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Group Practice Model
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•
•
•
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3 GPs
Oral Surgeon
Orthodontist
Pediatric Dentist
Periodontist

• Specialists 1
day/week
•...
Dental Staff Training Manuals
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(later AIDS) changed
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gloves to mini hospital
op...
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Dental Practice Coaching
Coaching dentists & office managers
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www.de...
Dental Practice Coaching
Coaching dentists & office managers
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Weaknesses (OFIs)
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right questions
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Our Results
New Clients

Marketing $ spent / New Patient

1500

$60.00

1000

$40.00

$50.00
$30.00

500

$20.00
$10.00

0...
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% of Total Staff in Level 4+
100%
80%
60%
40%
20%
0%

Case Acceptance
80%
60%
40%
20%
0%
2008

We measured ou...
Good Story
New Patient Adults
700

600

Prophy /
Comp
Exams
Emergen
cies

500
400
300
200
100

0
2008 2009 2010 2011 2012
...
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90%

Would you
...
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300
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100
0

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Your numbers tell you:
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% the hospital gave coronary intervention within 30 minutes of admission

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Using the Baldrige to Accomplish your Vision: One Dental Group Practice's Story

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Dentistry is just beginning its journey into performance measures and using the Baldrige criteria is a great way to help dentists accomplish their vision and make decisions based on solid data instead of emotions.

