Quality – More Than Just Clinical
In 1911, Fredrick Taylor wrote a breakthrough study describing three principles for management. In 1950, W. Edwards Deming and J. M. Juran were invited by Japan to rebuild its economy.
Deming and Juran came up with the ideas that the Japanese packaged into the system we today call Total Quality. In Total Quality people feel they are permitted to contribute, as well as expected to contribute, because the system was designed to evolve based on their input. I believe this system allows the Doctor and Staff to simultaneously improve quality and productivity indefinitely. In my own practice, I used these techniques successfully for 30 years.
Sounds impossible? What you need to do can be stated in three sentences:
1. Get and keep only the best people.
2. Make clear to them what needs to be done–define their jobs in terms of what is considered good performance and what results are expected, and measure it.
3. Let them do it–create conditions in which they can do what needs to be done.
That’s it. Like most apparently simple approaches, it works very well, but, in fact, demands a lot of hard work to make it succeed. There still is no free lunch.
Once you have the three principles that tell you what to do, the next trick is how todo it.
You need a framework, a management philosophy. The foundation of this framework is taken from every motivational speaker and management consultant I have ever heard. It has just two points.
1. Doing things a little bit at a time all the time, has the highest probability ofsuccess.
We work in the real world. We are constantly balancing one priority against another. Problems tend to set these priorities. That’s why crash programs and grand designs do not work. Attack your problems a little bit at a time. Remember:
1. Any effort is worthwhile if it is done all the time.
2. Learn by doing – don’t wait for a detailed plan.
3. Start simple – take a good idea and run with it.
4. No improvement is too small to implement. Fine tune continuously.
5. You never arrive – life and managing our staff and practice is a journey, not a destination.
2. Leading beats managing.
Your job as a leader is to get and keep only the best people, to make clear what needs to be done and let them do it. You are attempting to create an atmosphere of job ownership. Enthusiasm and persistent dedication always comes from the top. In other words, you are the example, you set the pace through your leadership.
Here’s how a true leader applies these three steps. Remember, the journey of a thousand miles begins with a single step.
ONE: Get and keep the best people.
Acquiring and keeping good people is a leader’s most important task. Reward them well both financially and emotionally by regularly meeting and talking with each staff member oneto-one. Focus on learning whether each staff member understands what we are trying to do and whether they can do it.
Remove poor performers from the practice. This is as important as finding good ones. The best time to remove them is right now.
TWO: Make clear what needs to be done.
Good performance means more than a list of specific tasks. The whole job is to satisfy patients, establish good relationships and improve performance continually. Office monitors such as vital statistics kept by your staff and discussed with them in staff meeting crystalizes important products in their job descriptions.
Invite constructive complaining. Your staff needs to know their opinions are important. The best indicator of a poor system is when good staff can’t perform. Never assume that your staff is well-trained and motivated. Ask them.
THREE: Let them do what needs to be done.
Give staff job ownership. Make clear who is responsible for what. Cross-training is essential, but everyone should have an area of primary responsibility with well-defined job descriptions.
Attach authority to responsibility. Your staff must feel you support their decisions and know that they can make mistakes. It’s part of the learning process. Develop a goal for continuing education. Staying on the cutting edge, or as Naomi Rhode says, “being the 1%” is essential.
Peter Drucker said, “The common denominator of all successful people is a perfect balance between thought and action.” This is true for you as Doctor and business owner in your dental practice. Your staff and your patients will share the benefits derived from your consistent efforts to improve the quality of your practice.
Michael Abernathy, DDS