Outsourcing—Converting Clinical Goals to Fabrication Solutions

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By Andrew L. Steele, MBA, CPO

When asked about the attributes of a quality fabrication outsourcing center (i.e., central fab), we all agree that a quality product in a timely fashion is a must. With the ever-increasing number of fabrication outsourcing centers, how does a discerning practitioner choose a quality central fab?

Among the top nationally recognized fabrication facilities, product differentiation is becoming less of a factor. So what differentiates the superior fabrication companies from the mediocre? The critical factor is clinical support. Every practitioner needs to know that there is someone on the other end who has been through the challenges of delivering orthotic and prosthetic care. It is also vital that practitioners have a person they can call who understands the various situations and can convert clinical goals into fabrication solutions.

One of the barriers keeping many practitioners from outsourcing their fabrication is the loss of control or lack of personal supervision. Therefore it is vital to have a clinical liaison who you can communicate with and trust to make sure your job gets fabricated correctly in a technical and clinical sense. The old adage goes that anyone can learn to do an appendectomy; the value in having a doctor do the procedure is that he or she knows what to do when things go wrong and knows what not to do.

The same can be said when outsourcing fabrication. We can teach anyone to make a device--the value in the service lies in an awareness of how each device works from an anatomical and biomechanical perspective. Maybe even more important is knowing what can reduce the effectiveness of a component or cause the device to be rendered useless. Each fabrication center needs a staff person with clinical expertise willing to jump in and brainstorm new ideas and monitor the fabrication process. This person should also be familiar with the wide array of components on the market and demonstrate the ability to combine fundamental skills and new technology to create superior solutions.

In most cases, mistakes made in fabrication are communication-related. Often, a lack of information needs to be followed up with probing questions from someone familiar with a specific diagnosis or how a particular device should be fabricated. You must communicate with the outsourcing center just as you would your own internal technician. Anything short of this will set up both parties to fail.

Of course, there needs to be an efficient blend of clinical support and technical expertise. One without the other is worthless. The clinical support contact needs to act as a facilitator, helping both the practitioner and technician to understand each other's needs in order to create a quality outcome on time. The motto at O&P1 is:

"Your clients' satisfaction, your professional reputation, and the

success of your business all depend on your ability to deliver what you promise. It's our job to ensure that this happens."

Your organization is only as good as the people who support you. Fabrication support should not be a missing link, but rather, the jewel in your crown.

Andrew L. Steele, MBA, CPO, is vice president of Orthotics and Prosthetics One Inc., a prosthetics and orthotics outsourcing center in Waterloo, Iowa. He is also a partner at Clark & Associates Prosthetics & Orthotics, Waterloo. He has been a lecturer at regional and national meetings and a guest lecturer at the university level.