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  • Welcome to “Sharing our Success: Growth using National Quality Standards ” I am Jill Nesbitt. 2 hours togetherSay hello those around youGreat opportunity to trade business cards2 objectives:#1 – Share Baldrige national quality standards – what is it, how does it work and why should you care?#2 – Practical help – some hands-on examples of how you can use the concepts shared in the Baldrige to measurably improve your practice. Just the fact that you are meeting someone from another practice who has the same interest as you do – someone who wants to learn more about quality in dentistry. By trading business cards today, you could open up a great dialogue with a practice across the country, so you have no fear of competing for patients or giving away your secret sauce. Instead, when we dig into what the Baldrige national quality program is – you may very well have created a small group – even just one other practice that is willing to share real numbers with you – and that may help you to evaluate your own performance!
  • As dental practices, we have a lot on our plate:Dental insuranceFinancial pressureNew patientsTechnology – websites, social media, videos, apps plus lasers, Cad-Cam, even cone beamHiring & staff management – a perennial challengeEconomy – getting better – maybe?, but still a challengeManaged careMedicaidGovernment regulationsMid-level providers
  • Baldrigehas been used by organizations across the country for over 15-20 years. Governments, schools, manufacturers and hospitalsIn fact, Health care is the fastest growing industry to use the Baldrige principlesSo, today, I will show you how to use the Baldrige principles to make sense out of all the mass of things going on in your practices – and I’m going to use HealthPark, the practice I ran for 16 years to show you how we did it.
  • Today, I will accomplish three objectives in our time together.
  • So, today, I plan to tell you a story. Tipp CityDr Smith – After 3 years as a Navy dentist, moved to Tipp City & rented 550 sq. ft. on a 2nd floor 40 step walk up. 7 years later he built the first 5500 sq. ft. of HealthPark. 10 years later he added 6500 sq. ft – and that’s about when I came on board. I started my career in dentistry as an OM while I was working on my MBA where I learned about the Baldrige National Quality program in my classes. This approach to running a business just made sense to me – and to Dr. Smith as well. So we partnered up to implement the Baldrige concepts into HealthPark.My story starts in Tipp City, OH – a small town of 6,500 where HealthPark was one of only 2 general dentistry practices. This is the building our dentist built – it has 18 operatories, 7 dentists, 25+ staff and at it’s peak cared for more than 10,000 active patients!Today, I want to share with you the secret, behind the scenes story of How we did it. How we lead this motley crew of dentists, specialists, hygienists, EFDAs, assistants and treatment coordinators to move in one directionHow we make plans to deal with the new challenges that pop up at dentists and small towns year by yearHow we listen to his patients – listening to 10,000 patients is no small trick! – and provides them the services they want – and therefore continue to attract new patients also!How we keep track of the performance of each dentist, each hygienist, each EFDA – filling schedules, increasing productivity and maintaining quality. As you know, in a group practice – you’re only as strong as your weakest link.How we hire enough staff to support this group – how we trainthem and retain and manage what we all know is the biggest expense and the biggest challenge – dental staff.How we runs the whole place – keeping up with the building needs and equipment desires, managing inventory, keeping one consistent approach to dental care among the clinical providers, in general, keeping everything moving forward according to his visionAnd finally, I’ll tell you the secret of our results – not just financial, but performance measures for staff, dentists, patients.
  • One of the unique features of the practice is that GPs & specialists work together. Here’s how that got started.Dr. Smith & Dr. Vrudny partnership – Tipp too small for specialist officeLots of teenagers – orthoThen PedoThen PerioBuilt an additional 5 ops for pedo as pedo grew b/c only pediatric dentist in the countySpecialists work 1 day/week – we provide . . .Win for the specialist – coordinate cases, full schedule of referrals, incomeWin for the practice – One stop shop, marketing, easy referralsBenefits to our staff also:RDH – l&l w/perio, coach ortho staff, earn implant bonusesAdmin – respect, coordinate w/others in weekly mtgAssts – extra hours & income, expanded skillsMy role – the challenge to put it together, make it work & keep everyone happy!This is detail for me to memorize:Usually our specialist works 1 day/week – we provide everything – space at least 2 ops, equipment, even all general supplies, a scheduling coordinator, all billing/insurance, shared external marketing and referrals. The specialist provides her own assistant and brings her own specialty equipment. It’s a giant win-win for the specialist & the entire practice. The specialist gets to coordinate cases with other specialists, receive a full schedule of referrals on her one day/week, add a substantial amount of income in a very efficient setting. The practice now has the opportunity to market itself as a ‘one stop shop’ for all types of dental care and the GPs can do the cases they are comfortable with, they can do challenging cases on days when that specialist is in the office, so they can walk over and get a consult as