The leader in online solutions and dental front office training!
The leader in online solutions and dental front office training!
Laura witnessed first-hand what was missing from the front office of dental practices - training. After twelve years as an office manager and two fee-for-service dental practices, Laura sought to bring resources to directly to other dental practices.

Schedule Makeover: From Reactive to Proactive

Schedule Makeover: From Reactive to Proactive

5/22/2017 1:13:28 PM   |   Comments: 0   |   Views: 161
The schedule causes the greatest amount of stress in a dental office. The one thing we know about the schedule is no matter what we do, no matter how often we confirm, regardless of how much we plan there will be changes in the schedule.  There will always be people who run late, doctors who run late or emergencies we must fit in and those situations have the potential to create issues among the team.  Before you know it, the front office gets mad at the back office because they're running behind, the staff gets upset with the front office team because they schedule emergencies where there is no room, or a hygienist feels frustrated with the assistants because they need the doctor to do an exam.  

What’s the solution? When it comes to the schedule, offices must shift from reactive to proactive attention. When I print the schedule in the morning, I can guarantee what is printed there in the morning is not what it will look like at the end of the day.  If we know this, why do we wait until something happens during the day and react by running around trying to figure it all out versus being proactive and planning for these problems before they happen? 

10 Ways to Shift from Reactive to Proactive

The future is now.  The tendency is to schedule appointments in the future thinking, “that's six months from now or that's a week from now.”  If you do not schedule the patients and appointments correctly or per your office policy, when the day in the future becomes today the likelihood increases that the day will be stressful because the appointment wasn’t executed correctly.  Maintain a scheduling plan and even when you are scheduling patients for future appointments follow that plan.  When each day arrives, there are no surprises and you have been proactive about creating a productive well-run day instead of being reactive just trying to make the day work because that's how it was booked in the past. 

Put in blocks.
There are various appointments that should be blocked in the schedule. If we don’t put in the blocks, the schedule gets filled with other appointments and specific things you want in the schedule don’t happen. When I say fill the schedule with blocks, I mean blocking the schedule and not moving that block until the appropriate appointment is put in the corresponding spot. First, block primary appointments or large high dollar value appointments.  These blocks support your daily goal by giving you the greatest impact and are most likely to help you achieve that goal.  If we don't block primary appointments, when we try to fit one in there won’t be any room because the schedule is filled with smaller, low dollar value appointments. Next, block for new patients to ensure we get new patients in as soon as possible. What happens if you don't block for new patients? When a new patient calls and your schedule is so full you can't see them for a few weeks, you will potentially lose that new patient. If the team is having trouble getting other appointments into the schedule, like perio, block for those too. Finally, block for meetings and lunches.  It's important your office take time to have meetings whether it's an entire staff meeting or department meetings. If you don’t make room in the schedule in advance, the meetings will not happen. Create the blocks and schedule around them rather than try to find availability in the schedule once it's full of patients. Don’t forget to create blocks for lunches – everybody deserves some sort of a break during the day and if the office starts to run behind in the morning the block for lunch will allow the staff or the schedule to start back up on time after lunch. 

Clean up future days. As you work through the schedule and you look forward a day, a week, two weeks or a month out are there holes in it? If so, it’s likely it did not get scheduled correctly – for example there is a thirty-minute opening between hygiene appointments or a patient is not scheduled at the start of the start but half an hour before or half an hour after the start of the day. Try to move those patients up, down or around to maximize your schedule but do it in soon because patients are easier to move a week or two in advance then they are the day before their scheduled appointment.

Take a three-day approach. Today, tomorrow and the next day - work to improve the schedule and create more productivity in that order. If today's schedule isn't the best it could be, then today is the priority and the focus is fixing today. If today’s schedule is great, then work on tomorrow’s schedule. When you have today and tomorrow set schedule the way you want it to look, start addressing future dates. As you work on future dates, if something happens to today’s or tomorrow’s schedule, your priority shifts back to today and tomorrow.

