
  • decrease stress
  • improve your practice efficiency
  • help to train new employees
  • help to scale your business

A documented system clarifies roles, eliminates panic, prevents unnecessary stress and ensures continuity when a staff member is absent. It also fosters the kind of harmonious environment in which most of us – rehab practitioners, clients and animals – would prefer to spend our time.

Picture the Unexpected

When planning your system, picture the kinds of unexpected emergencies that can so easily occur in a rehab practice:

Electricity goes off and the phone lines are down (this may apply more to some countries than others): Do you have a cellphone number as an alternative number for the practice, is the number communicated to clients, and is the cell phone associated with that number kept charged at all times?

The underwater treadmill breaks down: Do you have a system in place for contacting clients when appointments need to be cancelled? Who is responsible for this?

Your computer crashes: Will you lose everything, or do you have a back-up system in place? It is essential to regularly back up all documents and invoices; do this on a daily basis or use a cloud-based storage system, such as Google Drive or Dropbox.

Think about all the emergencies that you have had in the last month and brainstorm how you intend to handle them if and when they occur again. Every time you encounter a new emergency, think about how you handled it and document the process in a simple step-by-step way, so that any member of staff can read and understand it.

Documenting an Efficient Process: the step-by-step way

A well-run rehab practice is a network of different processes particular to each function. The best way to document these processes is to have each person do their various tasks and take notes on what they did. Start with yourself:

  1. Do a task and write down each decision you made and action you performed in simple, easy-to understand language. Break the task down into steps, and number each step.
  2. Do the same for all the tasks you perform during a typical day, even the seemingly insignificant ones.
  3. Keep it very simple and easy to understand. Someone who has no idea how to do your job might have to read your notes and perform the tasks one day. Therefore avoid acronyms, complex concepts and assumptions. Write the steps down clearly and in detail.
  4. Have a team member or family member attempt to follow the notes and do the tasks you have written down. Be with them as they do this and answer any questions they might have. The fact that they have to ask questions indicates that your notes are not clear enough. No questions should need to be asked. Use their questions as an opportunity to refine and improve your notes.
  5. Get each person in your practice to do exactly as you have done. Let them take detailed notes on each task they perform in a typical day, and have them test out their notes with a colleague (who could be you).
  6. Evaluate your processes: Some of your systems will be effective and others will not be. You’ll need to change the ones that aren’t. To identify what specifically needs to change, try and locate where in the process a sense of stress arises. Think about why you sense stress and what you could do differently so that the task is possible without it.  Try it out and alter your notes accordingly.
  7. Visuals help clarify the process; use visuals, screen shoots or videos to augment your notes.
  8. Store all notes on processes in Dropbox or Google Drive, so that team members can access them easily. Also store all documents that the practice needs in the cloud. Now test each process again with someone who is not usually involved in that process. Remember, the aim is to enable any staff member to easily step into the shoes of any other staff member. It must be simple and easy to understand.
  9. Lastly, delegate ownership of the process. The person to whom you delegate becomes responsible for continually updating the process, as and when problems becomes apparent.

Communicate

It sounds so simple, but communication is the area that usually trips us up. Ironic, because there are so many means to do it.

A great way to keep everyone informed is to create a WhatsApp group and use it. Videos of patients can be shared and any concerns or emergencies can be posted, alerting everyone to what needs to be done. A WhatsApp group is especially useful when one has part-time staff.

Keep it Going

Practices should continually strive to improve their processes. Getting processes documented will not be an overnight fix, especially if you already have staff members. But it will yield results in the end. For those who are one-man bands, implementing processes and systems is a lot easier; you’re in the ideal position to start documenting processes and updating them as you expand.

If you ever want to sell your practice, documented processes will help; they enable a potential buyer to see themselves stepping right into your shoes and running the business successfully.

Life is complex enough. Make it easier for yourself and your staff by investing the time required to work out optimal processes and to document and store them accessibly. It’s hard work at first, but believe me, it pays off in the end.

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