needed. Or, they can refer and even block their schedule to observe or be involved in that case. I’ve watched dentists enjoy lunches together and we sponsored a twice a year All Doc Dinner where each dentist could share his/her latest CE or interesting cases – and help each other. On the staffing side – Hygienists enjoy the variety of specialists, they have a regular lunch & learn with the periodontist, have coached the ortho staff on products & techniques for kids with braces, and have the opportunity to earn some extra bonuses through motivating patients to receive an implant. On the admin team – becoming a specialist coordinator holds a certain level of respect and appreciation throughout the practice. That admin becomes the ‘go to’ person for that specialist on the days when the specialist isn’t in the office. She takes the responsibility for filling the specialist schedule, managing the collections, following up on case acceptance, coordinating staff, effectively acting as the office manager for that specialist. Plus, in our weekly meeting – I have a coordinator for ortho, perio, pedo & oral surgery – and these same women schedule & manage the GP practice as well – so we can smooth out issues between these dentists without the dentists even being present!Lastly, the assistants have the opportunity to expand their skills and increase their hours when they work for a specialist. This has been a great foot in the door situation for new assistants – just one day a week to help support a specialist opens their eyes to what is expected from a great dental assistant. Plus, since the specialists run a separate payroll, the staff that are willing to work can earn extra income. As the manager of this group – my job was to coordinate all the moving parts and keep everyone on the same page as we moved toward our vision. I performed almost as an in-house consultant for the specialists and the office managers – someone they could come to when handling a particularly challenging patient situation or staff upset.
  • Another unique feature was the dental staff training manuals – here’s how those got started.As AIDS grew rapidly and deadly in the 1980’s Dr. Smith attended dental meeting to learn how to keep his patients safeHe learned - Used to treat patients as if guests for dinner – however now, with AIDS, the patients need to treated as if one guest had a heart attack & needed open heart surgery on the dining room table!realized he better write it downExpanded into all tasks - what needed done and why3 teams – into levels - lev1 new hires, lev2 regular workLev 3 – assistants run own column; secretaries coordinate for a specialist, hygienists work assistedLev 4 – management responsibilities, insurance management, inventory, training of other staff, deeper clinical training for shading or mounting facebows to understand occlusionLev 5 – team leaders – meet weekly with meLev 6 –EFDA, admin staff bring in new patients, increase productivity, reduce expenses and manage and coordinate the practice and all its moving parts.
  • We started with the ASQ Dayton group – our local Baldrige chapter in Dayton, OH. The Dayton ASQ invited small business owners to learn quality management – and we joined up.
  • Have you ever sat in a traffic jam? What are you thinking? Reactive, should i get over a lane, should i call someone if I'm going to be late?Baldrige is like being in the traffic helicopter so you can think strategically & see the big picture
  • The Helicopter View of a dental practiceThe Baldrige Burger7 sections Criteria – each have a series of questionsAll How questions – not prescriptive Do you have a process?This may look complex, but the key is the right side of the screen. To tie the first 6 sections to get results.The more you understand about the 1st 6 sections, then you can figure out how to improve your results.Think about all the many pieces of a dental practice – from doing dental procedures to marketing to working with labs & 1000’s of other pieces. Each piece has an organized place in 1-6. Once you have the pieces of your puzzle in the right places, you will see an organized picture of what your practice looks like – for the first time!
  • Dr. Smith & I agreed to evaluate each of the 7 sections of the Baldrige – as a way to make sense of all the activity going on in our group. In past – consultants came in, stayed a few days, applied a patch to a problem, then charged a few grand & left. Similar to placing a filling for a patient who isn’t changing his diet or oral health habits.With his background as an MAGD dentist, he was comfortable with new ideas – and my focus on the Baldrige process as a comprehensive practice management approach began. We wrote an application.We started with Organizational Profile (top bun) – this is where you set the stage for who your organization is and how it fits into the industry as a whole. Strengths: Group practice. Dental staff training program. Facility 13 to 18 ops.Weaknesses – Or called opportunities to improve – we needed more new patients and our finances just weren’t as strong as the benchmarks we read about in the dental journals.Strategic Challenges - painted a picture of the dental field – Dayton, OH local economy of General Motors suppliers (air conditioners, interior parts, etc.) and loads of tool & die shops around. Manufacturing weakened and families lost jobs – people who were well acquainted with dental insurance. Our regular patients simply stopped coming to the dentist. Recruiting – even one day a week for our specialists – into Tipp City, OH. An hour away from Columbus and Cincinnati – where most dentists preferred to live and work, recruiting was a major challenge.
