Enhancing Quality Improvement in Health Care via Innovation: A Lead for Change #innovation #health #care

quality improvemnet

Quality is a complex notion and means different things to different people. So before we challenge ourselves to improve quality, we need to define exactly what it means. The definition of quality is essentially very simple; we see it as the ‘degree of excellence’ in healthcare. Excellence has many dimensions. But within the healthcare sector it is widely accepted that excellent healthcare should have the following six characteristics1:
•    Safe – avoiding harm to patients from care that is intended to help them.
•    Effective – providing services based on scientific knowledge and which produce a clear benefit.
•    Person-centred – providing care that is respectful or responsive to individuals’ needs and values.
•    Timely – reducing waits and sometimes harmful delays.
•    Efficient – avoiding waste.
•    Equitable – providing care that does not vary in quality because of a person’s characteristics.
However, there are tensions among them that need to be balanced – for example, person-centeredness may not always go hand-in-hand with efficiency.A number of solutions that have the greatest potential to make lasting and widespread improvement to health services are:
•    A sustained focus on continuous improvement in the quality of health services is needed.
•    Emphasise the importance of internal motivators (for example, professionalism, skills development, organisational development and leadership), alongside external ones (for example, regulation, economic incentives and performance management).
•    Align quality at every level to make sure that all levels of the system relate to each other in supporting quality.
•    Redefine the nature of the relationship between people who use services and those who provide them.
•    Build knowledge, skills and new practices, including learning from other sectors that have improved their performance and reliability in highly complex areas.
Most important ingredient to improve quality and achieve sustained improvement. The way in which the change is introduced and implemented. Best outcomes achieved through utilising a combination of change behaviour and systematic change methods and structures
The Key Principles of Leadership and Quality Improvement are the following:
•    Vision of what the organisation should look like and agreed strategy
•    Agreed role responsibilities for Quality Improvement
•    System changes (data collection, rewards, incentives)
•    Training and development
•    Communication and commitment (Ovretveit 2005)
•    Aims of improvement and Board commitment
•    Systems alignment ( strategy, projects, leadership learning)
•    Channel leadership to system level improvement
•    Right people
•    Financial support
•    Clinicians engagement
•    Build improvement capability (Reinersten et al. 2005, IHI 2008)
We should be aware too about the Key Principles to Quality Improvement which are:
•    Governance, leadership and management (as opposed to policies and procedures alone)
•    In-built quality and safety measures (rewards, penalties for breaches)
•    Self-assessment of culture and values (expressive behaviour) –of the organisation are expressed in behaviour of quality improvement approaches, commissioners will be better placed to ask the right questions about providers’ focus on improvement and the progress
•    Performance management (setting standards, measurement, corrective action: feedback loop)
•    Dialogue and communication with key stakeholders: interaction loop
Focusing on your Service Improvement goals with the organisations strategic goals is needed to achieve those goals which serve the common organisation objective of Improving Quality and Services Improvement.

Adapted from Reinerstein J.The work of pursuing perfection. Cited by NHS Institute for Innovation and Improvement (2005) Improvement leaders Guide: Leading Improvement, Personal and Organisational Development

Challenge to organisations is to implement the change. Change is a necessary condition for survival and in organisations and individuals is a never ending search for improvements to gain competitive advantage. Change is a necessary condition of survival. In fast changing environments not to change is to lose. Change in terms of clinical leadership is to devolve power to frontline staff- to innovate locally. Use the softer term of innovation as it has less connotations to that of the term change. Innovation- term combined with change and progress.
In Core Principles change management for the purpose of patient and service improvement are Diagnosis or assessment, Planning, Implementation and Evaluation.

