Staff Management

How I Used Slower Days (Thanks, COVID!) to Retrain Staff

By Jessica Goldman, OD

Feb. 3, 2021

My mother, who was a nurse, once told me, “If you go to the hospital, always bring treats for the nursing staff. They can make or break your stay.” In that same vein, we all know that technicians can make or break your practice. They, with the front desk staff, are your patients’ first impression. For better or worse, they set the tone for the duration of the exam. Your staff can help you enjoy your escape from home, or have you dreading another workweek.

“It’s not my job to make staff happy,” I heard a colleague say. “If they’re not happy here, they can leave.” I hope you’re as horrified by this statement as I was. While he was factually correct, it’s such an outdated way of thinking. Current thinking is that creating a happy workplace retains employees. Think about how much time it takes to train a new employee, and how disruptive it is to both you and the rest of your office. Your patients are also tuned into this. They are good at recognizing a harmonious practice versus an unstable one. And the chances are slim that they will want to return to an office they perceived to be unhappy and unstable.

Garbage In, Garbage Out
My office slowed in the wake of COVID-19, with many cancellations and no-shows. Was there ever a better opportunity for staff training? As I came up with a list of items on which my staff most frequently needs direction, I found a not-so-startling commonality. The most frequent errors in patient interactions all stem from lack of appreciation of the purpose of the test. Meaning sometimes technicians don’t know why they’re gathering that data. And if they don’t know why, they cannot know its importance. And if a staffer doesn’t know the importance of a test or question, they risk giving a patient false information, or not engaging with the patient as they should while conducting the test. They may even not gather all the necessary data if they don’t understand what is at stake if the doctor does not get all the information they need to make a diagnosis.

Breaking it Down
I started with the most common eye diseases: glaucoma, macular degeneration and diabetic eye disease. I scheduled 1-2 hours of training time per week, usually giving myself an hour to discuss each condition. Spacing it out gives everyone a chance to digest the information, and it feels less like a lecture. For glaucoma, I summarized the disease process, the groups of people mostly likely to develop it and how it affects the eye. By explaining the disease as a whole, I was able to impart the importance of accurate eye pressures and visual acuities, pupillary testing, checking angles and taking a careful history.

During my lessons, I like to harness the brilliance that is Google Image Search. (Man, do I wish I got a Google commission for this!) This is an endless resource of graphics for illustrating everything from “narrow angles” to “optic nerve head cupping.” If you’ve never used this before, take a minute now to test it out. As an aside, I use these same images for explaining conditions to my patients. It is much easier to grasp a new concept with an image to display.

Editors’ Note: Be sure that you have the legal right to use photos found online for patient education or marketing.

Following each disease summary, if there is time, we then practice the associated skills. After teaching about glaucoma, I then taught the technicians, or reviewed, how we perform Goldmann tonometry. We practiced checking angles. We discussed difficulties with visual field testing, especially now that our patients are wearing masks, and then practiced ways to adapt. I also showed my technicians the gonio lens, and how to properly clean it, so they automatically set it out for me when they see that there is a patient scheduled for gonioscopy.

Reinforcing the Lesson
To reinforce their new knowledge, when time and staffing allows, I have a technician accompany me into the exam room to listen to how I explain exam findings to the patient. Hearing me explain to a patient why I feel their glaucoma is not well controlled is an invaluable real-life example of the lesson on glaucoma. When a staff member has learned about macular degeneration and then hears my recommendation for AREDs 2 supplementation, that staff member is less likely to tell a patient that the vitamins improve vision. (Yes, I overheard that unfortunate statement told to a patient years ago and had to spend serious time with that patient back-pedaling the technician’s error).

Empowering People Builds Trust and Loyalty
Another good reason to educate your staff is the joy of teaching and learning. By knowledge-sharing, you are connecting with them. They gain a sense of pride in what they do, and in turn, are more conscientious. When there is an open line of communication, technicians are more likely to ask questions to further their education.

It is far more logical to commit the time upfront for thorough training and education, to save time on the back-end, avoiding poor patient care and the communication of inaccurate information. Well-trained staff are more capable of providing high-quality care and more efficient. When you’re not spending your day putting out fires created by poorly trained staff, you and your employees are more likely to enjoy your days together while serving patients to the best of your ability. And if that sounds a little zen–and better for patients and practice–that’s because it is.

Jessica Goldman, OD, practices at Eye Physicians Medical/Surgical Center in Chula Vista, Calif. To contact her: goldmanx2@gmail.com

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