  • We followed these 4 steps to apply:Self-assessment – write the application. 50 pages. Full of statistics & graphs to show our results.Submit – We applied to the Quality Dayton program (later the Ohio Partnership for Excellence), paid $2000 and prepared for a team of volunteers to read through your answers and start to identify your organization’s strengths & opportunities for improvement. Examiner review & site visit – Team of 6-8 members show up and stay for 2-3 days. These are volunteers, trained in the Baldrige concepts, but they know nothing about dentistry. They interviewed dentists, team leaders and staff;reviewed documentation of how your organization runs like meeting notes, financial or market share data. They asked dozens of questions. (All confidential. Destroy when done. You can feel confident – the more you help them understand your organization, the better feedback report they can provide to you.) Then they left. Feedback report - phone call from Director with final score & award tier. Higher tier the better. Then receive feedback report. This report takes each section and documents in bullet points your strengths and opportunities for improvement. It also scores each section.
  • Each year after our initial application in 1992, we used a cycle of continuous improvement:Wrote applicationSubmitted to BaldrigeUsed the feedback report to tie into StratPlanAnnual StratPlan meeting to review w/TLs & DocsCreated objectives & goals – to implement throughout the yearMeasured our resultsAnd start all over!We won the top level award in 1999 at the Quality Dayton event. You can see, we invited our dentists & staff to attend this celebration. After winning the top level in our city, we moved to the state level – applying for the Ohio Partnership for Excellence award every few years. Generally, we score in Tier 2 – displaying a Commitment to Quality. However, anyone involved with Baldrige will tell you – its not about the awards. Frankly, as the business manager I’ve tried to use these awards as a way to promote our practice – and just nobody knows about it!
  • Biggest benefit:self-assess your organization, Measure your results and to get your team moving in the same directionCriteria give you the right questions to ask so you can develop your leadership skills Create the practice of your dreams - by answering each questionThink strategically - in your town Example – results – Healthcare Outcomes - Why is it better for a patient to come to you instead of the dentist down the street? Not b/c you’re friendlier - how you are improving your patients health in a way that can be measured? Now – how’s that for a challenge? Ask your team Do research – sleep apnea, AAOSH,Caries risk assessmentYou can set your vision – and use the Baldrige to help you accomplish it.
  • Some benefits we’ve experienced – New patients – we avoided PPOs - the measurement forced us to see the reality in our area – and then focus on marketing Marketing $ spent per new patient
  • Staff development To make sure we can afford this well trained staff – large case acceptance These are just a few of the graphs I’ve tracked for years to measure our results.
  • One good story about how our tracking paid off – new patient emergenciesAlways tracked NPs and how startDramatic increase in NP emergenciesOpportunity!Re-evaluated the visit – patients would have been recall but poor economyUpdated the form – 1st secretary, then assistant “Do you plan on dentures or do you want to keep your teeth for a lifetime?” Bonus - $10 to assistant if form completely filled outCoached the assistants on how to have this conversation Measured who was most successfulIf you focus on your numbers and measuring your outcomes – then you can make better decisions.
  • Okay – it’s time, let’s take 5 minutes for you to say hello to the folks around you. Ask each other these questions & see if you can create a connection.Also – I have one extra bonus for anyone who likes to win things! I am giving away 2 copies of the Baldrige criteria for Health Care – to someone in this room. If you would like to win this criteria – then, please drop your business card or a slip of paper with your name/email address into the hat I will pass around and I will select a winner at the end of this presentation!Also, if you have any questions, my contact information is on my brochure at the back of the room.Need to ask DemandForce – would someone help me to gather these names?
  • Now you know about the Baldrige award and you have seen the 7 sections of the criteria. Next, we’re going to look at each of the criteria and see how they fit into your practice, then you can really dig in and apply these ideas into your own practice.Start with Leadership.Which way is north? Point. (Friend have compass on phone to tell answer.)Baldrige is about setting direction – and then communicating to your team which way we’re going.Its all about your leadership system - start with vision, mission & values then translate these into a handful of strategic objectives then into stratplan, into scorecard, into individual, then evaluate all & that feeds back to the beginning.Baldrige doesn’t care about your leadership style – only about how effective you are!Dr Smith created a management team – TLs, DDS, OMVision/values into the staff training – seclev1 - philosophy on answering phone questions; watch the Caine Mutiny movie in level 4 & answer questions; read a children’s book “Mr. Hatch” in general level 1; even how we handle the balance between business & healthcare written into lev3 the business of dentistry. For new dentists – interview questions on philosophy & how would you handle situations.Deploy:Regular meetings – TL, staff, DDS – quarterly all togetherTo Measure - practice growth (patients, $); staff career advancement