Innovation in Quality Improvement:
In Finding the Important characteristics of an innovation it will include the following:
•    Relative advantage (the degree to which it is perceived to be better than what it supersedes);
•    Compatibility (consistency with existing values, past experiences and needs);
•    Complexity (difficulty of understanding and use);
•    Ability (the degree to which it can be experimented with on a limited basis);
•    Observability (the visibility of its results).
The important roles in the innovation process include:
•    Opinion leaders (who have relatively frequent informal influence over the behaviour of others);
•    Change agents (who positively influence innovation decisions, by mediating between the change agency and the relevant social system);
•    Change aides (who complement the change agent, by having more intensive contact with clients, and who have less competence credibility but more safety or trustworthiness credibility

About the Author:
Dr.Hisham M Safadi (Hisham Safadi ) BDS & MSc Leadership and Management in Health Care Practice form the University of Salford where his Master dissertation was in the effect of Emotional Intelligence on improving Dentistry care in Middle East. He was born and raised in the Emirates of Ras Al Khaimah, United Arab Emirates. Dr.Safadi had start his professional career as a dentist then turn to the field of managing medical facilities and investment management. His main interest is business start-up, leadership and mentoring. Currently he is leading several projects in Manchester that is related to enhance patient experience and improving leadership style through education.
Twitter: @hishamsafadi
References:
–    Foundation, H. 2015. What is quality? – Health Foundation. Health Foundation. http://www.health.org.uk/about-us/what-is-quality/, June 12, 2015.

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How to use Patient Experience in Developing Health Care Services. #MyIndustry #health #care #patients #business

Patient Experince  Hisham Safadi Health Care

Patient Experince
Hisham Safadi
Health Care

Learning from patients Experience is not new knowledge anew or theory but it is away or a method where patients can tell us what they can’t ‘
it’s not simple but at the same time it gives us a great Opportunity to share with our patients more opinions via more chatting and discussion. By directly listening and understanding how that experience was dealt with rather than someone just repeat the story’

Learning from patient experience is not a model based on scientific knowledge but also based on narrative knowledge’ Narrative knowledge requires a threefold competence know how which are knowing how to speak knowing how to hear and knowing how to develop Emotions’

Current health care policies especially in Weston countries places an emphasis on the greater involvement of patients and health care providers in all aspects of their care, including planning provision and Evaluation .On the hand turning these policies into practice remain difficult. There is a great need to continuously trying to form a solid partnership and develop more collaborative working practice In A turbulent environment, Patients and Academics share their experience of health care practice through the process of education. At the same time patients and Medical students are sharing their experience through the process f clinical Education, We shall be looking to Enhance Patients and carer providers sharing of Experience methodology in real life and in real time.
There is no doubt that several knowing Health arthritis and organisations had developed, several tools to enhance and benefit from patients experiences through feedback systems. Although those system are rich with information some are arguing that those systems may be useless because patients are having the options not to share their experience. Unless the patient mentality is transformed to be the driver that encourage the patients to share their experience.

Finding ways to involve patients in developing, planning , delivering and evaluating health care services is a continue challenge, for Example, HealthCare providers can use habitus 1 the patients fo inform and shape treatment and care ‘ Such an assertion is attractive. Habitus functions as a matrix of perceptions, Appreciation and action.
The Patient Experience knowledge requires the doctor or the nurse to move their instruments from the body of the patients to the patient living a life. In doing this, which require attentive listening medical stall will be able to come to know what the meaning of therapeutic intervention might be for the patients, better understand behaviours that are open labelled non-compliance and the significance of these for patients.

In conclusion HealthCare Organisations can achieve better operational performance and patient satisfactory rate if the management Allie Theoretical and Practice knowledge of their staff with patient knowledge staff. By allowing the staff to spend more time with patients. This practice can empower the staff with insight of patients feeling and Experience in different situations in return the staff will enhance their experience and ability to make Conscious decision that offer support for patients.

 

 

 

 

 

About the Author:

Dr.Hisham M Safadi (Hisham Safadi ) BDS & MSc Leadership and Management in Health Care Practice form the University of Salford where his Master dissertation was in the effect of Emotional Intelligence on improving Dentistry care in Middle East. He was born and raised in the Emirates of Ras Al Khaimah, United Arab Emirates. Dr.Safadi had start his professional career as a dentist then turn to the field of managing medical facilities and investment management. His main interest is business start-up, leadership and mentoring. Currently he is leading several projects in Manchester that is related to enhance patient experience and improving leadership style through education.

