McKenzie Newsletter 468

3 Steps to Establish Performance Expectations
by Sally McKenzie CEO
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It stands to reason that most dental practice team members are far more likely to succeed when they know what is expected of them, when there are goals they can seek to achieve, when they are part of an overall effort to attain a common objective, and when they know what path to follow. It seems so profoundly simple and obvious, as fundamental as turning on the lights, unlocking the doors, and opening the practice for business each morning.

Yet this simple concept is often lost on dental practice owners. Commonly, the assumption is that employees “instinctively know” what is expected of them, particularly if they have worked in another practice. McKenzie Management consultants walk into countless offices in which the doctor can’t understand why employees don’t just “do their jobs,” and employees can’t understand why the doctor “won’t tell them what s/he wants.” Consistently, the culprit is lack of or weak performance measurement systems. Successfully measuring employee performance requires a clear and well defined strategy, and it starts with three key steps:

Step #1 - Create Specific Job Descriptions
Define the job that each staff member is responsible for performing. Specify the skills the person in the position should have. Outline the specific duties and responsibilities of the job. Include the job title, a summary of the position, and a list of job duties. This can be the ideal tool to explain to employees exactly what is expected of them.

For example, your dental assistant’s job description should include points such as attending beginning of the day meetings, completing case presentations, reinforcing to patients the quality of care delivered in the practice, directing the doctor to check hygiene patients, completing post treatment care calls, converting emergency patients to new patients, turning the treatment room around promptly, etc.

Avoid the common yet dangerous pitfall of overlapping job duties. Instead, cross-train so that each area has coverage when the point person is out ill or is unavailable. If you overlap duties, employees are given tasks but not responsibility. Consequently, the team member quickly becomes frustrated. S/he wants to take ownership for a particular system, but can’t because it’s not “her/his system” to oversee. It’s simply not in the practice’s best interest to have multiple people responsible for areas such as collections or scheduling.

Step #2 - Lay The Groundwork For Success

Provide the necessary equipment and tools to perform the job
Provide training to help team members carry out the job duties most effectively
Evaluate the number of staff to ensure it is adequate
Explain what is expected of the employee and how their performance will be measured

For example, if you are measuring the performance of your dental assistant, you should be able to see the distal of the cuspid on every bitewing X-ray, you should never have to reach for an instrument on any setup, and the molds the assistant pours should be free of defects. In addition, if you expect your assistant to achieve an 85% case acceptance, s/he needs to know this. If it’s your expectation that s/he give a daily report on post-treatment calls, s/he needs to be told. If you expect her/him to convert 75% of emergency patients to comprehensive exam patients, and that s/he is to keep the cost of dental supplies at no more than 5% of practice collections, make sure that direction is abundantly clear to the employee.

Step #3 - What Gets Measured Gets Done
Appraise employee performance using an effective performance appraisal instrument that evaluates key areas such as:

The employee’s ability to follow instructions
Their willingness to help others and cooperate with others
The incidents of errors in their work
Their initiative, commitment, and innovation in carrying out their responsibilities and improving work flow
Their work ethic, attitude, and individual productivity

When you provide your team with clear direction they have the opportunity to do more than just perform a task. They can excel. Remember, the vast majority of employees want to deliver a quality work product. They want to feel they are part of a harmonious team that not only enjoys working together, but also is committed to succeeding together. They want to feel that they are rewarded based on their individual ability to achieve what is expected of them. And they want to know that they are heading down the right path to achieve individual and overall practice success.

Want more of me? Click here to visit my blog, The Lighter Side, for more Dental Practice Management info.

Interested in speaking to Sally about your practice concerns? Email her at sallymck@mckenziemgmt.com. Interested in having Sally speak to your dental society or study club? Click here.

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Nancy Haller, P.h. D.
Leadership Coach
McKenzie Management
coach@ mckenziemgmt.com

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The Leadership Academy Award Goes To...
By Nancy Haller, Ph.D., Leadership Coach McKenzie Managemen

There’s something fundamental about storytelling. It’s the way we process and experience life events. Stories resonate with us, down to an unconscious level. We learn best through stories. History is passed down through stories. And this Sunday, the Motion Picture Academy of Arts and Sciences will award the Oscar to the best “story” in film of the past year. Having seen all of the Best Picture nominees, one story stands out for me. Not because it was the most intriguing or creative (my vote for that category goes to Inception) but because it has the most to teach us about leadership. The film is The King’s Speech.

The story is about the Duke of York who was unexpectedly thrust into leading England when his brother abdicated the throne. It is the brink of WWII, radio mass media is taking off and he has a debilitating stutter. He’s expected to lead the country to war and that means being connected to his people. But he can’t speak. The film tells the remarkable and true story of a man who battled to find his voice, for his country and the world. There are classic themes of heroism imbedded throughout the movie. Here are some parallels that might relate to you and your practice.

Lesson #1: Sometimes we have to accept the role of leadership - even when we don’t want to.
When you chose to go to dental school, I doubt you realized you were signing up to be a “leader.” While learning how to extract teeth and administer nitrous oxide, you probably didn’t give much thought to hiring, firing, handling office disputes, or delegating job responsibilities. You focused on learning clinical skills. Now your success depends on leading people every day. You need to teach your employees what you want them to do, and how. You need to guide your patients, so they’ll comply with treatment recommendations. Accept this reality and look for solutions and support.