  • 2.0 Strategic PlanningDevelop your strategy: Identify your core competencies, strategic advantages & strategic challengesCore competency – always internal – it’s what you do To identify yours – think about your work system.Work system – Check in patient, Greet/seat by assistant, Dentist comes in provides & tx, Maybe to RDH for cleaning/periotx, Check out at front desk, Financial arrangements, schedule next visitStrategic Advantage – technology, great relationship with your lab, physical locationStrategic Challenge – hiring staff, outdated equipment Implement strategy Gather ideas & input – staff, dentists, suppliers, patients, statisticsJanuary – run our statistics – patients, staff, finances, each dentist/specialist, suppliersMeetingsCreate workbook – full day with management team off-siteCreate the planImplement throughout the year in team meetingsSet specific measurable goals in all sorts of areas – encourage new dentists to expand clinical skill – track # procedures & set goals.Providing real numbers allows us to see realityActual planning gives us content for meetings – and keeps us focused on moving forward.
  • 3.0 Patient / Customer FocusDifference between Customer Engagement vs. SatisfactionEngaged clients go to extra steps to advocate for the organization. More involved. Even if satisfied may not be engaged. How many of your customers would be willing to tattoo your brand on their arm? Or put a sticker on their car? Are they willing to wait in long lines?Think about what brands you’re engaged in? Certain things are not satisfiers, only dissatisfiers. Such as cleanliness & billing accuracy. If we cross off these items only left with what actually engages patients.So – how do you engage your patients? What is your process? To find out – identify your patients that are engaged (writing great reviews) and ask them!How are you listening to your patients? In comp exams, email surveys, FB comments, comments to staffAnother major item here – Patient complaints – How do you handle these?Great way to identify dissatisfiers & eliminate them!
  • Let’s dig deeper into this section. 3.1 Voice of the Customer – How gain info?3.2 Customer Engagement – How build relationships?3 examples of How HealthPark tackled this challengeSatisfaction Patient ComplaintsPatient engagement – FB commentsExtra bonus – measurement of our supplier DemandForce!#1 – Patient Satisfaction – How did we listen & measure?Listen & gain info through surveys – used to do hand printed, then discovered DforceDforce surveys – 5 questions standard, 2 custom & benchmark dataPlus public & private comments – great way to listen/gain infoFor positive comments – reply and thank the patient! They’ll be shocked you actually even read their survey comments!Plus – measure our performance to other DF customers for each question! #2 Patient Complaints – What is our process to handle these?Negative comments on surveys – staff trained to give to me – I called the patient & thanked them for taking the time & sharing their thoughts. I asked more questions to find out what happened, then f/u with provider & got back to the patient to resolve. Great PR. In fact, on the OM page in the practice website, I also encouraged upset patients to call me!This also allowed for excellent tracking – Complaints per Total patients (24 in 2012 out of 5839 patients), Type of complaint ($, insurance, scheduling, communication or unreasonable), % satisfied / staying in practice – I averaged 78% over 10 years!Here’s an aside – how would you feel about your office manager who was not only responsible for handling patient complaints, but also could provide you the tracking for her success at maintaining these patients? When you use the Baldrige concept – and in this case, DemandForce – you can establish a solid system of listening/learning that you can end up using in your marketing!
  • #3 – Patient Engagement – FB commentsHOW do you do this? One way was again through Dforce & their connection to FB. We set our DF survey comments to automatically post onto our practice FB page – this is not generally recommended b/c if you get a negative comment – it’s shared also. But – for OM’s and dentists fighting every day to add fresh content to their FB page – why not let your patients do the work for you? So – this absolutely meets the Baldrige goals of engagement – people love to see what other people say!Again – measurement is key – tracking our FB fans and patients with opted in emails and website unique visitors. You can see our resultsAnother bonus of using the Baldrige process – measurement of your suppliers.DF provides an end of month report that provides:# visits scheduled & their total $ valueFrom – recall emails sent out (monthly & yearly); from referrals, from quarterly newsletters (WOW), and from our quarterly reactivation for 2+ years patients – each with the associated $ valueIn fact, they also assign a $ value to surveys & confirmations, but I never counted those as real $$ coming in. Look at the $ generated from Dforce! You can see why I’m such a fan.And – if I didn’t pay attention to track my numbers thanks to the Balrige concept – I would never know what a great performer DF really is.