Twitter: @hishamsafadi

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Health, healthcare, leader, leadership, business, organisation, start up, emotion, intelligence, emotional intelligence, scale, research, study, big data, science, Salford, Dubai, university, Saudi, united Arab emirates, Arab , middle, east, Egypt, Qatar, Jordan, , free zone, industrial, talent, management, entrepreneur, nation, Manchester, hisham, safadi, hishamsafadi, , ras al khaimah, UAE, Abu Dhabi, dentistry, dental, patients, staff, employee, government, conflict, compete, growth hacking, marketing, sales, management, administration, nurses, doctors, business plan, talent management, USA, United, State, Kingdom, UK, Europe, Auditing, White, paper, white paper, project, project management, HK, twitter, facebook, linkedin, social, media, social media, news, platforms, apple, android, google, MSN, yahoo, article, must read, read, references, resources, risk,

Mind and Medicine: Toward #Care in #Medicine and Dentistry by working with #Emotional Intelligence

mm

To enlarge the medicine and dentistry vision to embrace the impact of emotions, two large implications of the scientific findings must be taken to heart:
1- Helping people better manage their upsetting feelings – anger, anxiety, depression, pessimism and loneliness – is a form of disease prevention. One of the ways to do this would be to impart most basic emotional intelligence skills to children, so that they become long life habits. Another preventive strategy would be to teach emotion management to people reaching retirement age, since emotional well-being is one factor that determines whether an older person decline rapidly or thrives.
2- Many patients can benefit measurably when their psychological needs are attended to along with their purely medical ones. Emotional care is an opportunity too often lost in the way medicine is practiced today ; it is blind spot for medicine
Though more and more patients seek a more humane medicine, it is becoming endangered. The changing culture of medicine itself, as it becomes more responsive to the imperatives of business, is making such care increasingly difficult to find.
On the other hand, there may be a business advantages to humane medicine: treating emotional distress in patients, early evidence suggests, can save money- especially to the extent that it prevents or delays the onset of sickness, or helps patients heal more quickly. Such care also makes patients more satisfied with their physicians and medical treatment. In the emerging medical marketplace , where patients often have the option to choose between competing health plans , satisfaction level will not doubt enter the equation of thses very personal decisions souring experiences can lead patients to go elsewhere for care , while pleasing ones translate into loyalty.
Finally, medical ethics may demand such an approach. There is a clear dimension that psychological factors like depression and social isolation distinguish diseases patients at highest risk means it would be unethical not to start trying to treat these factors.
If the findings on emotions and health mean anything, it is that medical care that neglects how people feel as they battle a chronic or severe disease is no longer adequate. it is time for medicine to take more methodical advantage of the link between emotion and health. Compassion as one patient put it in an open letter to his surgeon, ‘’ is not mere hand holding. It is good medicine’’.

Adapted from: Goleman, D., Goleman, D. and Goleman, D. (2004). Emotional intelligence. London: Bloomsbury.

About the Editor:
Dr.Hisham M Safadi (Hisham Safadi ) BDS & MSc Leadership and Management in Health Care Practice the University of Salford where his Master dissertation was in the effect of Emotional Intelligence on improving Dentistry care in Middle East. He was born and raised in the Emirates of Ras Al Khaimah, United Arab Emirates. Dr.Safadi had start his professional career as a dentist then turn to the field of managing medical facilities and investment management. His main interest is business start-up, leadership and mentoring. Currently he is leading several projects in Manchester that is related to enhance patient experience and improving leadership style through education.
Twitter: @hishamsafadi

References:
1- Goleman, D., Goleman, D., & Goleman, D. 2004. Emotional intelligence. London: Bloomsbury. Pages (183-185)

