Yanke Bionics Team Thrives in Tight Market

Roger Marzano, CPO, CPed

"You're only as good as those who surround you," has been the business philosophy of Mark Yanke, Yanke Bionics, Akron, Ohio, according to Roger Marzano, CPO, CPed, vice president of clinical services. "Mark has made sure he has very good people in all areas." Yanke has encouraged his staff to continue reaching standards of excellence and acquiring certification in as many areas as possible as well as licensure.

"The secrets to the company's success in a tight reimbursement environment are a highly qualified staff, efficient, streamlined procedures, and team organization," Marzano said. "We have to be very cost-effective because we have been so impacted by managed care, competition, and competitive bidding processes. We have to maximize our cost efficiency because profit margins are so much smaller, with managed care contracts coming in below Medicare allowables."

Hanger Orthopedic Group also has a strong presence in the market area, Marzano noted. "Instead of 100 percent, we need to give 110 percent to stay on the cutting edge."

To meet these challenges, Yanke Bionics provides 24-hour service seven days a week for hospitals, nursing homes, and patient home visits, plus extended hours two days a week for patients who need to come in after regular working hours. The company has an on-call team of five practitioners. Being able to provide around-the-clock service seven days a week is required for the company to get a contract with the hospital as a preferred provider.

Yanke Bionics runs a second shift from 5 P.M. to midnight. "If I cast a TLSO at 4 P.M., it's done when I come in the next morning," Marzano said.

Using a CAD/CAM spinal facility has sped up turnaround time. "Even if I take measurements for a TLSO late Saturday afternoon and fax it to the provider, I can get the device back the next day," Marzano said. "If the physician allows customizable body jackets, we can custom-fit them to the patient and get him up and out quickly."

Evolving Efficiency Roger Marzano, CPO, CPed, fits a patient with a bivalve CROW AFO and bilateral wrist sprints.

Team organization evolved with a search for a more efficient system. Originally one administrative person, acting as a dispatcher, answered all calls for practitioners handling hospital, home, and nursing home visits. However, she had to decide what calls had priority. "For example, someone wants a home visit to show Mom how to put on her TLSO, and a post-op patient in the hospital needs a knee brace in the next hour," Marzano explained. Of course, not all decisions would be that easy to make, especially when the office worker is not a clinician.

Now the work has been divided into two practitioner-office worker teams, with one practitioner handling hospital work and another taking all the home and nursing home visits. Each has an office worker who handles the incoming calls in these areas.

The new system provides a better way of analyzing the activity of each practitioner. "We go through learning curves and evolving processes as the hospital and overall health care scene changes," Marzano said. Separating a hospital team from a home/nursing home team enabled the company to be more responsive to demands. "Now the hospital says a 24-hour turnaround isn't fast enough. They want the device fit the same day, regardless of the time it was ordered," Marzano said. "A trauma hospital doesn't want patients held up waiting for a brace."

Another method of streamlining operations and maximizing time is the way manufacturers' sales representatives visits are handled. Instead of reps calling on each practitioner individually, they talk to Marzano, who evaluates the products. If he feels the products have merit and fit into the company's operations, he discusses them during a regular staff meeting.

Teams are organized on the basis of the activity performed, and staff members may be part of more than one team. Department teams include clinical services, finance, purchasing, and a central fabrication department which provides devices for other companies. Yanke has strongly encouraged cross-credentialing and training, which adds depth to the company's personnel resources. "If someone's sick, someone else is available to step up to the plate," Marzano noted. If a practitioner has a 16-patient day, another practitioner can take some of the load. "If a patient calls at 4:30 P.M. on Thursday, and has an urgent need, he can be seen Friday morning. There will always be a clinician available for urgent needs, regardless of the days' schedule," he added.

E-mail traffic has hugely increased, so Yanke Bionics has an administrative staff member and her assistant to handle patients' e-mails. Again, depth is the answer. When the primary person is absent, the assistant can take over. "That way, no communication or time is lost," Marzano said. "It's amazing how many senior citizens and disabled persons spend considerable time on their computers."

Communication Vital Technology enhances intra-company and patient-practitioner communication. All the clinicians use cell phones which serve as walkie-talkies within a 100-mile radius. The practitioners can access e-mail from the phones.

Communication is encouraged for staff meetings. All employees, even the cleaning person, can add items to the meeting agenda. "Clear lines of communication are important," Marzano said. "If people are not communicating with one another, you are not going to have a responsive, well-tuned business."

Leadership: The Right Stuff Strong leadership is vital. Marzano quoted Michael J. Fox's comment to Michael Douglas in the movie, "The American President": "In the absence of true leadership, people will cling to anyone or anything." If leadership roles are not clearly defined in the company, people will find their own, and these may not be the best for the company. "They may follow someone with the loudest mouth, who may not be the person you want to set the example for the rest," Marzano pointed out.

Yanke Bionics has a friendly, professional staff with motivated, outgoing team leaders, he added. Golf outings and other activities foster fun and camaraderie.

Yanke Bionics finds that effective teamwork helps the multi-facility company stay on the cutting edge in a competitive, cost-conscious environment, Marzano said. "As you have more offices and more geographical coverage, you have to have better systems in place."

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Related posts:

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