In the cataract and refractive surgery practice of Kerry Solomon, MD, an internationally renowned surgeon and president of the American Society of Cataract and Refractive Surgery (ASCRS), the entire staff is involved in strategic planning — an action Dr. Solomon credits with accomplishing his practice’s goals.
“Most of the time, my staff, not me, knows where specific improvements can be made to achieve my vision of efficiency and an exceptional customer experience, so I believe in empowering them to make suggestions and changes in my practice,” says Dr. Solomon. “To keep them motivated, I provide bonuses when a goal is achieved, allow opportunity for continuing education, and promote staff members who show improved skill and initiative.”
Here’s how Dr. Solomon involves staff in strategic planning, the ways they have achieved goals, and the effect this participation has on staff morale and engagement, which has translated to practice success.
In the last quarter of each year, Dr. Solomon closes his practice for one day while he and his staff, along with a marketing and/or media consultant, discuss the practice’s current goals. The team reviews what they did and did not achieve and sets new goals based on practice data, customer surveys, and online reviews. For example, as described on page 12, a review of patient satisfaction surveys and practice data led the practice to not only decrease patient wait times, but also increase the number of surgical evaluations.
Breakout sessions have proven beneficial during this day of planning. During these sessions, staff work in small groups to identify the stumbling blocks of the prior year’s unmet goals, ways to overcome them in the new year, and ideas for achieving the new goals, Dr. Solomon says. “Each group is given a different goal, and leadership roles within each group are given to those who typically don’t have leadership roles in the practice.”
Crissy Justice, the practice’s director of operations, adds that team-building activities are also included in the planning meeting. For instance, the staff once took color personality training designed to facilitate communication among the staff and with patients. (For an example, visit http://tinyurl.com/colorpers .)
“This training really helped us to understand one another and our patients. We quickly learned how to adapt to the various personalities, which ultimately improved morale among our co-workers and patients,” she says.
“At the strategic planning meeting’s end, each staff member takes on specific responsibilities toward meeting a certain goal, so that they’re accountable, and the entire staff then meets quarterly regarding goal progress,” says Dr. Solomon.
The following examples demonstrate how the staff has achieved goals born from the strategic planning meetings.
Delivering a consistent customer service message. This goal came from Dr. Solomon’s observations of how staff interacted with patients.
“What I found was that each staff member was saying what he or she thought the patient needed to know, resulting in the patient getting a lot of repeat information or differing explanations, which can be confusing to them,” he says. “So we decided to script every aspect of the patient’s visit, getting each staff member’s input. Now, everyone knows what he or she should say and who’s responsible for delivering certain information.” For example, Parker Bellamy, one of the practice’s surgical counselors, has helped to develop the script used to educate patients on their options regarding traditional vs. premium refractive options.
In terms of all-around communication, each staff member now introduces himself or herself to patients both in person and via phone, addresses patients as “Mr.” or “Ms.,” explains to patients what they can expect at every patient touch point, and introduces them to a fellow staff member during a handoff, Dr. Solomon adds.
The scripting also helps patients feel at ease, says Nikki Weas, one of the practice’s certified scribes and ophthalmic technicians. “They [patients] are coming to talk about surgery, so they’re already uneasy,” she says. “When we can make them feel more comfortable, everyone wins.”
Decreasing patient wait times/increasing surgical evaluations. After evaluating patient surveys and practice data from 2013, Dr. Solomon discovered that patients were unhappy with their wait times and the amount of time they spent in the practice.
“The average wait time was typically 45 minutes after a patient’s scheduled appointment, and surgical evaluation appointments took three-and-a-half hours, so patients were in the practice for roughly four hours,” says Ms. Justice. “To solve these issues, improve customer service, and enable Dr. Solomon to see more surgical evaluation patients (with his role in ASCRS, he has a heavy travel schedule), that one appointment was split in two.”
Specifically, the first appointment is now comprised of a comprehensive exam with Dr. Solomon — including IOLMaster (Zeiss) and Lenstar (Haag-Streit) diagnostic tests — patient education regarding the procedure, and a review of the patient’s health insurance and expected procedure costs. The second appointment consists of additional testing, such as Verion Image Guided System (Alcon), topography (Atlas, Zeiss), and optical coherence tomography (Cirrus, Zeiss and Avanti, Optovue). This is also when Dr. Solomon discusses the final surgical plan one-on-one with the patient, Ms. Justice says.
“The average wait time now is, at most, 15 minutes. We see upwards of 20 surgical evaluations a day, and we still have 14 pre-op (diagnostic testing) appointments,” Ms. Justice says.
Ms. Bellamy says that, since the template change, she’s noticed less patient anxiety, as the patient is now able to “let the education from the first appointment soak in,” and then broach concerns or ask follow-up questions at the second appointment.
Going paperless for surgery planning. “In using paper charts, it takes me quite a bit longer to find the information I need to be able to effectively make the surgical goal, so a team was put into place at our last meeting to determine how to organize the chart in a more efficient way,” Dr. Solomon says. “The result is a binder system that contains little paper and has greatly improved efficiency.”
Ms. Bellamy says that the binder is the first step toward going completely paperless for surgery. These changes allow staff to reduce the amount of printed testing and to scan administrative paperwork directly into the electronic medical record, eliminating much of the paperwork Dr. Solomon once had to sort through.
Staff morale and engagement
Staff agree that being included in the decision-making for the practice has had a huge positive influence on their engagement at work.
“We don’t feel like just an employee; we feel valued,” says Ms. Weas. “Dr. Solomon often says, ‘Team Solomon,’ and it’s so true. High fives are given out frequently. We are very much a team, and he and Crissy’s doors are always open for ideas.”
Ms. Bellamy adds that being able to provide input and ideas also enables the staff to “learn how to be better people and better caregivers.”
Another plus: The financial incentive staff members receive when they meet all the metrics created for specific goals, says Ms. Justice. She calls it an “extra motivating factor.”
Lisa McKay, one of the practice’s certified scribes and ophthalmic technicians, says the opportunity to further one’s education is another item that has enabled staff engagement.
“We are always encouraged to take courses and get certifications, and the practice pays a certain amount toward education each year,” she says. “That’s pretty fantastic.”
A practice of firsts
In addition to becoming the first surgeon in the U.S. to perform topography-guided LASIK, Dr. Solomon was the first in the state of South Carolina to:
- perform a LASIK procedure
- perform laser-assisted cataract surgery using femtosecond technology
- implant the iStent for glaucoma
- perform PRK
- perform iLASIK
- implant multifocal and toric lifestyle lenses
- perform astigmatism correction using femtosecond technology
- use advanced OZil ultrasound to remove cataracts
Everyone is important
“Every member of my staff is a key player in the practice, and I mean that,” says Dr. Solomon. “The entire customer experience is totally dependent on the staff working as a team, and that’s why they deserve my thanks. As a business owner, there is just no way I could operate a successful practice without their valuable input and ideas.” OP