By: Trude Henderson
You must always remember that, essential as it is, technical competence will not by itself enable your dental practice to realize its full potential. From our own experience, we have concluded that practices only become sustainable when their leaders model a service-oriented culture and seize opportunities beneficial to all stakeholders. This includes pinpointing and solving problems as swiftly as possible and then preventing their recurrence.
You solve a problem when you understand the relationship between cause and effect and then take appropriate action. High Reliability Organizations (HROs), defined as “an organization that conducts relatively error-free operations over a long period of time, making consistently good decisions that result in high quality and reliable operations,” ¹have a knack for problem-solving and communicating as a group, and do everything in their power to help prevent recurrence. What sets them apart is that they are consistently good. Their leaders encourage feedback and problem-solving in the work area, as opposed to the occasional conference room meeting, when appropriate. This is important for dental practices because rapid and effective problem-solving results in a better customer experience, lower costs and a stronger overall brand.
Below are 4 types of problems that dental practice leaders should consider addressing in the work area, as they arise, as opposed to the occasional conference meeting.
1. Problems of which you are certain you know the cause. If you already know the cause, it makes sense to take action right away so that the problem is less likely to be swept under the rug, and perhaps recur. We recommend that you consult the people with the most knowledge of the task at hand, then probe them regarding the possible causes of the problem, as well as possible solutions.
On the other hand, we caution you against jumping to conclusions, accepting ‘simple’explanations for problems. I recently heard about a supervisor who ran a recall report in the practice management software after learning that production had declined. The report indicated that patient recalls had been completed for the past 60 days (this practice has a policy of setting timely recalls in the practice software for every patient who doesn’t start treatment the same day; a phone call is placed for each recall and then staff checks each of them off as complete). However, the practice has a second barrier in place to double-check recalls—patient feedback e-surveys. Feedback concluded that a high number of patients had not been contacted for their recalls after all. The supervisor insisted on accepting the ‘simple answer’ (that the software was correct) but was re-directed, learning that practice software recalls can be “pencil-whipped” by personnel facing time and/or management pressures. Patient feedback— feedback straight from the source— is generally more reliable.
The HRO lesson here: look below the surface and continue asking “Why?” as many times as necessary, in order to get to the bottom of any issue. Also look for trends. Avoid a cursory problem-solving process at all costs, because it generally leads to gratuitous repetition of unwanted incidents and mistakes that cost your practice precious time and money.
2. Problems you become aware of through social media reviews and real-time patient feedback surveys. Feedback provides you with new opportunities for identifying performance gaps that merely reinforce the status quo. I recently worked with a team that received a 1-star Yelp review. A mother expressed her disappointment in the orthodontic teams’ lack of empathy for her daughter’s pain during her finishing appointment. It was true that the patient had practiced poor hygiene throughout her treatment, but the unfavorable review could have been averted via an explanation that puffy, inflamed gums are likely to bleed when braces are removed.
Nonetheless, as soon as the review was posted, supervisors and the doctor sprang into action and personally called the girl’s mother to apologize. They also hand-delivered flowers and movie tickets the same day. The upshot: mother and daughter were “wowed” by the teams’ swift response and the mother retracted the negative review. The practice manager shared the story with all locations as a pro-active ‘lessons learned’ to ensure that the same mistake doesn’t happen elsewhere.
The HRO message to staff and doctors is: “when you lose focus, you lose value.” We would add: remain mindful and deeply concerned about complacency, routine and lack of engagement — treat others as you would want to be treated.²
3. Problems directly affecting your customer experience. Given the amount of touch points, devices and time patients are exposed to during treatment, there are many opportunities to improve their experience. The more objective insights (e.g., those gleaned from patient feedback via e-surveys) you have, the more likely you are to ensure that your patients are valued, appreciated and well cared for.
We recommend that dental practice leaders address customer service concerns immediately, which sets a good example for staff and doctors by signifying that problem-solving is a high priority. In addition, on-the-spot coaching can be useful in addressing the shortcomings noted from person-to-person, team-to- team, and office-to-office, as well as those identified in patient feedback surveys. Prompt but tactful reactions, in the form of positive coaching, can result in enhanced staff accountability and faster results.
Please Note: we caution you to make sure that all conversations regarding these matters are out of earshot of your patients.
4. Problems having a negative impact on employee morale.
Conflict is unavoidable in your dental practice, but the faster you address problems, the more likely you will be to prevent them from affecting individual and team morale, not to mention the customer experience and your organizational objectives. Every year, I meet new supervisors who express surprise at the number of ‘people problems’ they encounter daily. One of them told me recently, “If I had only known that dealing with people was going to be such a frustration and hassle, I never would have become a supervisor.” Leaders with weak or underdeveloped leadership skills often have difficulty dealing with people, failing to realize that embracing conflict is part of the job. Poor employee attitudes can affect the morale of your entire team and we can guarantee that this will have some level of impact on your customer experience, as the two go hand-in-hand.
We recommend that you have a good set of pre-defined behaviors or principles in place that set the bar high, as well as systems that align with them.³ For example, your hiring process should consist of a set of pre-defined principles and expected behaviors designed to ensure that your organization achieves its goals. And one of the most important decisions you, the practice leader, can make is to insist that the right people with the right skills are hired or promoted into the right positions, including leadership positions. If someone was hired or promoted before you became the boss and you discover that they are not the right fit, it is in the best interests of your position and the practice to remove and replace them as soon as possible.
Unfortunately, it is not always easy to undo a bad hiring decision, but the consequences of ‘making do’ or ignoring the problem can be far worse. Furthermore, doing nothing will likely result in organizational decline, due to increased turnover, and poor employee engagement, team development and performance, just to name a few of the possible implications.
We repeat: the work area (including your dental practice’s front office and clinical areas) is the place where work gets done and the only place where value can be added to your dental practice and customer experience. You’ll be surprised how much problem-solving in the work area, geared towards continuous improvement, contributes to the high impact value delivered to the customer.
For more information about High Reliability Organizational concepts, read our previous blogs:
Watch the video by Dr. David Shen on this topic:
Connect with Trude Henderson on LinkedIn