The Domino Effect

[Anonymous]

Have you ever seen a domino cascade?

Have you ever seen a domino cascade? The dominoes are all lined up in a row. You keep standing dominoes in the line until one domino bumps another in the line and they all crash. Our dental teams function much like dominoes. Each team member depends on other team members to stand up straight, do their job and not tilt over. When the tilt happens, it creates a domino effect on the team. It is like the expression, "You are only as strong as your weakest link."

Here is an example: Sally, at your reception area, gets distracted and does not signal the arrival of a new patient. She also fails to give the new patient either a greeting or any forms that need to be completed. That delay becomes a domino effect. The dental hygienist or the dental assistant who needs to seat the patient is unaware because there has not been a signal. Now time passes until the hygienist or dental assistant goes to see what's the delay. Stress sets in. The extra wait for the patient to complete their forms makes the appointment start late. This domino effect can create a sharp tone in the voice of the hygienist or the assistant as they attempt to complete all of the necessary steps before the dentist's exam. The dentist, now, may have less than ideal time with the new patient.

Domino effects occur when any one person on the team is not well trained AND does not understand their job priorities. Job duties done correctly and on time keep the dominoes upright. Job duties neglected, done incorrectly or without regard to priority effect the entire team. Even if the mishap is not in your area, you will hear the grumblings, blaming and domino effect through osmosis.

How do you get your dominos upright and lined up? It starts with the top domino, the leader/owner. The leader creates stability by understanding the value of systems, training to those systems and timely execution of those systems.

Let's say you had a consultant work with your practice and you got systems implemented. The next step to prevent dominoes falling in your practice is accountability. For some reason this seems to be the most difficult step for dental leaders. Once the system is outlined, put in a checklist and use it as a training guide. Accountability is the process of keeping tabs on right things done right. Dentists are not always at the front desk, in the sterilization area or in the hygiene room, so how can they hold someone accountable? It has to come from an empowered team. IF you are a large enough practice, this may include team leaders who help keep the systems in place. There are benchmarks for some areas of the practice, such as the business office. Yet, even if there are benchmarks, you have to meet with the person to check in on the practice statistics compared to the benchmarks.

Problem solving can also help systems stay in place. If a system is failing, then check to see if there is a system problem or a person problem. Let's go back to our example. What if the practice had embarked on a direct mail, TV or radio marketing campaign that brought a lot of calls in to the reception desk? All of a sudden the receptionist is overwhelmed with new patient calls. She was told that the new patient call is very important, so she focuses on the new patient call. While on the new patient call, a new patient arrives and she neglects to greet that new patient. She forgets to signal the team of the patient's arrival. Is there a better way for this scenario to unfold that does not create a domino effect?

Too often teams and leaders just keep on keeping on in a stress mess rather than take the time to put systems in place. Document those systems. Train everyone to the best practice standard of the system. When something breaks down-a domino goes down-it is time to stop. Review the system and the priorities. If there is a problem, then get to work together toward a solution. Is there a person unwilling or unable to perform the system the way they were trained?

Leaders need to intervene when there is an ongoing domino effect for a procedure. Leaving it alone to eventually solve itself is rarely the answer. Leaving a domino stress mess alone will only bring down the good intentions and actions of the other team members. Even the strong dominoes will eventually fall.

Great systems are the cornerstone of a great practice.

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