Written by Bradley A. Dykstra, DDS, MBA Wednesday, 31 August 2005 19:00
Practice management consultants recommend that one of the ways for dentists to have a smooth-running practice is by conducting regularly scheduled staff meetings. This concept is very reasonable and not a difficult initiative to grasp and attempt. Any dentist or staff member who has attended a practice management seminar is familiar with standard recommendations of how to conduct staff meetings and how to institute them in the practice. Dentists are generally advised to rotate facilitators, who will lead each meeting and cover things such as schedule changes, systems changes, verbal skills, and a review of monthly monitors, and, in effect, deal with all the minor things that routinely cause stress in the office before they become major issues.
One of the problems that may develop with this method is that the discussions frequently get off track because the designated facilitator may have no vested interest in the outcome or has had little or no guidance in conducting the meeting in a way that keeps the discussion focused and heading in the right direction. Often this type of meeting results in venting by the staff or the doctor. The meetings habitually turn into ineffective gripe sessions, and the doctor finally abandons the idea of holding staff meetings altogether.
Another major consideration for the doctor in making the decision to hold regularly scheduled staff meetings is that they can be very costly to the practice. Will the perceived benefits of the meeting be worth the time and money invested? The doctor's cost for these meetings is not only the sum of the attending staff members' salaries (which is considerable, especially in offices with larger staffs), but also the lost profit during this hour or 2 of missed production time. Add these costs together with the preparation time and the amount of money the doctor spends for lunch for the staff, then multiply this each month by the number of meetings you schedule, and a picture of the true cost begins to emerge. Objectively, looking at the economic cost for the little bit that is accomplished in addition to the stress level that is caused by the gripe sessions explains why staff meetings are often discarded.
The reality is that regular staff meetings are important for the office to function smoothly. Having a well-organized, highly profitable, and low-stress office does not simply happen by chance. Conducting meetings in a new format that complements the totally digital office is a way of taking the traditional staff meeting and raising it to a whole new level. The digital staff meeting now becomes a genuine staff learning session. This is an effective and efficient method that allows more to be accomplished in a shorter time frame. The name for this new concept is "the digital staff learning session," and it causes us to alter the paradigm of how we view the way we conduct our practices.
An important component of making this system successful is to begin each day with a short morning meeting or "huddle" to develop strategy for the day and deal with all the little things that constantly come up. When the minor annoyances are dealt with as they develop, they do not grow into major blowups later. This allows the semi-monthly staff meetings to become effective staff learning sessions.
GOALS FOR THE DIGITAL STAFF LEARNING SESSION
The goals for the digital staff learning session are more expansive than the traditional staff meeting. The main objective is to use the time for real staff learning and growth so the doctor, staff, and patients all benefit from this time, and the cost of the meetings becomes an investment instead of an expense. This learning time may include items such as the introduction of new materials like a luting cement or bonding agent, a visual demonstration of their proper use, changes or additions in clinical or business procedures (such as adding a digital patient education system or a new patient finance program), communication skills, or personal or professional growth skills.
An office that implements the totally digital patient record system quickly finds that many of the distinctions that existed between the front office duties and operatory duties such as appointment scheduling, case presentation, patient education, and treatment planning become blurred. Because everyone's range of duties expands and becomes more intertwined, it is important for the whole team to be on the same wavelength and to arrive on the same page quickly and easily. When everyone hears and sees the same information on the screen or watches the same demonstration on such things as scheduling a recare visit or mixing and using a new type of encapsulated cement, there is a common starting ground, and any confusion or questions can be dealt with immediately. Again, this is very important in the totally digital or paperless office because the distinction between employee duties in the front and the back is continuously being diminished. Any employee should be able to answer any patient's questions and should be completely knowledgeable about all procedures done in the office.
One demonstration of how to use this new staff learning system is given in this example of what happens when the office starts restoring implants. During the first couple of procedures, a staff member takes digital photos of each step of the procedure, from taking out the healing cuff all the way through the impression process and replacing the healing cuff. Photos are also obtained of each of the implant instruments and implant components used. The process is repeated at the seat appointment with photos taken at each step of the procedure. Once all the necessary photos are taken, they are imported into a PowerPoint presentation, where brief explanations or labels are attached. Copies of the appropriate digital radiographs are also imported, showing the complete seating of the impression posts and permanent posts. Combine all of these with quality before-and-after photos taken with both a digital extraoral camera and intraoral camera, and you have for the whole staff a photographic demonstration of the implant procedure from beginning to end.
Once this PowerPoint presentation is completed, it is then shown at a staff learning session. Now every person in the office understands the steps involved so they can confidently answer patients' questions about implants in the office or on the phone. This is beneficial for proper scheduling, treatment acceptance, and room setup. If anything in the procedure changes in the future, the new steps can be inserted and the outdated ones removed.
Once this project is compiled it can be used in several other formats in addition to the staff learning session. In PowerPoint notes page view, each step can be spelled out in detail and can be used either on a staff training CD or printed out and placed in a training manual to instruct new employees as they join the practice. It can also be adapted for patient demonstration CDs or information booklets placed in the reception room.
