Urologists around the country lament the difficulty in finding and keeping good employees, and even gripe about the deteriorating performance and attitudes found in some of the more demanding positions. My advice: They're your employees, so it's time to take ownership of the problem.
Experience tells me the root of substandard performance and high turnover in demanding positions is a lack of orientation and training of new employees. Each practice needs to develop its own "boot camp" that will acclimate new employees to their position, help them to understand what is expected, and allow them to develop the skills to perform the position well. The same is true for existing employees who are shifted to a new position based on practice demand, rather than a logical transition that would include reviewing the job description and being properly trained.
Each practice's boot camp should include the following components:
Orientation. Orientation for new employees should be broad, covering all the issues pertaining to employment with the practice. Of course, it's a time to issue keys and complete paperwork, but it's also important that the employee understand the practice's mission and history. New employees should review the employee manual and have a clear understanding of office policies and issues critical to employment in a medical office, such as HIPAA requirements. Discuss these issues before moving on to the position requirements and the practice's training plan.
Open dialogue. An employee new to a position needs to have upfront time with her supervisor, reviewing the job description and understanding how it fits into the department and the entire practice. What key support of the position is required to keep work flowing and the practice humming? Encourage open dialogue and obtain feedback throughout this process.
Shadowing. The new hire should spend time shadowing someone who works in this position. That worker should be prepared to explain what he is doing, why he's doing it, and what the expected outcome is. He should also invite the observer to ask questions and take notes.
Setting standards. It's important for the practice manager or department supervisor to develop standards for the primary tasks of each position and use these to develop a training module. How many appointments is a scheduler expected to make per day, and with what degree of accuracy? Should she end each patient conversation by asking, "Is there anything else I can do for you today?" or, "My name is Tammy, call me if you have further questions or need assistance."?
The new employee should not be left on her own until she meets the established standards. These objective measures are critical to providing a training session that is fair and imposes reasonable expectations while providing the support needed to meet those expectations.
Training schedule. Next, establish a training schedule, a matrix that lists what tasks will be trained, what processes will take place, how progress will be measured, the expected outcomes and time frame for each, and who will be responsible for training the individual. This tool can then be used not only to train new and existing employees, but also to monitor compliance and provide feedback when it's time for the annual performance review.
Feedback. Communication is a key component in developing a successful boot camp program. It is important to allow enough time at the end of a session or before the beginning of the next session to review performance and provide the encouragement and support essential to help employees learn new tasks, become confident, and overcome obstacles that may interfere with their ability to succeed. If feedback needs are not met, the employee will incorrectly assume that she is either doing poorly or has actually mastered a skill before she really has, resulting in the potential for higher error ratios.
Practice performance must be measured by setting standards and measuring outcomes, and the practice's commitment to these processes includes staff training and accountability. It begins with a commitment to develop an internal boot camp that meets the practice's needs, supports superior patient service, and sets up everyone to succeed.
Judy Capko is a health care consultant and the author of Take Back Time - Bringing Time Management to Medicine. She can be reached at 805-499-9203 or firstname.lastname@example.org
Key components of boot camp