Why you need a practice manual
In the frenetic pace of everyday business, having a proper guide to processes will help to create an efficient, patient-focused service
“A collaborative approach is often best. involving your most experienced, trusted staff will give valuable insight into processes”
There are a multitude of activities happening within a practice, every minute of every day. Because of the nature of the business, with patients constantly arriving, being treated and leaving there is significant scope for things to go wrong.
Patient payments being incorrectly recorded or lab work not checked can lead to significant disruption behind the scenes at the practice, to patients being inconvenienced and money lost.
Here, we review further why a practice manual can be useful, what it might contain and how to create one.
I can remember when I first starting working in dentistry, I asked a staff member how they dealt with recalls. The vague reply I received did scare me. She said: “Well, (pause for thought), what I tend to do is …!”
Much of the recall process is automated with texts, emails and letters, but there are two elements that currently are not; I would suggest that these could be clearly outlined in a process within our practice manual.
- Reception staff should know and have been trained in the techniques to get the next appointment/examination booked before the patient leaves. They know how to respond when the patient says “I haven’t got my diary, so I can’t book it”.
- After the automated part of the recall process (texts, email, etc.), the practice manual then lays out clearly what to do next: how, when, how many calls and so on are made to the patient to get the appointment/examination booked.
If a process is documented it gives it legitimacy. It says to every staff member:
- We want every action here completed to the highest standard.
- We want to do this every time.
- We want to continuously improve.
- If something doesn’t work correctly we want to know about
it and fix it.
- We want to reward staff members who look for the quickest, easiest, cheapest way of completing an action that gives patients a better service.
A practice manual helps when inducting new members of staff.
It provides a great way to structure an induction period and ensures that the efficiency that you have spent so long creating within the practice is perpetuated. Your existing staff are not constantly distracted by questions. The new employee can go straight to the manual. Staff appraisals are made easier as staff behaviour can be compared directly with what is written down in your practice manual as “best practice”.
So, what might you include in your practice manual? Ultimately, I would suggest every single system, process and procedure. It might be broken down into: reception, clinical and administration. Naturally, there will be overlaps with the policies that you already hold to ensure your compliance with CQC/RQIA, but a policy doesn’t always tell you “exactly how we do it, here, in this practice”.
How would you create your practice manual?
The answer is to start small and build it, one process at a time. Within 10 minutes of finishing this article you could have the start of your own practice manual.
Initially I would strongly suggest having a hard and soft version i.e. create a folder on your PC (in a shared drive, so others can access it) and also print each procedure and put it in a file, so it is easy to flick through. Here are the key steps
- Create ‘Contents’
- Create the template for each procedure
- Draft a procedure
- Keep adding more procedures
- Have your practice manual at every staff meeting and refer to it when a particular procedure is discussed
- When a staff member refers to a procedure, ask them to open the relevant procedure (soft or hard copy)
- Have a non-compliance report template, which is available to everyone. Whenever a system failure is found, the staff member who discovered it investigates what went wrong, and they complete a non-compliance report. Note: It is quick and to the point. What is key is that we find what went wrong and fix it. Perhaps by changing some practical aspect of the process or possibly a staff member might need some retraining.
The last three points are very important. Many practices are not process-led and so to ‘change’ your practice to be process-led you will have to reinforce the message at every opportunity. Even more importantly, however, the staff will need to understand the benefits.
A collaborative approach is often best. Involving your most experienced, trusted staff will give valuable insight into processes, and you might well find that they enjoy coming up with the best way to perform each operation.
Some suggestions for what you might include in your practice manual:
- Appointment booking (how is the ideal day constructed for each clinician?)
- Taking payment (cash, card, cheque)
- Patient recalls (what happens before and after ‘automation’?)
- Signing up a patient to the plan
- End of day cashing up
- Confirming patients by telephone (for tomorrow, all appointments over
- Lab work, in and out
- Materials ordering
- Staff communication (daily huddle, weekly meeting, monthly review).
What is included in a ‘procedure’?
- Procedure No.
- Overview – brief description of why this procedure is relevant
- Responsible person(s) – might be “All”
- Approved by (principal or practice manager)
- Next review date (three, six or 12 months from now).
We all know that every large, successful business has a well-documented system for how they perform their core operations. Tesco doesn’t allow their shelves to be stocked just how the operative feels like it. A practice manual will help you to create a patient focused, differentiated and efficient service where patient care is at
Richard Pearce spent some of his early years living in Ballymahon and now lives
in Northern Ireland. Following a business career in various sectors and an MBA, he joined his dentist wife in dentistry. Richard combines his wide commercial experience with being attuned to what it is like for an associate dentist, a practice owner and a practice manager. His unique perspective ensures he can assist a practice owner with every area of the practice to create a more profitable practice and to achieve their smart objectives.