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Effects of occupational regulations on the cost of dental services: Evidence from #dental insurance claims #USA

dentalinsurance

In the United States, occupational regulations influence the work tasks that may legally be performed by dentists and dental hygienists. Only a dentist may legally perform most dental procedures; however, a smaller list of basic procedures may be provided by either a dentist or a dental hygienist. Since dentists and hygienists possess different levels of training and skill and receive very different wages, it is plausible that these regulations could distort the optimal allocation of skills to work tasks. We present simple theoretical framework that shows different ways that such regulations might affect the way that dentists and dental hygienists are used in the production of dental services. We then use a large database of dental insurance claims to study the effects of the regulations on the prevailing prices of a set of basic dental services. Our empirical analysis exploits variation across states and over time in the list of services that may be provided by either type of worker. Our main results suggest that the task-specific occupational regulations increase prices by about 12%. We also examine the effects of related occupational regulations on the utilization of basic dental services. We find that allowing insurers to directly reimburse hygienists for their work increases one year utilization rates by 3–4 percentage points.

In the dental sector, state governments have expanded the legal scope of practice afforded to dental hygienists. It is still true in every state that dentists and hygienists are required to hold licenses, and that only a dentist may legally perform most dental procedures. But in recent years, licensed dental hygienists have gained the authority to perform a smaller list of basic procedures. The content of the list of services that may be provided by either a dentist or a hygienist varies across states and over time. In some cases, allowing hygienists to perform a service may open the possibility of hygienist-led firms. However, the regulations usually restrict what hygienists are allowed to do with and without the direct supervision of a dentist, which suggests that the overlapping regulatory framework is likely to matter most to firms that employ both dentists and hygienists.

Simple economic theory suggests that increasing the independent scope of practice of hygienists should put downward pressure on the prevailing price of dental services that can be produced using hygienist labour. The price effect is plausible whether the regulations are framed as a barrier to the entry of hygienist-led dental service firms, or as a restriction on the production function of firms that combine hygienist and dentist labour inputs to produce dental services. Although the end result is similar, the production function framework is more revealing about the ways that scope of practice regulations might affect market outcomes in the health sector. For instance, regulations might represent monitoring requirements that function as an implicit tax on the use of hygienists. Another possibility is that task limitations are a type of factor de-augmenting technology, which lowers the productivity of hygienists. More broadly, scope of practice regulations may alter the elasticity of substitution between hygienists and dentist in the production process. In each case, the regulations bind when at least some firms are forced to adopt a more dentist intensive production process then they would use in the absence of regulation. The upshot is that scope of practice restrictions – either entry barriers or production constraints – could lead to higher equilibrium prices relative to an unregulated or less regulated environment.

It have been studied the effects of a task based graded occupational licensing scheme that affects the way that dentists and dental hygienists are used to produce dental services. By presenting a simple theoretical model that helps explain some of the ways that such regulations might affect the dental service production function. A simple implication of the model is that the regulations lead to a more dentist intensive production process, which is likely to affect the equilibrium price of dental services. The use of a quasi-experimental approach to study the effects of the regulations on prevailing prices using data from dental insurance claims. The results showed that the price of basic dental services were about 12% higher when the service could only be provided by a dentist rather than by either a dentist or a dental hygienist. These results were quite robust to key assumptions related to spill over effects and statistical inference. In further analysis, the found that utilization of dental services is 3–4 percentage points higher when hygienists can be reimbursed directly for their services, which is an important gain given well-documented disparities in dental health and access to dental care. Overall, the results are consistent with the constrained production function model presented in the paper.

In most instances, the costs and benefits of licensing are difficult to empirically assess because licenses, almost by definition, make it difficult to construct reasonable comparison groups that can be used to estimate the levels of key health and economic outcomes under alternative policies. Cross-state comparisons are the most common way to proceed (Kleiner, 2000 and Kleiner, 2006), but these methods make it difficult to separate the effects of licensing changes from state-specific trends in the demand and supply for the affected services. In a broader sense, most of the licensing literature examines the effects of licensing on wages rather than on the prices that prevail in related product markets. By focusing on service-specific regulations, the ability to compare the effects of regulations within the same state by comparing prices in different product markets that should share similar underlying demand and supply conditions was enhanced. By studying prices rather than wages, the analysis gave a different perspective on the way that licensing restrictions affects consumers.