  • 4.0 MeasurementThis is the bottom bun – supports everything. Criteria look for 2 items:Continuous improvement – image of straight line slightly increasing- improvement in recall or unscheduled txInnovation – Brand new idea or new way of doing something – Introduction of new service in your practice – implants or sleep apnea appliance; could be new marketing approach – use of video in your websiteYou’re the CEO of your practice – and only allowed to measure 10 things – what would you choose?Wrap back into your strategic objectives – patient care, staff satisfaction, financial performanceOne interesting aspect – how measure patient care?Leading vs lagging indicators - give you a clue are the leading ones. Story: Friend in college had car with broken gas needle. Ran out of gas – lagging indicatorSo, she took ping pong ball & put into tank & when she heard it rattling around she knew time to get gas – leading indicator
  • 5.0 StaffHow do you engage your staff? Again satisfied vs. engaged. – Do they contribute ideas? Volunteer to help on special projects? What is your process for hiring & training new staff?Workforce capacity vs capability- number of people to get the work done vs the skillsDental staff training manualsHiring & all advancement based on completing levels – we fire you if not!Allows like-minded staff to work together – & gets rid of the slackersHelp each other – especially general levelsHiring processEngage staff – set incentives tied to bonuses for teams & individualsRDH production / commitmentsAssts – production of their dentist & conversion of NP emergencies to recallSecs – incentives by level – Lev3 - filling hygiene schedule, production goals for each dentist, Lev4 – Case acceptance, Using CareCredit, Lev5+ – Individual – our collections/insurance manager has AR goals; Specialist coordinators have case acceptance goals; Team leaders have training goals for their team membersOrganizational success – Share our results & cheer for achievement!Personal success – can use the people skills, financial security infoWe measure:Turnover, retention, level advancement Goals accomplished – bonuses earnedHow would you answer these questions?
  • 6.0 OperationsThis section is all about Processes.Process is a series of linked activities to create a desired outcome. Example of a process diagram on making coffee. The value of this section is identifying your key work processes – essential to your success. Most organizations have 50% key & 50% support processes. Core competency leads to your key work processes. This is where your practice success comes from.So – ifHealthPark’s core competency is the how we provide general & specialty dental care – then one of our key work processes would be scheduling appointments – making sure we schedule to coordinate all the specialists/GPs needed for that patient.When you take the time to write down your key work processes, you realize how valuable they are – and then you can set up your expectations – and measures so you know how you’re doing.
  • 7.0 ResultsTypes of results:Your levels (current performance this yr)Trends (3 data points)ComparisonsIntegration (match to process)Practice/healthcare outcomes - measure our success at keeping patients healthy (kids & adults decay free; teeth lost in our recall population, warranty expense)Patient outcomes – DF survey results – each question, Patient complaints; clients over 10 years, cancellations/no-showsStaff outcomes – staff bonuses, Hygienist productivity, EFDA production, OSHA accidents, turnover & absenteeism by team & altogetherLeadership outcomes – patient safety & strategy accomplishment; Financial/market outcomes – collections for each dentist & specialist, overhead – dental supplies, general expenses, marketing expenses, market share – comparing population of Tipp & Troy with our active patientsWhat results do you track in your practice?
  • So – even today, after 25+ years – the Baldrige is still virtually unheard of by the general public. However – hospitals & the medical industry are already getting on the bandwagon.Dentistry is next – there is a new quality movement in dentistry – DQASponsored by ADAPurpose: To develop performance measures for oral health careI attended their 1st conference in June 2013 – 100 people starting to come up with these measures & spread the word in dentistry. Some ideas from this conference:Government is already stepping into healthcareAlready in Medicare/Medicaid with hospitals – reimbursement is based on health care outcomes & performanceSince dentistry follows medicine – our next steps will be for our reimbursement to be based on our health care outcomes and our own performanceSo – what measures will be used to measure dental health? The start is Yelp & Angie’s List reviews – FB & Google reviews – but still, this is patient experience – soon this will turn into websites that will compare clinical health outcomesThere are websites now that compare hospitals – how many heart surgeries were done? Complications?
  • Here’s an example – on the Medicare.gov website you can select up to 3 hospitals to compare – and here is a graph showing % of time each hospital gave coronary interventions within 30 minutes of admission – and the benchmark for top hospitals is 100%. If one of the 3 hospitals doesn’t even rate on this scale, would you go there?What will that look like for dentistry?What will this look like for your practice?
  • So – if you’re interested in the Baldrige, its as easy as 1 – 2 - 3For free – read the criteria at the NIST website www.nist.gov/baldrige You also can find a Baldrige program close to you – in NY & Mass – Partners in Performance ExcellenceAll white states have a state Baldrige program – the colors show regional programsYou also can check out the DQA website and start learning about quality in dentistryAlso – remember the friends you met sitting beside you? You could agree to exchange data between you. Finally – you’re welcome to pick up one of my flyers and call me if you have questions
  • Thank you for your time today.Happy to answer questions.
  • Using the Baldrige to Accomplish your Vision: One Dental Group Practice's Story