THE MANY BENEFITS OF DIGITAL LEARNING
There are several other benefits of holding the meetings in this format. Since the meetings are clearly thought out ahead of time, the agenda items are prioritized, the most important items are covered first, and time is not wasted on unimportant things. If the discussion should get off track or stalled, it is easier to get back on track by just advancing to the next slide and bringing the staff back to the focal point of discussion. This format prevents the meetings from becoming gripe sessions, which waste time and raise everyone's stress level unnecessarily, and allows the time spent in these meetings to become profitable, both in economic and personal growth terms. An unexpected benefit is that the meetings are now all clearly recorded and organized, which allows for future review, reference, or clarification.
Most of the items necessary to conduct a digital dental staff learning session should already be in place if the office is paperless. The technology tool list includes the following items:
(1) A computer equipped with Microsoft PowerPoint and Excel, preferably a laptop, with a remote clicker and laser pointer.
(2) A wireless keyboard and mouse so a staff person can immediately record brainstorming or action items.
(3) A large-screen TV monitor or a digital projector and screen or large area on the wall for projection to allow easy viewing.
(4) A room large enough for staff to fit in comfortably, preferably with lights that will dim, and a conference table to use for workspace during staff exercises.
(5) A way to hook into the office server, either wired or wireless, to access patient digital records, radiographs, photos, the schedule book, production or patient monitors and graphs, or anything else to be included in the discussion. This assumes also the office is totally digital in its practice management software with clinical charting, radiographs, photography, and patient education systems.
The logistics of the meeting are really quite simple, and most of the necessary tasks can be delegated to the appropriate staff members. The doctor sets the preliminary agenda with input from the staff, and all contributors are notified regarding what is expected from them as well as the due date. Each presenter submits information on PowerPoint slides one day in advance of the meeting to the doctor or designated staff member, who then puts the agenda items on PowerPoint for the meeting. This format gets everyone involved because those in charge of each area leads their respective part of the meeting. The scheduling coordinator reviews any upcoming schedule changes, days out of the office, and continuing education days for the doctor or staff. The patient relations coordinator reviews new-patient monitors, presents marketing programs both internal and external, and shares any upcoming theme days or special events. The hygienists or assistants lead through their respective clinical sections, and similarly, the doctor leads through his or her appropriate sections. There are many ways to keep the session interactive; it should not be a boring lecture.
The content and format of these staff learning sessions can be as creative as you want to be. Following is a list of possible items to include in these meetings. Time constraints prevent doing all of these each meeting, so make each meeting different and include only the most important items.
(1) An inspirational quote is frequently a way to get the meeting off on a positive note.
(2) A section of the mission statement should be reviewed followed by a 5-minute discussion of how well you are living up to it or what areas need to be improved to do so.
(3) A quick review of the schedule, especially any changes in the near future, is often beneficial.
(4) At the monthly numbers meeting, trends and monitors with graphs can be imported from Microsoft Excel and reviewed. It is then easy to see if you are on track month to date and year to date. If not, an action plan can be developed to get back on track.
(5) Showing upcoming case presentations to staff with before and imaged photos complete with appropriate music prepares them for the upcoming patient visit and facilitates treatment acceptance.
(6) It is easy to demonstrate scheduling guidelines and how to schedule efficiently and effectively by showing examples of excellent and poorly scheduled days.
(7) Digital radiographs can be brought up on the screen to demonstrate the importance of open contacts, correct angulations and exposure, and showing examples of what is clinically and diagnostically acceptable and unacceptable.
(8) Any new system or change can be clearly shown and explained.
(9) It is common knowledge that a picture is worth a thousand words, and this is definitely true in a dental office. Photographs of oral pathology or laser surgery are reviewed when appropriate.
(10) This format also facilitates role playing and aids in reviewing scripts and practicing verbal skills.
Because digital meetings are well planned, organized, and clearly thought out, it is easy to stay focused. If the discussion goes off on a tangent, it is easy for the facilitator to return to the area of focus by just advancing to the next slide and moving on in the learning process. The decisions made, action items, to-do lists, or items from brainstorming or brain-writing exercises are immediately recorded and projected for everyone to see, and an accurate history of the meetings is saved and recorded for future reference. The staff meetings are now focused, effective, efficient, low stress, profitable, and even enjoyable.
Dr. Dykstra started his solo dental practice in 1978 in Hudsonville, a small town in western Michigan. His original office was expanded 3 times, and in 1994, he built his dream office with just more than 3,800 square feet of working room. Dr. Dykstra's practice is in the top 1% or 2% of production and collection of solo practices in the United States. His overhead is consistently in the low to mid 50% range. He went paperless in the fall of 2002 and has successfully incorporated total electronic records with digital clinical charting, digital radiography, digital intraoral and extraoral photography, and digital imaging. He added a laser to his practice in 2003. In addition to working full time in his practice, he speaks and consults in the area of successfully integrating technology into the dental office. He can be reached at (616) 669-6600.
- Clinical Update
- CE Articles
- Dental Materials
- Dental Medicine
- Digital Impression Technology
- Forensic Dentistry
- Geriatric Dentistry
- Infection Control
- Interdisciplinary Dentistry
- New Directions
- Practice Management
- Oral Cancer Screening
- Oral Medicine
- Oral-Systemic connection
- Pediatric Dentistry
- Pain Management
- Post-and-Core Technique
- Sleep Disorders
- Sports Dentistry
- Technique of the Week
- Treatment Planning