Another contribution comes from the analysis of graded licensing regulations. The bulk of the licensing literature frames policy discussions in terms of licensing, certification, and free entry options. This may be a natural statement of policy options, but there are very few examples of occupations that have been de-licensed in the United States (Kleiner, 2006). The graded licensing approach that was discussed in Arrow (1963) may offer an alternative approach that can reduce the economic disadvantages of licensing without overtly deregulating an incumbent occupational group.

The explicit link between job tasks and skill levels that is built into scope of practice regulations seems to fit well into the labour economics literature that is concerned with the factors shaping recent changes in the structure of wages (Acemoglu and Autor, 2011, Autor et al., 2003 and Goldin and Katz, 2008). Occupational regulations have not been examined much in that literature, which has instead focused mainly on the slowdown in the supply of skills, increases in demand for skill produced (perhaps) by skill biased technological change, changes in international trade that have led to the “off-shoring” of certain types of work, and changes in labor market institutional structures such as labor unions and minimum wage levels (Autor et al., 2008). One conceptual insight from the wage structure literature that may be particularly useful for research on occupational regulation is the idea of separating the concept of the skills possessed by different workers from the concept of the job tasks that workers perform in the economy (Acemoglu and Autor, 2011 and Autor et al., 2003). This perspective seems to apply very naturally to the notion of scope of practice regulations, although it does not appear to have been considered in this way in previous work.

Reference:

Wing C, Marier A. Effects of occupational regulations on the cost of dental services: Evidence from dental insurance claims. Journal Of Health Economics [serial online]. March 2014;34:131-143.

About the Author:

Dr.Hisham M Safadi (Hisham Safadi ) BDS & MSc Leadership and Management in Health Care Practice the University of Salford where his Master dissertation was in the effect of Emotional Intelligence on improving Dentistry care in Middle East. He was born and raised in the Emirates of Ras Al Khaimah, United Arab Emirates. Dr.Safadi had start his professional career as a dentist then turn to the field of managing medical facilities and investment management. His main interest is business start-up, leadership and mentoring. Currently he is leading several projects in Manchester that is related to enhance patient experience and improving leadership style through education.

Twitter: @hishamsafadi

Tags and Keywords:

Health, healthcare, leader, leadership, business, organisation, start up, emotion, intelligence, emotional intelligence, scale, research, study, big data, science, Salford, Dubai, university, Saudi, united Arab emirates, Arab , middle, east, Egypt, Qatar, Jordan, , free zone, industrial, talent, management, entrepreneur, nation, Manchester, hisham, safadi, hishamsafadi, , ras al khaimah, UAE, Abu Dhabi, dentistry, dental, patients, staff, employee, government, conflict, compete, growth hacking, marketing, sales, management, administration, nurses, doctors, business plan, talent management, USA, United, State, Kingdom, UK, Europe, Auditing, White, paper, white paper, project, project management, HK, twitter, facebook, linkedin, social, media, social media, news, platforms, apple, android, google, MSN, yahoo, article, must read, read, references, resources, risk,

What Dentists Should NOT say to Patients? Critical Thinking Paper 2015 #Dentists #Patients #Healthcare

dentist

I may receive negative feedback from my dental colleagues in regards to the title of this paper, with all the respect I am not defining any dentists and I am asking my dental colleagues who are concerned to read this paper till the end. I believe that thinking in positive way may lead dentists to be aware about their dialogue with their patients focusing on choosing the right terms and explanations to choose what to say and not to patients. It is a fact when dentist is able to develop his emotional intelligence and self-awareness he or she as a dentist will be able to enhance the trust level with his or her patients.

Back to the subject of the paper things that dentists in general says to their patients not necessary to be during a treatment plan session or a diagnosis session , it may rise during a general chat with the patients in front of the reception desk or at the waiting area.

