In O&P, innovation can start when someone notices that the way things have always been done may not be the safest—or smartest—way forward.
For Greg Mattson, CPA, CTPO, that moment came at the beginning of his career while managing fabrication operations. What began as a safety concern eventually led to a small process improvement that changed the company culture from there forward.
The Problem Hiding in Plain Sight
At the time, the fabrication lab followed a common practice of recycling used attachment blocks for test sockets. These blocks were typically attached to diagnostic sockets, then removed and prepared for reuse on future diagnostic systems.
The process seemed to involve a few manageable steps and appeared worth the effort, especially when each block cost $50-$65. Reusing the blocks seemed economical. However, the realities of carrying out these tasks created unnecessary risk, consumed time, and introduced inefficiencies that prompted a deeper analysis.
Safety Risks in the Fabrication Lab
One procedure in the harvesting process involved detaching the block from the socket, which required cutting through thick materials on a band saw with the guard raised high enough to clear the socket. Although this was the most mechanically efficient way to accomplish the task, it introduced several risks, including an exposed blade, blade flex while cutting thick acrylic, smoke and fumes from overheated materials, airborne dust, and the potential for blade failure.
Anyone who has spent time in a fabrication lab knows the smell of acrylic heating under friction. When cutting through a socket on a band saw, smoke and chemical odors often filled the room. Prying a block from a socket is also a tricky process, and it is easy for a technician’s grip to slip and cause injury. Dust from grinding reclaimed blocks spread through the machine room and occasionally drifted into patient care areas. This created a range of physical, chemical, and ergonomic risks not just for the fabrication staff but for people throughout the clinic.
One day, a technician slipped while harvesting a block and cut his hand.
The injury wasn’t catastrophic—but it was enough to trigger a detailed review of the entire process.
A Simple Idea: Eliminate the Harvesting Step
Confronted with the safety costs of a supposed money-saving strategy, Mattson asked a question: “Why?” To assess whether reusing blocks was truly saving money, the costs of the workflow needed to be fully understood. What did it mean to save? Conversely, what did it mean to waste? And, most fundamentally, why was the company doing this?
To understand waste and the ways it appears in the workplace, lean manufacturing principles, which aim to maximize product quality while minimizing cost and waste, can be a helpful reference point. Lean, as these principles are often called, is a philosophy inspired by the Toyota Production System, or Kaizen, and identifies seven types of waste:
- Overproduction
- Waiting
- Transportation
- Overprocessing
- Excessive inventory
- Defects
- Unnecessary motion1
Joshua Thornton, MS, CP/L, Sola Prosthetics, Texas, emphasizes the importance of the approach in cost analysis as he describes his own experience evaluating casting procedures. He states, “You can find numbers to prove a point, but if you truly go with an objective approach…what I did is counted.” He describes counting rolls of fiberglass, numbers of casting socks, milliliters of epoxy, and other materials down to the smallest measurable unit used in his casting process. This approach ultimately led him to propose an entirely different diagnostic socket process based on the cost breakdown.
There is a kind of delayed subjectivity in these analyses. It takes integrity and commitment to the truth to reach a point where you can look at the numbers and then ask, “Is this worth it?” This values-based question can only be considered honestly if it is preceded by a rigorous analysis. Thornton advises, “You have to come at it from a truly neutral and objective approach…. That’s the best form of research.”
Beyond precise cost analysis, one method for evaluating waste identified by lean processes involves tracing every step required to complete a task and creating a visual map of the movement of people, parts, tools, and materials throughout the process. This is known as a spaghetti diagram.2 When Fabtech applied this technique, it became clear that harvesting and reusing blocks consumed significant technician time and movement: finding reusable sockets, preparing the saw—often by installing a new blade—cutting off the blocks, grinding away residual material, cleaning and preparing the blocks for reuse, and then cleaning the surrounding work area. In many cases, technicians also accumulated boxes of used sockets because harvesting blocks was an unpopular and disruptive task. As a result, the work often piled up until someone eventually spent hours processing it.
As a result, the lab environment became increasingly cluttered with stacks of used diagnostic sockets waiting to be processed, while dust and smoke from cutting and grinding created additional housekeeping and safety concerns.
The operational impact extended beyond labor inefficiency. At times, patients arrived for appointments only for staff to discover that no prepared blocks were available. Technicians then had to stop productive work, locate an old socket, remove the block, and prepare it on demand. This interruption not only disrupted workflow but also reduced the quality and consistency of patient delivery.
The process was not just inefficient—it was unpredictable. Once the true labor costs, including technician time, workflow interruptions, overhead, and lost productivity were calculated, the perceived savings quickly disappeared. Rather than trying to eliminate every last bit of waste from the harvesting process, Mattson asked, “What if the process were eliminated entirely?”
The Surprising Financial Result
After analyzing the process and its associated costs, the company found that it was spending far more to support the reuse process than it would have spent simply purchasing new blocks. An alternative, using disposable blocks, instead of harvesting and reusing them was proposed.
As expected, some team members were initially skeptical about transitioning to single-use blocks. Purchasing a new block for every diagnostic socket appeared more expensive than reusing existing ones, and discarding something still perceived as “good” was understandably a difficult concept for many to accept.
As the analysis deepened, a pattern Mattson would encounter throughout his career began to surface. Management teams often focus on the numbers that are easily seen and measured. In the case of the attachment blocks, leadership could clearly see the material cost on a spreadsheet, so reusing the blocks multiple times appeared to reduce the cost per unit and save the company money. On paper, the logic made sense and made it seem like nothing needed to change. What was not immediately visible or easily measured were the inefficiencies: labor hours, workflow interruptions, handling, delays, equipment usage, cleanup, and production disruption associated with harvesting and reusing old blocks. Pursuing change and reconsidering long-standing habits is difficult for anyone. It takes humility, neutrality, curiosity, and genuine creativity to adopt this mindset and make continual improvement a habit.