Lesson #2: Don’t be afraid of showing imperfections. They are our humanity.
Many people think that being a great leader is about doing everything perfectly. Not true. Strong leaders have many foibles. The difference is that they recognize their own frailties. They are aware of their weaknesses and they tackle them. Stop beating yourself up for failing to be perfect. Admit your shortcomings and find ways to overcome them. Commit to life-long learning.

Lesson #3: Confidence is a fickle thing. Let others provide help.
No leader can ever do it alone. By reaching out, listening, and seeing who supports you, leaders achieve the best version of themselves. If you have a weak point, you should look for someone whose skills can compliment that hole in your armament. Find trusted advisors who can help you with financial, practice management and personnel issues. Business results are better when you don’t do it alone.

Lesson #4: Never give up.
Even if you didn’t see the movie, you know from history that it ultimately works out. But it didn’t happen because of “good luck.” More than any other characteristic or quality, leadership is about perseverance and resiliency. The lesson is that no matter what, you keep at it.

Lesson #5: If you're serious, get a coach.
King George VI was helped by an eccentric speech therapist named Lionel Logue. In contrast to the countless doctors who had tried to "cure" the King, Logue coached him to help him perform better. The right coach helps you set goals and keeps you on track in terms of the work you need to do to progress. They help you to make changes and accomplish goals that really matter to you. Invest in your own Lionel Logue.

Ballots for the 83rd Academy Awards are being tabulated by PricewaterhouseCoopers. The auditors maintain absolute secrecy until the moment the show’s presenters open the envelopes and reveal the winners on live TV. Whether the King’s Speech takes home the grand prize remains to be seen. But its leadership messages are no secret, and they are timeless.

Dr. Haller provides training for leadership effectiveness, interpersonal communication, conflict management, and team building. If you would like to learn more contact her at coach@mckenziemgmt.com

Interested in having Dr. Haller speak to your dental society or study club? Click here.

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Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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It Is Not Only About The Hygienist
By Jean Gallienne, RDH BS

Having a hygienist that is good at patient care, finding potential work, and promoting your dentistry is very important. However, so is patient comfort, quality of work performed, and operator comfort. Staying with the same type of instruments or manufacturing company because it is what you used in college may not be staying on the cutting edge of dentistry. Of course, if you do not look to see what other options are out there, you will never know what opportunities you are missing.

So many times, we think about the people and not the tools that are being utilized by the hygienist in order to help increase production. Is your hygienist using the tools of her choice, and are they up-to-date in order to provide the most comfort to the patient and the operator while they are being used? Could your patient retention be less than you want because your hygienist is not able to provide patient comfort during instrumentation?

Let’s go back to the basics for a minute. Does the hygienist have varying sizes of handles in her packet in order to change her grasp? Does she have separate sets of instruments for root planing? If so, does her root planing set have instruments that may work better for deep subgingival calculus removal compared to that of a mouth that has healthy gingival tissue? Are her instruments sharp? Do they need to be replaced? Remember, instruments are consumable items that will need replacing.

It is recommended to have separate root planing sets. This set should have instruments with a wide-angle blade for deep heavy subgingival calculus, a long blade in order to reach further interproximal, longer terminal shank, a variation of handle to help decrease operator fatigue, and some area-specific instruments for those hard to get concave root surfaces. They should also be sharp.

Sharp instruments are such an important part of our job when it comes to being a hygienist. It is important when it comes to operator fatigue and patient comfort. Why scale seven times on a tooth with heavy pressure when all you have to do is have a sharp instrument in order to scale one or two times with little pressure? Not only will your patients love you, but so will your hygienist’s hands. Find instruments that stay sharper longer and seem to be the sharpest out of the package. American Eagle Instruments has a wide variety available to choose from.

Our new favorite instrument made by American Eagle Instruments uses XP technology which is a patented process that hardens the stainless steel, and then encapsulates the steel with a diamond like layer. This enables the edge to remain sharp for months without sharpening. This will help to reduce the force used during scaling and root planing, which will lead to a lighter grip. These combined benefits should help reduce operator fatigue and increase patient comfort. The instruments are designed for fine subgingival scaling and root planing.

Not only are sharp instruments imperative to being able to perform our job, but we also need to know when to replace our instruments. Using instruments past their life expectancy is not good for patient comfort or the career of the hygienist. Maintaining a set of new instruments in order to compare the instruments side-by-side is the easiest way to identify hand instruments that need to be replaced. Another way is to use light reflection, along with loops, or a magnifier to determine if the shape of the instrument can no longer be maintained.

When it comes to ultrasonic tips, they do not last forever either and if they are used past their optimum efficiency, there may be increased patient distress and pain, practitioner discomfort, and reduced deposit removal. They should be compared to the wear indicator card in order to measure the amount of wear your tips have endured. If they are short, get rid of them and buy new.

Having instruments that are well maintained and cutting edge, along with a quality hygienist, may be the answer to increasing your patient retention and employee longevity.

Interested in improving your hygiene department? Email hygiene@mckenziemgmt.com and ask us about our 1-Day Hygiene Training Program.

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