In this paper I am not aiming to discuss dental practice ethics or dental fraud practice, I am looking to argue the thoughts and words that may dentists use during their conversation with patients and may develop a non-sense fear for patients.

  • Dentist are saying to their patients to have fluoride dosage in any form of intake. That’s a wrong say, in fact dentists shall explain further to their patients that an extra intake of fluoride will be causing poisoning for the patient. In 2012 Harvard study showed disturbing evidence that fluoridation greatly affect brain. Studies also begging to link fluoride effects on the brain to Alzheimer’s.
  • Dentist shall not say that removing a wisdom tooth or a third molar at early age is less traumatic. That is wrong. Studies shows that only 10-12% of people will develop impacted wisdom tooth that need a removal in one day. Yet dentists are claiming that 85% of wisdom teeth need to be extracted (Jay W. Freedman, 2012).
  • Don’t say that Amalgam fillings and silver fillings are not dangerous. Although your patients may seek the cheapest filling you shall advise them on the harmful content of amalgam and silver fillings. These fillings are primarily in question for their mercury content, about 1,000 mg.  Amalgam fillings contain more mercury than any other product you or your patient may know. Mercury poisoning can affect the body’s neurological, immunological, and endocrinological processes.  Mercury hinders the body’s ability to detoxify itself which leads to further illnessDentists are taught that because the mercury is bound with other metals, mercury does not leak into the patient’s body.  However, studies show that mercury vapour can be measured from the tip of an amalgam filled tooth.  The fact that this vapour can be measured, means that mercury is leaking into the body (Dr. Joseph Mercola).
  • Dental X-ray’s shall be taken every 6 month or yearly. Dentist should not ask, advice or convince their patients as part of their yearly visit to have another Dental X-ray to maintain a proper dental record. That’s wrong. We are exposed to more radiation today than ever before in human history. Airplanes, cell phones, x-rays, even our food contributes to our radiation levels.  Radiation is cumulative over the body’s lifetime. Radiation has been linked to thyroid cancer and brain tumours even small babies in those women who were administered a dental x-ray during their pregnancy. “The mistaken assumption is that the ultraviolet light from the sun is comparable to the penetrating photons of x-rays and gamma rays. … Ultraviolet radiation does not penetrate past the skin, it does not cause cancer of internal organs such as the tongue, lungs, breast, pancreas, colon, etc. Ultraviolet light can cause cancers of the skin (and probably some cancers of the eye). X-rays can cause cancer not only of the skin, but also of any internal organ exposed by the x-ray beam.” (By John W. Gofman, M.D., Ph.D., and Egan O’Connor. My advice, skip the x-ray if it is just a regular dental check-up.
  • Latest technologies can solve dental problems. That’s wrong. Dentist who are claiming that without modern dentistry patients will be toothless are not aware what are the benefits of Practical Dental Care. I had read a lot of stories about people who are fighting cancer and all it started with led tooth filling.

In my point of view dentists shall advise on brushing and flossing daily, the most simple and logical step that patients can take to proactively care for their teeth.  By using fluoride-free toothpaste!  Secondly, eating a healthy, whole foods, nutrient rich diet can impact patient’s dental health more than they know.  Sure we overhear that sugar will result in occurring of cavities, but did patients know that they can actually reverse tooth decay without ever going to see a dentist? Dentist role is more just than performing diagnosis and treatment, it is more to be a role of a magician to draw smiles on faces and not only treat caries.

Finally, did dentists know that a one case of two Laminate veneers worth the filling of 4 molars and 2 incisors with less efforts and much profit.