Lean manufacturing teaches that the lowest purchase cost does not always produce the lowest operational cost. In many cases, investing more in a component, tool, or streamlined process actually has great potential to increase profitability by streamlining workflow, reducing waste, minimizing variability, and freeing skilled technicians to focus on revenue-generating work rather than minimally valuable activities.
Once the complete workflow was analyzed and the previously hidden labor and overhead costs were quantified, the results became clear. By eliminating the harvesting process, the company saved an estimated $20,000-$30,000 annually in labor, material handling, and workflow inefficiencies. More importantly, the project introduced the organization to the concept of opportunity cost—the realization that every hour, and even every minute, recovered from non-value-added work creates additional production capacity that can be redirected toward profitable output and higher-value activities. The team also benefited from reduced injury risk, faster workflows, and a cleaner lab environment—nonfinancial gains that improved everyday quality of life at work.
What initially appeared to be an increase in material expenses ultimately became a significant operational and financial gain.
The Nonfinancial Impact of Lean
The simple act of removing unmanaged, dirty boxes from the corner of the lab had an impact far greater than Mattson recognized early in his career. Looking back now after 34 years in company management, it is apparent that the boxes represented much more than clutter. They represented a passive work environment.
Idle environments are built around workarounds, interruptions, firefighting, and unmanaged accumulation. People spend their days responding to problems rather than improving systems. Over time, this creates frustration, inefficiency, fatigue, and operational instability.
By eliminating the boxes and the process they represented, Fabtech unintentionally signaled a cultural shift. This event catalyzed a new company habit of recognizing long-standing assumptions and consistently asking a simple but powerful question: “Why are we doing it this way?”
That mindset became foundational to the lean manufacturing journey at Fabtech.
Rather than waiting for major capital projects or large-scale reorganizations, the company focused on making small, continuous improvements every day. These efforts were called quick fixes—changes that could be implemented in five minutes or less and cost under five dollars to execute. In a single year, the team completed 685 quick fixes throughout the lab.
The process was much like compound interest in investing. Small improvements made consistently over time begin to accumulate, reinforce one another, and produce results far larger than any individual change would suggest. Over the years, those daily investments in improvement transformed Fabtech. The company became cleaner, calmer, safer, more organized, and dramatically easier to work in.
Lean manufacturing did not simply improve our processes—it changed Fabtech’s culture from passive, avoidant, and idle to proactive and innovative. And that cultural transformation ultimately became one of the company’s greatest competitive advantages.
Fabtech has been practicing lean now for over 25 years since Mattson’s experience with the attachment block, and another interesting byproduct of operational change is the psychological impact it has on the company. This is something that rarely appears on a spreadsheet, yet it carries very real value. In Mattson’s experience, strong work environments and healthy company cultures are more productive, more stable, and ultimately more profitable for everyone involved.
From a talent acquisition standpoint, Thornton notes that efficiency can be “more of a selling point than even the compensation.” He says that implementing lean manufacturing principles allows him to focus on the care he wants to provide, “versus being overworked and concerned with excessive waste.” The compounding effects of small but serial inconveniences, which thwart small goals over and over, causing chronic frustration. And the opposite is true for Thornton; he progressively eliminates these minor inconveniences, clearing cognitive space for him to focus attention on decisions that immediately affect patient care.
Thornton importantly recalibrates the conversation. “Yes, [the point] is to eliminate waste, but even beyond that…it’s for patient care. These things directly influence the patient’s experience with a practitioner and in your clinic at large.” The downstream effects of an efficient fabrication facility relieve frustration, increase efficiency, and reduce cognitive load for everyone involved—technical and clinical alike—which patients readily perceive.
Ultimately, Thornton rounds out his professional philosophy explaining that seeking improvement and efficiency in these independently minor tasks compounds into a clinical practice that is all about finding “sustainable ways to pursue excellence.”
The Broader Lesson for O&P Labs
Innovation in O&P is often associated with advanced materials, new component technologies, or digital workflows. However, some of the most meaningful improvements come from rethinking the everyday processes inside the fabrication lab.
In this case, the impact extended beyond the attachment blocks themselves. It demonstrated how a single operational change—supported by a willingness to question long-standing assumptions—can improve safety, workflow, profitability, and overall manufacturing performance simultaneously.
Every O&P device ultimately exists to help someone live better. Behind every successful patient outcome is a team of technicians and clinicians whose daily work makes that care possible. When we improve the systems supporting those teams, and make work safer, cleaner, more efficient, and more proactive, we do far more than improve lab operations. We improve consistency, reduce frustration, expand capacity, strengthen culture, and ultimately enhance the patient experience itself.
Lean manufacturing transformed Fabtech through hundreds of small improvements that compounded over time. The result was not only greater efficiency, but a fundamentally better place to work.
Sometimes the most important innovation begins with a simple question: “Is there a safer, smarter way to do this?”
Greg Mattson, CPA, CTPO, is CEO of Fabtech Systems. With over 34 years of experience, Mattson is recognized for advancing technical excellence, product innovation, and lean manufacturing principles throughout the O&P profession.
Kendall Brice, MS, CPO, is the education and research coordinator, Fabtech Systems.
References
- Kumar, N., et al. 2022. Lean manufacturing techniques and its implementation: A review, Materials Today: Proceedings 64:1188–92.
- Senderská, K., et al., Spaghetti diagram application for workers’ movement analysis, n.d. 79:139-50.
Opener: Fly Frames/stock.adobe.com