Look for issues and opportunities. When we have times in the schedule where things may be a little jammed with patients, rooms need to be turned over or we squeeze an emergency in, a reactive office who hasn’t planned accordingly will end up with upset employees who feel like no one is there to help them. Instead, look at potential issues or opportunities during the morning during the huddle. The team can look at the schedule and discuss certain times of day where things may back up. If there are a lot of rooms to turn over at a certain time, discuss it in the morning and a cross-trained front office team member can plan to go back and help or you are short-staffed up front and the front office employees need lunches mid-day, an assistant can plan to answer phones during that time.  Discuss these times in the morning and develop a game plan rather than have disgruntled employees at the end of the day. 

Ask where to put emergencies. We know throughout the day there is a high probability that patients will call in need of an emergency appointment. The mistake is made when emergencies call and the front desk employee schedules them where they think is best. Or, they let the patient tell them when they want to come in – neither option is necessarily the best for the office schedule. They may even ask the doctor where the emergency should be put and usually the doctor (who doesn't seem to need to take lunch like the rest of us) will tell them to squeeze them in at lunch or at the end of the day.  The result is growing animosity over where emergencies go because the assistants are the ones who take the emergency back, handle x-rays, and all the information necessary for the doctor to do the exam. This is another opportunity to be proactive, utilize the morning huddle and ask the assistants where to put emergencies. When the front office schedules emergencies based on the assistants input, there is no chance of animosity. 

Double and triple confirm flaky patients. There are many questions about when and how to confirm patients, what you should say and how far in advance to confirm. It really depends on the patient. There are certain patients that one confirmation call or one email or a combination still won't get them to arrive. If you have patients like those, don’t be reactive when the patient doesn't show up for the appointment and say, “see I told you they weren't going to come.” Be proactive. If the patient needs two phone calls, three emails and a text -then do all those things because it's our job to make sure we do everything possible to ensure patients arrive for their appointments. If you have issues with certain patients that still don't arrive after you've done all this? The proactive approach is not to continue to pre-book them and instead put them on a same day only call list.

Do a time study. If you are regularly running behind, do a time study. A two-week time study is an exercise to determine how long each of appointment lasts in your office. When you complete a time study, you're doing an across-the-board evaluation of each appointment in your office, how long it takes and then divided by the number of times that procedure was done over the course of two weeks. The result is the average amount of time per procedure. Two weeks includes the appointments that went smoothly with no problems and the appointments when a patient couldn’t get numb or was a gagger and took longer.  It includes all the appointments for a two-week period and will give you an average of how long it takes. Now, you can schedule appointments based on the actual time needed to help alleviate constantly running behind. 

Set daily goals and schedule accordingly. Every office should have a monthly schedule or production goal, and a weekly production goal which subsequently creates your daily production goal. Many offices have a goal, but don't schedule to that goal.  A daily goal sets the pace for the schedule.  Don't try to meet the goal and then continue to schedule over that amount on one day and the next day be significantly under that amount.  It’s better to have a daily goal and 
schedule to that goal every day and create consistency rather than struggle every day while pressuring your team to produce double the goal one day and the next day leave them with nothing to do because you are scheduled well below the daily goal. 

Have a scheduling policy. Have a scheduling policy and make sure that everyone on your team knows and schedules in accordance with it.  If you do not have a scheduling policy, get together as a team and create one. The Front Office Rocks website offers our clients a sample policy you can use as a starting point. During your policy meeting, discuss the different things that come up in the office throughout the day and decide (as a team) how each should be handled. Now that you have a policy, it’s important the staff follows it and collectively become more proactive about handling issues and not be reactive and waiting until these issues arise. Because we know - no matter what we do issues will arise in the schedule every day.

A proactive, well-built schedule that handles issues before they arise coupled with a thoroughly developed scheduling policy ensures your team knows what to do when issues come up (and they will come up!) and will create a stronger, more cohesive team environment among a staff who know how to prioritize. Both will help you hit your daily goals and eliminate the constant stress that can result from the schedule and how the day runs.
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