    1. 1. Sharing our Success Growth using National Quality Standards
    2. 2. Top Issues facing Dentists Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    3. 3. Baldrige can help • Used by governments, schools, manufacturers & health care • Hospitals using Baldrige: • Are 83% more likely to be among Thomson Reuters Top Hospitals • Outperform non-Baldrige hospitals on 6 of 7 100 Top Hospitals measures • Of 100 Top Hospitals winners, 80% extensively use Baldrige practices Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    4. 4. Course Objectives 1. Discover the Baldrige 2. Learn to use measurable criteria to make decisions 3. See examples from a group practice so you can steal & adapt! Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    5. 5. HealthPark Dentistry Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    6. 6. Group Practice Model • • • • • 3 GPs Oral Surgeon Orthodontist Pediatric Dentist Periodontist • Specialists 1 day/week • Win-win for specialist, practice, RDH, admins, assistants • My role Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    7. 7. Dental Staff Training Manuals • Legionnaires disease (later AIDS) changed sterilization from no gloves to mini hospital operating room • Word of mouth training left risky gaps • Written manuals solved the problem • Grew into Levels for assistants, hygienists, secretaries • General levels for all Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    8. 8. American Society for Quality • 80,000 ASQ members worldwide (156,000 ADA members) • ASQ helps organizations improve their quality • Invited small business owners to learn quality • Dr. Smith & Jill partnered to apply the concepts • Dr. Smith focused on dental skills – MAGD, Dental Society plus community service Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    9. 9. Value of Baldrige Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    10. 10. Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    11. 11. Comprehensive Overview Strengths • Group practice • Strong dental staff training program Weaknesses (OFIs) • Growth of new patients • Profitability below goals Strategic Challenges • Local economy – dropping dental insurance • Challenge recruiting dentists into Tipp City Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    12. 12. Our application experience Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    13. 13. Awards Continuous Improvement • Wrote application • Submitted to Baldrige • Used feedback report • Strategic Plan • Measured Results In 1999, HealthPark won the top level award at the Quality Dayton event. State-level awards Tier 2 Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    14. 14. Benefits of Application • Self-assessment • Measure your results • Criteria provide the right questions • Think strategically • You set vision For Example: Healthcare Outcomes Why is it better for a patient to come see you instead of the dentist down the street? Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    15. 15. Our Results New Clients Marketing $ spent / New Patient 1500 $60.00 1000 $40.00 $50.00 $30.00 500 $20.00 $10.00 0 2007 2008 2009 2010 2011 2012 Measuring our results helped us see the reality and we focused on marketing & added PPOs $2009 2010 2011 2012 We also tracked the performance of our marketing investments. Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    16. 16. More Results % of Total Staff in Level 4+ 100% 80% 60% 40% 20% 0% Case Acceptance 80% 60% 40% 20% 0% 2008 We measured our dental staff training program performance. 2009 2010 2011 2012 To afford our large, welltrained staff, we measured case acceptance. Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    17. 17. Good Story New Patient Adults 700 600 Prophy / Comp Exams Emergen cies 500 400 300 200 100 0 2008 2009 2010 2011 2012 • Tracked our new patients • Identified a drastic increase • Re-evaluated the emergency visit • Updated form • Coached assistants • Bonus: $10/NP converted to recall Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    18. 18. What do you measure in your practice? What changes have you made based on your results? Thinking about your practice today, what would you like to measure? Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    19. 19. Leadership Baldrige sets direction, & then communicates to your team which way we’re going. Leadership System: Vision/Mission/Values into Strategic Objectives & a Strategic Plan then measure Results & start again! • HealthPark management team: Team leads, Dentists & me • Vision/Values into staff training: phone questions, Mr. Hatch book, training on the business of dentistry • Measured: Active patients, $, staff career advancement Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    20. 