Simple, effective approach logs and solves practice issues
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“Strive for continuous improvement, instead of perfection.”
– Kim Collins
“The employees who share innovative ideas may also be the folks who have some hidden talents that would help incorporate their suggestions.”
– Harvey Mackay
Source: Adobe Stock
What is a “customer?” In ophthalmology, we are all familiar with the usual, external kind — patients directly, plus a host of indirect customers:
- our patients’ family members;
- third-party payers;
- referral sources;
- crowd-sourced quality directories such as Yelp; and
- regulatory officials.
For both clinical and commercial success, we have to serve these familiar customers effectively (some would say flawlessly) over long periods of time. Each expert procedure or flawless recall appointment adds to the quality of your service and your reputation, along with your sustainability and financial performance as a business entity.
But, at least as importantly, you also have internal customers. What is that? An internal customer is any individual in your practice who receives a service from any other member of your team that affects that individual’s job performance. Which means just about everyone in your practice.
The concept of exchanges with these internal customers may be unfamiliar to you, but you are surrounded by them. Consider a few of these.
- As an owner-surgeon, you have to show up on time for clinic so the team is not left hanging. You have to keep up a work intensity that keeps the cash flowing. You have to be consistent in your requests and policies. And perhaps most importantly, you have to deliver leadership and positive reinforcement for the entire team.
- Administrators are accountable to a whole array of “customers”: the biller who needs a software upgrade; the technician who needs their testing equipment serviced; an optician who needs a sign-off on a new frame line; or an ASC nursing director who needs help with a difficult surgeon.
- Department heads have to deliver rational protocols for their staff. They have to deliver the proper disciplinary balance between toughness and fairness. And in today’s leaner environment, they have to deliver for the owners by extracting as much value as they can from every worker.
- Non-leaders in your practice have internal customers, too. Even the most junior receptionist is responsible for serving up patients for the clinical team by putting them in an appropriate appointment slot. And they have to deliver accurate patient demographics for the billing staff.
With that as a backdrop, it helps to have some kind of system in place to assure that all of these internal customers are being served well. In most practices, large and small, this system is overly casual. It mostly falls on the administrator, who, without the benefit of a formal tracking system, has to make sure that everyone is delivering on their promises to one another and then play whack-a-mole when promises are not being kept.
There is a better way. And we do not have to look any further than the “trouble ticket” systems that most IT departments use to keep track of software, hardware and peripheral problems. What follows is a simple system you can put into place to log and stay on top of staff and provider concerns and suggestions.
Creating a simple “issue ticket” system
While numerous elaborate trouble ticket software platforms exist, here is an easy process to create your own “issue ticket” system.
1. Create a five-column Word file like this (Table).
2. Post this file to your information system’s shared drive so that everyone has access to it.
3. Follow these simple suggestions for success.
- Keep this tool in Word, which is easy for everyone to use.
- Postings can be named or anonymous.
- Postings should be polite, well-intended and helpful; take down inappropriate items.
- Expect higher early traffic as staff and doctors submit their saved-up items; volume will then decline over time until new habits are developed. Encourage one posting per staffer per month; consider cash awards for the most helpful suggestions monthly. Do not let this new tool fade away.
- Set a deadline for management to post a response to each item; be sure to follow up on open items.
- Postings are preserved even after they have been closed; old postings can be accessed by keyword using Word’s “find” function so staff can see if their item has been covered before.
- This ticket system is not a replacement for staff going to their supervisors directly with ideas. Supervisors may then either handle the matter directly (in the usual fashion), ask staff to post their item or post the item themselves.
As my partner and I make our client site visit rounds, one of the more common complaints we hear from staff and doctors alike is, “When I make a suggestion to our manager or have a complaint, it’s like a black hole. I rarely hear about a decision that’s been made or where we’re going with the issue. So, I’ve stopped making suggestions. They don’t go anywhere.”
By using a simple system like this issues log — with whatever variations fit your individual practice — you can break this frustrating cycle.
- For more information:
- John B. Pinto is the author of several books on ophthalmic practice management, including John Pinto’s Little Green Book of Ophthalmology: Strategies, Tips, and Pearls to Help You Grow and Manage a Practice of Distinction, UP: Taking Ophthalmic Administrators and Their Management Teams to the Next Level of Skill, Performance, and Career Satisfaction (with Corinne Wohl), Simple: The Inner Game of Ophthalmic Practice Success, and Ophthalmic Leadership: A Practical Guide for Physicians, Administrators, and Teams. Available now for purchase at slackbooks.com. Receive 20% off with promo code PINTO20. He can be reached at 619-223-2233; email: pintoinc@aol.com; website: www.pintoinc.com.
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