Staff Management

Establish a Culture of Execution to Achieve Practice Goals

By Arthur Geary

You the ECP are the practice CEO and can enable your staff to achieve goals. Establishing a “Culture of Execution” is a primary responsibility of the doctor as practice leader. Create a culture in which staff members are challenged to not only come up with new ideas, but to contribute to the completion of the projects those ideas generate.

Nothing happens in business until a human being takes an action and another human being reacts with their own action, so on and so on.

The discussion of behaviors has two levels, the group or enterprise level and the individual level. Both are important. The individual level behaviors of front line staff are the ones that usually get most of the attention from practice leaders because they are in direct contact with the patient. Execution that directly and positively impacts the patient is the goal. But modification of individual front-line behavior won’t happen without support from the rest of the staff and the doctor who heads the practice.

If you want your optical staff, for instance, to establish and implement a new frames inventory management system, you as practice leader have to be the guiding force behind that change. You also need to model the way you want those employees to treat patients in your dispensary in order to improve the patient experience.

Think about which of the businesses you personally interact with that you would describe as dysfunctional. The person trying to help you wants to help, but they are prevented from doing so because of a problem in another part of the business such as an ill-conceived policy dictated to them or miscommunication between operating areas.

10 Steps to Enable Staff to Better Serve Patients

1. Establish guiding beliefs of the practice. This may includecommitment to quality, customer service, employee and management standards and improved internal communication. Many of you already have a mission statement or vision statement that is shared with staff and the public. Now, try creating an “employee culture statement” or a “beliefs of the organization” document. Whatever you call it, this document will define beliefs that govern individual and group behavior internally, and are shared only with employees. All employees should be required to exemplify both the mission and culture statements.

To be clear, the internal beliefs statement is not the employee policy manual. This statement should be on a higher, broader level, for example:

“At XYZ Eye Care, as a professional practice, we are individually and collectively committed to the following beliefs:

–Every staff member and doctor will be treated with dignity and respect at all times.

–All communication, whether verbal, written or face-to-face will adhere to the same standards; rigorous, candid dialogue is encouraged and welcomed as long as it is mutually respectful, professional and conducted at an appropriate time and in an appropriate manner and location.

–We acknowledge that no one is in sole possession of all the best ideas, therefore, we encourage each other to continually look for ideas to improve all aspects of our practice, and to freely share those ideas with the appropriate people internally.

–We believe in, encourage and support open communication among all associates regardless of position.”

Notice that this statement primarily delineates beliefs related to interpersonal communication and the flow of ideas. Open and rigorous communication and the flow of ideas are absolutely critical to maximizing execution.

2. Recognize behaviors employees bring to the practice from prior experiences and habits. It is this challenge that contributes to the difficulty of creating a culture of execution. As we all know, human beings are creatures of habit, and a small minority are successful at voluntarily changing their habits. How hard it is to discipline ourselves to lose weight, exercise, quit smoking or eat a healthy diet? You are dealing with cravings, life-long habits, outside pressure from friends, family and advertisers. As individuals we can let ourselves off the hook because we’re accountable only to ourselves.

The same is true in an optometric practice. People have life-long communication styles or patterns. You may have employees, doctors and managers who are shy, non-confrontational or have one of the many other personality traits that exist. Your employees likely worked at another employer prior to accepting a position with your practice, and you have no idea what bad habits they developed, or behaviors that were driven by less-than-progressive management.

3. Culture change begins with the doctor as practice leader. If you have agreed as a practice that staff must treat patients with more care and attention, start by demonstrating that to staff in the hand-off from the exam room to the dispensary. Instead of just handing off the patient, show both the patient and the staff that you have taken note of the patient’s needs and want to ensure that patient gets the right eyeglasses.

4. Set clear goals with defined expectations as to the results and time line. If you want to keep up better with frame board inventory, set the goal with dispensary staff that within three months a system will be in place to better monitor inventory, and within six months, turnover of frames will have improved with more inventory in the product lines that sell best more readily available.

5. Follow through and follow-up. Be sure staff knows you are watching. If you promised something they will need, make sure it happens. Don’t wait until the deadline to follow-up. Check-in periodically for updates and unforeseen obstacles. If your dispensary staff requested access to Microsoft Excel to better track frames turnover and inventory needs, make sure you deliver that access to them.

6. Reward those people who produce the desired results. It is important when changing behaviors to align rewards/incentives with the desired new behaviors. If your frames sales meet the benchmark you established for the practice at the end of six months or a year, reward the dispensary staff that came up with the new frames inventory management system.

7. Expand the capabilities of individuals struggling to change behaviors. Correct behaviors through additional training or coaching before the person gets to the deadline and fails badly. If dispensary staff isn’t able to follow-through on the caring tone with patients that you requested, try role-plays to illustrate the conversations they should be having with patients.

8. Offer candid employee assessments and take appropriate action. If a staff member cannot make the necessary behavioral changes, or achieve the desired results, leaders must not be timid in addressing it. The employee deserves a fair and candid assessment and an opportunity, if possible, to be considered for a more appropriate position. If others asked to meet the same behavioral standards see that there are no consequences for failure, the culture of execution will be undermined. In the future it will be more difficult to convince employees that the beliefs and behaviors eschewed by the leader(s) are sincere. The integrity and trust in the practice leader will be undermined.

9. The doctor as practice leader must remain engaged in the transformation. It is not enough to implement that new frames inventory management system and achieve the sales results you hoped for. You have to talk about the system every week in staff meetings, and be proactive about asking staff how it’s going and whether there are any additional tools you can provide them with. You also need to ask them specific questions about the inventory turnover numbers, and maybe bring up recent dispensary staff-patient interactions you observed that didn’t match your vision for the practice.

10. Get staff to engage in rigorous dialogue. In that staff meeting in which you ask dispensary staff how it’s going and about a dialogue with patients that didn’t go as well as you hoped, also ask staff for their feedback. You might find that in addition to an Excel spreadsheet, it would help dispensary staff to have greater access to your practice management software system, or that they are struggling to adhere to your narrow warranty policy without alienating patients.

By making a concerted effort as practice leader to model behaviors that reflect your vision for the practice, and guiding your staff in the same direction, you will have a culture that facilitates your goals.

Related ROB Articles

Close the Execution Gap: Top 4 Roadblocks to Execution of Business Plans

Bridge the Execution Gap: Evaluate Yourself as Practice CEO

For Successful Execution of Initiatives, Start with an Engaged Team

This is the third in a series of articles examining thediscipline of execution in business:Bridge the Execution Gap: Leadership-Culture-Process, the 3 Pillars that Support Execution, and Will Take Your Practice From Business Plan to RESULTS!

Arthur Geary, founder and CEO of Execution in Business, Inc., is a senior executive and leader with a broad range of experience from start-up to Fortune 500 companies in eyecare, insurance, finance and securities, medical software and commercial construction. To contact him: ageary@executioninbusiness.com.

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