20. Strategic Planning Develop your Strategy • Core Competency – What you’re known for / What you do – Your Work System • Strategic Advantage – What you have: location, great lab, technology/equipment • Strategic Challenge – Hire dentist, Increase productivity Implement your Strategy • HealthPark approach: • January: Run numbers & gather feedback • February: StratPlan full day meeting to set goals • Create Strategic Plan – a calendar of projects/tasks • Implement through weekly TL meetings Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    21. 21. Patient Focus Customer Engagement vs. Satisfaction • • How many of your patients refer? How many drive more than 15 minutes to come to you? How do you engage your patients? • What is your process? How do you listen/learn? Customer Dissatisfaction • Dissatisfiers • How do you handle patient complaints? Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    22. 22. Dig Deeper: Patient Focus How gain info? How build relationships? DemandForce Surveys 100% 98% 96% 94% 92% 90% Would you return Refer a friend 100% Complaints Satisfied 80% 60% 40% 20% 0% 2006 2007 2008 2009 2010 2011 2012 Patient Satisfaction: Surveys • 5 standard questions; 2 custom • Public vs. private comments • Benchmarking Dental Practice Coaching Coaching dentists & office managers to run successful dental practices 2001 2003 2005 2007 2009 2011 Patient Complaints • Negative surveys & comments • Opportunity for Public Relations • Tracking: Complaints/Total Pts, Type of complaint, etc. • Your Office Manager do this? www.dentalpracticecoaching.com
    23. 23. Dig Deeper: Patient Focus How engage patients? How measure suppliers? FB Fans 2012 300 200 100 0 $200,000 $$ Generated from DemandForce $150,000 $100,000 $50,000 $2008 2009 2010 2011 2012 DemandForce & Facebook • Patient reviews/surveys auto shared on FB • Measurement is key: FB fans & website visitors DemandForce Reports • # visits scheduled & $ production from recall emails, referrals, campaigns (WOW) • Not include $ value of surveys, confirmations
    24. 24. Measurement CEO Dentist 10 Measures • • • • • • • • Your numbers tell you: • • Continuous improvement: recall? • Innovation: new service or marketing? • New patients Production/Collection Staff Compensation Overhead Recall % Total Active Patients Case Acceptance Unfilled hours Referral Sources Kids/Adults Decay Free Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    25. 25. Workforce • • • • What does an engaged employee do? How do you hire & train new staff? How manage capacity & capability? How create culture? Safe environment? HealthPark’s approach • Dental staff training levels – careers based on levels • Unique hiring process: staff interview & vote • Incentives tied to bonuses for teams & individuals • Assistants: Dentist production & NP emergencies • Front desk: Fill RDH schedule, Case acceptance • RDH: Production, Commitments • General levels for personal success (financial security) Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    26. 26. Operations Identify your key work processes to achieve success. HealthPark: Core competency is how we provide general & specialty dental care. A key work process is scheduling. Take the time to write down your key work process – then measure!
    27. 27. Results • Practice outcomes: What are your healthcare & process effectiveness results & how do they compare with your competitors? Kids & adults decay-free; Teeth lost in recall; Warranty • Patient Outcomes: Satisfaction? Engagement? Survey results; Complaints; Clients 10+ years; Cancel/No-shows • Staff Outcomes: Development? Engagement? Climate? Bonuses, RDH/EFDA production; Turnover; Absenteeism • Leadership Outcomes: Legal? Ethics? OSHA accidents • Financial/Market Outcomes: Financial performance? Marketplace performance? Collections; Overhead; Market share Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    28. 28. Quality in Dentistry Baldrige 25 years later . . . DQA – sponsored by ADA Purpose: To develop performance measures for oral health care Ideas from 1st conference: • Government into healthcare • Medicare/Medicaid reimbursement based on healthcare outcomes • Dentistry follows medicine • So, what measures will be used to measure dental health? • Online reviews measure patient experience now • Soon will include clinical healthcare outcomes Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    29. 29. Quality in Medicine % the hospital gave coronary intervention within 30 minutes of admission What will this look like for dentistry? What will this look like for your practice? Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    30. 30. What can you do? 1. Get a copy of the Baldrige Criteria 2. Find a Baldrige Program 3. Start to self-assess & measure: Use my flyer 4. Questions? Call me! Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
    31. 31. www.dentalpracticecoaching.com And the winner is . . . Dental Practice Coaching Coaching dentists & office managers to run successful dental practices www.dentalpracticecoaching.com
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