More Than Learning Tasks

What makes the difference between an average orthodontic practice and one that truly excels? A well-conceived and well-executed training program! When ongoing training and education are high priorities, your practice will improve productivity, profitability, and overall employee and patient satisfaction. With the proliferation of social media posts and online reviews, patients can instantly share glowing or damaging reports about their orthodontic experience with a wide audience. This is why it is now more critical than ever to have a well-designed initial and ongoing program for your team.

One concern orthodontists share is finding time to design and maintain a world-class continuing education program, but it can be done. Practices must make it a priority. You can start by asking your team, “What skills, abilities, or types of training would enable you to do a better job?”

Training and Education Differ

When you train team members, you teach them a specific way to do a task, such as entering a payment into the computer, assembling a tray setup, or placing a wire on a typodont. When performing a task, well-trained people should be able to follow a predetermined set of instructions.

When educating, you explain why something works so that team members can understand how to make decisions. Then, when an unusual situation comes up, they are more likely able to apply critical thinking for the best outcome. For example, when a patient arrives with a broken wire, it is most productive for an assistant (preferably referred to as a “patient manager” or other term aligned with the significant responsibility of the role) to evaluate the patient to determine the best course of action. It might be to replace the same wire, move up a wire size, or, if the patient is scheduled to return soon to bond the second molars, possibly segment the wire.

What about the patient experience? Does your patient feel welcomed and honored as a person, or is he just another set of appliances to adjust on a tight schedule? No one intentionally creates a bad experience. However, an inadvertently sarcastic comment about inadequate oral hygiene or body language reflecting the frustration of a hectic day can instantly change their perception of your practice. All team members must understand the importance of customer service and embrace their roles as practice advocates.

Designing Your System

When putting together a training system, there are two primary areas to address: 1) understanding and performing job tasks; and 2) using appropriate communications and public relations skills. Both of these areas should have specific performance standards.

Performance Standards

To help employees consistently meet expectations, performance standards must be clear. Standards should be objective, measurable, realistic, and stated clearly in writing—and if possible, also on video. Define these standards in terms of specific measures to appraise performance, including quality, quantity, timeliness, and, as appropriate, cost-effectiveness.

How will you measure these standards? Is there a number or percentage that may be tracked? On the clinical side, clear goals may include knowing how long each procedure should take when an individual is fully trained. Granted, we are working with people, not machines, so there will be some patients who are more difficult to work with than others. However, procedures should have a time guideline as a goal so patient managers aren’t consistently running behind and making patients wait.

To determine if a change in protocol or additional employee is indicated, you can also track emergency visits and other appointments outside the treatment plan, such as those for loose appliances.

Another tool I recommend is the Checklist for Every Patient. This is a list of tasks that are done for every patient at every visit. For a patient with standard appliances, the checklist may include manually checking the ends of the archwire to confirm that they are comfortable rather than just asking the patient if everything “feels OK.” A patient should never need to return to the office with a protruding wire just because it wasn’t checked.

If an element can only be judged rather than measured, ask, “How can I identify when it was done well? What factors do I look for?” In the area of patient education, certainly cooperation is an indicator of successful interaction. However, not every patient is destined to cooperate after a single excellent session with a patient manager. Remember that demonstrating true caring for the patient with a follow-up phone call, a handwritten note, and coaching by the same clinician each visit can go a long way in encouraging patients to do their part in moving treatment toward a quality result.

Tasks

When documenting your system, you may wish to begin with steps for reproducible procedures—for example, how to run month-end reports or sterilize instruments. Team members should know how and also why procedures must be done in a particular way. Otherwise, processes may change without the doctor’s knowledge.

When a situation is not cut and dried, how should a decision be made? Typically, newer employees refer to their coach for help, but employees need to soon learn how to make decisions on their own, based on clearly understood goals.

Communication Skills

Another critical area is communication skills. What information must you deliver to your patients, and what is the best way to present it to encourage cooperation? Certainly, personal style plays an important part in communication, but by establishing standards, you will help your patients leave an appointment knowing what is expected and feeling good about the interaction.

What about addressing difficult situations? What do you say when a parent is upset with appointment-time options or when a patient refuses to wear elastics? We sometimes assume that an employee will learn what to say by observing others. Granted, there will be a certain amount of emulation. However, is everyone interacting with patients in the most ideal way possible? Scripting can be a significant help here. Having written examples of what to say and practicing how to say it will support confidence and competence in your team.

