Measure What Matters to Sustain Growth and Improvement
Carrie Webber
Your dental practice is currently headed in one of three directions: it's either growing, plateauing, or shrinking. "Busyness" does not necessarily equate to productivity. To create an intentional approach to continuous growth and improvement, a practice must set clear, specific goals and measure and evaluate performance in comparison with these goals. This article outlines three key aspects of a dental practice that need to be measured consistently.
Practice Performance Measurables
Key performance indicators (KPIs) should be measured regularly. Moreover, goals need to be set within these metrics to ensure the practice (ie, the leadership and team) is striving to grow and thrive while also meeting the financial and performance objectives necessary to keep the doors open and employees paid. Important KPIs for dental practices include the following:
Production. Production goals that the practice works toward regularly need to be established, including daily, weekly, monthly, and yearly goals. When the practice hits its goal consistently for 3 months, it is trending, and the goal can then be raised to begin stretching again.
Collections. The founder of the author's firm, Cathy Jameson, often says, "we want you to collect what you produce." When dental practices do not have a handle on their collection numbers, they can feel blindsided with how hard they are working versus very little financial reward being reflected in the bank. Streamlined collections systems need to be in place and insurance relationships and fees regularly monitored to ensure collections are on track.
Hygiene production. Just like setting overall practice production goals, hygiene, if it is a part of the practice, needs to perform as a pivotal producer. Along with hitting healthy production goals, practices need to have a strong hygiene retention system in place and be good educators and providers of periodontal therapy.
Accounts receivable. If accounts receivable (AR) snowballs, it becomes increasingly difficult to manage. Accounts that are more than 90 days past due become particularly difficult to collect. A practice needs to closely monitor its AR-ie, someone needs to be paying attention-to stave off the snowball effect.
New patients. A practice should know how many new patients it specifically needs to achieve its production goals and where its new patients are coming from. This information should be monitored and documented every month so that the practice knows what it needs to be working toward, how many referrals it is getting, and what marketing is working best.
Patient attrition. It is crucial to know how many patients are falling through the cracks and going inactive. It doesn't matter how many new patients a practice gets if its lost patients number is always higher. This is a "red flag" for a practice looking to grow.
Treatment acceptance. While a good goal is to accomplish 85% treatment acceptance, most US practices are closer to 37%.1 A practice should set attainable goals and course-correct its processes and skills to achieve more consistent success. When a patient walks out rejecting treatment that they want or need, everyone loses.
Overhead and cash flow. Obviously, a practice must know how much money is coming in versus how much is going out. This KPI should be in line with the usual and customary windows of percentages that a practice overhead should reflect. If the practice is out of alignment in any areas, it needs to find out what it can do to reduce cost in order to increase profit.
Systems Performance Measurables
Dental practices are often held back by the execution of key systems in their practice. Systems that can either build up or wreak havoc on practice performance and team cohesiveness include the following:
Scheduling efficiency.Scheduling must be made with an eye toward meeting production goals, in a way that is feasible for the clinical team to execute, and with a variety of appointments in the daily schedule. Mixing appointments that include high production cases, smaller production cases, and no production cases helps prevent the team from having an exhausting and busy day with little production to show for it.
New patient scheduling.How far out new patients are being booked in a practice is important. If a new patient cannot be seen in the next several weeks, the practice risks the patient canceling, no-showing, or not scheduling at all. Because a relationship with the patient has not yet been established, timeliness is crucial to building value in the new patient appointment. New patient appointments should be pre-blocked in the schedule.
Hygiene performance. For most general practices, the author's firm recommends that hygiene make up one-third of the practice's production. The practice should monitor whether its hygiene department is hitting the appropriate goals in production and in supporting treatment education and acceptance. Roughly 40% to 60% of the doctors' restorative schedules should be coming from the hygiene department.
The patient experience. There are pivotal touchpoints that impact the patient's sense of value in the practice, the treatment, and their decision to either proceed with treatment and stay loyal and active in the practice or not. The various hand-offs and transfers of, and interactions with, a patient throughout an appointment are crucially important. Everyone on the team should know the proper processes and their role in them, demonstrate appropriate verbal skills, and be "on board" with delivering everything that is expected plus a little bit more.
Financing (and collecting).The conversations with patients about their investment in treatment, the financial options that are available, including patient financing and in-house membership plans, and the follow-up to ensure that financial arrangements are in place and money is collected are vital to a thriving practice. Having a solid financial protocol in place, attractive options for patients, and an intentional collections process will keep a practice out of the banking business and financially healthy. Remember, it's the money that is collected that really counts.
Team Performance Measurables
The leadership of the practice sets the tone for the performance of the entire team. Building and nurturing a high performing culture is key. The engagement and conduct of each individual and the team as a whole will determine the success of the practice meeting and achieving its goals. Team performance can be measured by answering a number of questions, such as the following:
Are team meetings and huddles engaging and productive? Are there clear roles, responsibilities, and expectations identified for each team member? Are team members maximizing to the best of their abilities the tools, technologies, and systems in which the practice has invested? Has intentional and regular training been provided to build confidence and competence in these tools, and is implementation taking place? Are goals being regularly set, met, and evaluated? Do team members have positive attitudes, and is there any toxicity among the team that could be sabotaging the practice's progress?
In summary, to stay on the path of continuous improvement, dental practices must measure practice performance, systems performance, and team performance. This should be done regularly, with course correction and resetting done as necessary.
About the Author
Carrie Webber
Owner and President, The Jameson Group (jmsn.com), a dental management, marketing, and hygiene coaching firm
Reference
1. The State of Dentistry 2024: Is the Sky Really Falling? Dental Intelligence. https://www.dentalintel.com/ebooks/the-state-of-dentistry-2024-is-the-sky-really-falling. Accessed August 8, 2024.
