Outsourcing—Converting Clinical Goals to Fabrication Solutions
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. 
Table Of Contents - August 2003
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