Internal marketing is also becoming more important than ever. Does your entire team buy into the importance of the public relations aspect of their position? Is this emphasized during the initial training process and beyond?

Aligning Behaviors with the Practice Vision

What are your office expectations regarding behavior? Is it appropriate to continue a personal conversation with a co-worker while a patient waits to make an appointment? Of course not! This and other unprofessional behaviors can become commonplace if expectations are not clearly explained and demonstrated by all. Another common concern today is the use of smartphones. Is it acceptable to check messages during working hours? I received a call the other day from an orthodontist who had just fired a fairly new employee. She was surfing the Internet on her smartphone while waiting for him to check the patient. He assumed the employee would utilize good judgment. She assumed that she could go online since she couldn’t change the wire until the orthodontist confirmed the correct size.

Hiring well, providing a thorough new-employee orientation, and utilizing an updated and clear employee manual can go a long way in starting every team member out on the right foot.

Selecting Trainers

In-office trainers/educators need good training techniques. They must know how to develop productive employees and encourage career thinking. Trainers should know how to establish goals and objectives for their training sessions and to determine how these objectives may influence the productivity of your practice. They must also know how adults learn and how best to communicate for an optimum learning experience.

Another way to advance employees’ knowledge and encourage a career mind-set is to use outside consultants and trainers for in-office training. Having documentation and key employees onboard who will implement the system on an ongoing basis ensures that the message is not lost over time.

Training Modules

Utilizing training modules will help the trainer stay organized. You can provide guidelines for both trainers and learners by listing all procedures and standards to be taught, then grouping them into modules by level of difficulty. Items can be checked off as they are perfected, allowing employees to track their progress. Such checklists can be very motivational, particularly when associated with a reward or recognition.

Simulations

Researchers report that people remember 10% of what they hear, 75% of what they say, and 90% of what they do. Plan and deliver regular training sessions on specific topics. Keep sessions fairly short (1 to 3 hours) to encourage focus and long-term retention. As part of the ongoing educational and training experience, incorporate simulations. They will help send the message that performing with excellence is important. Consider including a communications or procedural scenario in monthly team meetings, too. This helps advance the skills of the entire team.

What Technology Offers

Today’s technology provides educational opportunities through interactive webinars, taped lectures, and online courses. Many companies now provide this convenient alternative for those who find it difficult to travel or are interested in a specific topic. Some online courses even incorporate questions to answer before the learner can advance to the next section. This is a great adjunct to video and print, but it is typically not actual training, but education. The key is to incorporate training along with this education to produce the desired result.

Skill Validation

When a new employee demonstrates skills, it shows two things: the trainer’s skill and the employee’s ability to perform job functions. For example, you might think you have the same vision of greeting the patient, but when you see team members in action, their interactions must meet practice standards. If employees aren’t coached, they may or may not perform to your expectations. Feedback starts with the word “feed,” or nourish. Quality feedback is a way to nurture both new and experienced employees.

Remember Positive Reinforcement

When you’re praised for something you’ve done, you feel good. Remember to show your trainees appreciation when they perform well. Catch them doing something right—and tell them so. Use the person’s name, and be specific about what was done well. This creates very strong and positive motivation.

Cross-Training

Every practice can improve, regardless of how effectively and efficiently it is functioning. The most successful and relaxed practices have continuous education and training for improvement. Your orthodontic team has the opportunity to enhance the health and lives of others, and with that opportunity comes the responsibility to do the best possible job. Cross-training can improve the efficiency of your practice and decrease stress levels as people can pitch in as needed. Understanding other team members’ responsibilities will enhance empathy, improve team morale, and develop teamwork.

Beyond the Office

Spending time out of the office can provide a rejuvenating experience for your team. Workshops such as Ortho Camp (orthocamp.net) provide your entire office an opportunity to learn and play at exciting destinations.

It’s a Process

Remember, training is not a one-shot experience; it’s a process. We didn’t get our driver’s licenses by just taking a written test. We also had to demonstrate our practical skills to an authority before earning permission to drive. Both education and training are necessary to succeed. When you provide proper, ongoing training and coaching, your team members will feel proud and the practice will improve its performance and maintain its excellence. OP

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Lori Garland Parker, BS, MA, is an orthodontic clinical consultant and co-founder of Consulting Network, Management and Training Solutions. She has developed numerous training and practice-management tools, and has lectured throughout the world. She can be reached via ConsultingNetwork.org or at (805) 552-9512.