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Nipping performance shortfalls in the bud!

April 1, 2007
In one of my previous columns, I gave SEVEN REASONS for employees' performance shortfalls...

In one of my previous columns, I gave SEVEN REASONS for employees" performance shortfalls, six of which are correctable and preventable through leadership and management.

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1 Lack of task clarity. This occurs when the employee has not been given a truly clear understanding of the tasks to be performed. For example, your new appointment coordinator, Sarah, may not have been shown how to answer the telephone in a way that makes callers feel welcome and cared for.2 Lack of task priority. Sarah may be unable to distinguish essential tasks from unimportant ones. This leads to bizarre incidents of poor performance and frustration for the dentist and staff. For example, Sarah, unaware of which tasks take precedence over others, may continue to file insurance documents and fail to acknowledge a patient's arrival for 30 minutes or more (a true story).3 Lack of task competence. Sarah may have been left on her own after too brief a training period so that she is performing tasks, such as scheduling appointments, without having mastered the proper way to do them. When this occurs, it causes quality and service to suffer and increases stress for everyone.4 Real or perceived obstacles to performance. Sarah may harbor hesitations, misgivings, or fears -- which may be real or imagined -- that hinder her job performance. For example, she may fear that she will be unable to learn your digital-charting system because she has never considered herself to be "tech-savvy." If you fail to address this, it can seriously hinder her from learning and improving her performing.5 Perceived reward for failure. If Sarah fails to file the insurance claims (which is required in her job) and she knows a co-worker will do this task for her, then she has been rewarded for not performing. It may be much easier for you or another member of your team to do things yourselves, rather than properly teach the tasks to a new staff member. This policy inevitably results in performance shortfalls.6 Lack of feedback. If you are not there to notice and acknowledge Sarah when she does something right -- such as taking extra time to obtain complete information and making a new patient feel welcome during the telephone interview -- she may feel the task isn't very important and slack off in how she performs it.

Rest assured, there are solutions to all of these performance shortfalls. For those of you who have a staff issue aching to be resolved, here are some tools that always work.

A landmark 1960s study of staff performance by General Electric uncovered principles still valid today. The study discovered that:

  1. Constant criticism of employees has a negative effect on performance.
  2. Empty praise has little effect.
  3. Constructive feedback and coaching are effective and needed daily.

To correct performance shortfalls, you must give employees the information (i.e., feedback and coaching) they need to adjust their behaviors to become successful.

To illustrate, meet another staff member, Anna, a hygienist who habitually talks to patients about movies, restaurants, and other topics unrelated to dentistry. Anna's employer wants her to discuss dental-related issues in order to educate and influence patients to embrace ideal oral health care. There are three key ways to help Anna improve and excel.

1 The employee handbook is the first way to nip performance shortfalls in the bud. By this, I mean a living, changing document that truly supports your current vision and values, rather than the canned, outdated manuals I see in many practices. Often, the reason for performance shortfalls is that expectations are never clearly established in the first place, and therefore, need to be revisited constantly. Employees feel in control when they fully understand expectations, guidelines, and boundaries. An ideal handbook includes a welcome message, a description of your practice philosophy, an equal opportunity statement, and your policies on punctuality, appearance, growth conferences, salary reviews, benefits, job descriptions, expectations, etc. Upon reading such a handbook, Anna, our hygienist, would have no doubt of her role in addressing her patients' ongoing needs. 2 With your handbook in place, the next thing to do is give feedback to Anna. This is the informal way of improving her performance. Feedback is an exchange of information that helps people monitor their behavior so they can be more successful. Change-oriented feedback reinforces what you expect (what was supposed to happen), why you expect it (why it's important), and how to meet your expectations (what behavior to change).

If I were the dentist providing Anna with feedback, I would say, "Anna, as my co-pilot in promoting the patient's oral health, it's essential that communication is focused on the individual's unique dental needs. That's what I expect [what was supposed to happen]. Our practice vision is to partner with our patients in achieving their long-term oral health needs. Your conversations are a key means of achieving that goal [why it's important]. How The employee handbook, feedback, and growth conference are powerful tools for molding a practice culture that inspires people to address performance shortfalls and grow in their jobs. can I support you in creating a dental-oriented verbal script to use from this day forward with all patients [what behavior to change]?"

3 Growth conferences are the formal method of giving feedback to inspire your team to new levels of excellence. Use these conferences to align the employees' actions with your practice philosophy, to set clear expectations, and to provide a basis for awarding salary increases.

Each growth conference consists of five steps:

  1. Open the meeting. Establish a supportive tone to put you and your staff member at ease for the rest of the conversation.
  2. Ask the employee to share thoughts about his or her accomplishments.
  3. Discuss with your staff member, in a give-and-take conversation, the opportunities for personal growth and improvement.
  4. Translate -- with your employee, in the same conversational way -- the ideas, perceptions, and insights that you have been discussing into the language of goals.
  5. End the meeting by coming to an agreement with your employee on an action plan to achieve these goals. You will need to follow up on this plan during the course of the year.

A growth conference is an excellent vehicle for Anna's dentist to reinforce and expand on his or her expectations for Anna to focus conversations with patients on their dental needs and issues, thereby enhancing her patients' hygiene experiences.

The employee handbook, feedback, and growth conferences are powerful tools for molding a practice culture that inspires people to address performance shortfalls and grow in their jobs. These tools provide a pathway to excellent service and care of your patients. If you want to empower your staff, then implement these foundational leadership tools. Is it easy? No. Is it worth it? Absolutely!

Amy Morgan is CEO and lead trainer of Pride Institute, the practice-management fi rm helping dentists better their lives by mastering the business side of their practices. For more information on the topics discussed here, see Pride's new CD/workbook program, "Take Pride in What You Pay," and attend Amy's flagship seminar on leadership, "The Dentist's Voice." Call (800)925-2600 or visit

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