In quite a few of the articles Sabri and I have written, we’ve hit on how “change” can negatively impact your practice, crash statistics just plain wreck an area of an organization.
Simple things like changing your marketing, staff functions, new office policies, etc. can inadvertently bring about disaster – even though they may have seemed to be a “good idea at the time.”
That said – when you’ve rolled up your sleeves to figure out what’s wrong with a particular area or statistic, there’s another angle (in addition to change) you should consider:
There’s a possibility that a core process or function in your practice that you “assume” is implemented or being done – is not actually being done.
In other words, no one made a huge “change,” to something like marketing, scheduling procedure, etc. Instead, something you expected was always being done, and maybe had been for years…isn’t. It, unbeknownst to everyone just stopped. Maybe you have a ton of cancellations all of a sudden. You assume confirmations are happening – because “we always do that.” Looking further you find – they are NOT being done.
What’s not being done might be so simple, and so ingrained in the practice that people don’t even bother to look – you know the: “we always do that’s.” It might be something so basic that you might almost feel stupid for asking
Regardless of how you feel about it, keep this in mind: any investigation of a failing statistic or area HAS to include a thorough inspection to see if “we always do that’s” are actually being done!
I say this – because I’ve lived it.
I can’t tell you how many times in my career I’ve found something which was dropped out in an area that was so basic, so “common sense” that I had a hard time even imagining how it happened. But….it did!
With this in mind, the next question might be: Why? Why does this normally happen.
My answer: I have no idea. Just kidding.
There can be any number or reasons things like this happen. Many assume the number one reason is a “problem” employee. And while this can be the case – it’s actually in my experience NOT the most common reason. The more common culprits are:
- Lack of policy on the subject.
- You have policy – but it’s not very clear.
- No one is trained on this policy.
- There’s no system of checks and balances to ensure these policies actually stay IN.
Let’s have a look at each.
1. Lack of policy on the subject.
The idea that you’d have to write policy is probably not a foreign concept. Policy is good – right? But how detailed should you go? A lot more than you might think.
You really cannot have too much of this stuff. And once you knock out the “big” stuff – i.e. financial policy, scheduling policy and so on, it might be time to move down through the organization and codify…everything.
For instance, do you have a policy on how your phone is to be answered? Does it include what the receptionist should say and how they say it? It might seem stupid…I know – but why not? Beyond the fact that you at least have a written record of what you want done when someone calls in, policy serves a number of other purposes. Not least of which serving as a means to detect problem employees – i.e. someone who cannot follow good policy!
In any event, I’d approach this from two angles – start with writing policy on the major subjects/issues in the practice – e.g. financial policy, scheduling policy, customer service, etc. At the same time, keep an eye on any area that gives you trouble – it might need some policy!
Of course, you’d want to also ensure this policy is accessible to your staff and keep in a central location as you build your policy library. And don’t be disheartened – if you have little to none, you have to start somewhere. Policy written every other working day would give you about 100 a year – 500 after five and so on – that’s quite a resource.
2. You have policy – but it’s not very clear.
So, maybe you have policy, but it’s not very explanatory or clear. OK, fix it. You don’t have to be William Shakespeare, meaning I don’t care how “well-written” it is. As long as people can understand (and more importantly) apply what you are writing. It doesn’t even have to be pretty. The biggest error I’ve found with this is that people have a tendency to “under-explain.” Don’t do that. If it’s going to take three pages to explain a procedure…do it. Don’t write one and wonder why no one can do what you wrote about!
3. No one is trained on this policy.
Policy is useless if it’s sitting in a box or binder. People have to KNOW what they are supposed to do. Assuming you
- Have policy and
- It’s clear
Then training people on it should not be a huge issue. And here’s where the proverbial “rubber meets the road.” Assuming someone has read and can apply what you’ve written, you now have something “in” which should stay “in,” (not always…but more on this next). It also opens the door to another important lesson: Let’s say a staff member studies and theoretically can apply your policy – but they don’t. Assuming it’s sensible policy you may have a problem with the employee! A problem you would have no idea about in the absence of sensible company policy.
How to train? Well, carve out a little bit of time each week. If it’s something important and a core process of an employees’ job then maybe you have them do it before they start that day.
And of course, you might have to have an employee study, then answer any questions and maybe work with them a bit to ensure they are applying correctly – e.g. answering the phone, handling a new patient call, etc. Assuming they pick up OK and know the right way versus the wrong way, you’re in pretty good shape.
Now, 1-3 puts you in a position where you have someone trained to do what they are supposed to do. Great right. After all, no one EVER stops doing what they are supposed to do! Yeah…and that leads us to…
4. There’s no system of checks and balances to ensure these policies actually stay IN.
Core processes (clinical and management), i.e. treatment, handling new patients, scheduling and collections are called “core” for a reason. They are vital to your practice’s survival. With that in mind, it makes it well worth it to you that they NEVER drop out. So, you write policy. You train people on it. Now what?
YOU PUT A SYSTEM IN PLACE TO MAKE SURE THESE THINGS NEVER, EVER DROP OUT!
How you do this depends on what process we’re talking about, but it should be simple.
Let’s take for example how new patient calls should be handled. Assuming you have policy and training done on this, how would you keep an eye on it?
Couple things I would do:
- Have these calls recorded for regular review (and correction) – maybe once a week or every two weeks – as a note ensure you have the infrastructure in place to record people legally – it’s simple and whoever you work with on this should have what you need.
- Keep statistics and review (weekly) calls in versus patients scheduled (and arrived).
- With a newer employee on this job – increase the frequency of these checks until you are certain they are capable.
You could follow a similar pattern with scheduling, collections, etc. In the end, it shouldn’t take you more than a few minutes a week to stay on top of this – but it can save you hours – maybe days – worth of work! And as an executive – this is your JOB! And of course the more you get trained – like on the MGE Power Program (had to plug something in this post) the easier it is to handle.
And keep in mind, nobody’s perfect. You will make mistakes. We all do. I don’t fault any of my executives on making a mistake – I’m more interested in “recovery time.” Do they recover (and does their area recover) quickly.
I hope this helps. If you have any questions, or would like to know more, please feel free to email me at firstname.lastname@example.org