About the Author:

Dr.Hisham M Safadi (Hisham Safadi ) BDS in Dental Surgery & MSc Leadership and Management in Health Care Practice from the University of Salford where his Master dissertation was in the effect of Emotional Intelligence on improving Dentistry care in Middle East. He was born and raised in the Emirates of Ras Al Khaimah, United Arab Emirates. Dr.Safadi had start his professional career as a dentist then turn to the field of managing medical facilities and investment management. His main interest is business start-up, leadership and mentoring. The dentist personality in Dr.Safadi still rising his concerns about the dental field and encourage him to work developing dental practice policy and enhance dental patients awareness and improving their rights. Currently he is leading several projects in Manchester that is related to enhance patient experience and improving leadership style through education.

Twitter: @hishamsafadi

Tags and Keywords:

Health, healthcare, leader, leadership, business, organisation, start up, emotion, intelligence, emotional intelligence, scale, research, study, big data, science, Salford, Dubai, university, Saudi, united Arab emirates, Arab , middle, east, Egypt, Qatar, Jordan, , free zone, industrial, talent, management, entrepreneur, nation, Manchester, hisham, safadi, hishamsafadi, , ras al khaimah, UAE, Abu Dhabi, dentistry, dental, patients, staff, employee, government, conflict, compete, growth hacking, marketing, sales, management, administration, nurses, doctors, business plan, talent management, USA, United, State, Kingdom, UK, Europe, Auditing, White, paper, white paper, project, project management, HK, twitter, facebook, linkedin, social, media, social media, news, platforms, apple, android, google, MSN, yahoo, article, must read, read, references, resources, risk,

White Paper: Why Dentists shall care about Dental Assistance Role? #nurses #dentists #care

da

In any dental practices dental assistance are playing an important role in organising, managing and assisting dentist to perform treatments for dental patients. Dentists and dental practice owners shall be aware about the importance of developing dental assistance staff skills and knowledge. In this white paper we will be reviewing number of literatures that discuss the importance of developing staff skills and what are the benefits of staff engagement to the performance outcomes of dental practices.

Most of literatures agreed that dental assistances formed important part of internal stakeholders for any dental practice. Adding to that dental assistances are categorised as high power with high impact role as a stakeholder. Mauno,Kinnunen and Ruokolainen (2007, cited in The King’s Fund, 2012a) concluded that the best predictor of staff engagement to give them control over how they work. This is important in improving healthcare performance because staff engagement enhances patient experience and increases staff satisfaction (The King’s Fund, 2012a). The challenges also is reflecting on the dental practices too. In the literature listening to employees is regarded an important communication skill that leaders need to develop and it is a form of staff engagement (Macmillan, 2011). The latter is one of the Leadership management at the dental practice dimensions that recognized its role in quality improvement as engaging the team of the dental facility leads to improve patient and staff experience and enhanced overall outcomes (NHS employers, 2013).

In addition to that, the service profit chain framework highlights the importance of staff including dental assistances satisfaction as well and its overall contribution to enhanced profitability through providing quality services to the patients (Storey & Holti, 2013). The link between staff and patient satisfaction is evident in a staff survey cited by West and Dawson in The King’s Fund (2012a) where they stated that staff engagement leads to patient satisfaction.

The King’s fund (2014b) described staff engagement as the driver that influences staff behaviours leading to better health, lower absenteeism, job satisfaction and reduced turnover which will, besides other factors, improve patient satisfaction, increase profits and eventually enhance the overall performance.

Although there are some dental facilities culture are supportive of staff engagement, the dental facility management’s findings report that staff and specially dental assistances are cultured to carry out orders based on certain working circumstances such as fear of doing things wrong, losing their job or being subject to increase in working load. There is an effort by the dental facilities to engage staff and the progress evaluation for those efforts is acceptable. Staff involvement and supporting staff with a ‘can do attitude’ supports organisational innovation and performance (NHS Institute for Innovation and Improvement, 2008). The Kings Fund (2012) reports that engaged staff deliver better outcomes for patients and organisations.

There is an opportunity to improve dental engagement which may lead to override the poor staff engagement which is slowing the organisation’s achievement of objectives. According to Clark and Nath (2014), medical engagement should lead to enhanced clinical and organisational outcomes and makes a critical contribution to achieving innovation and improvement for patients. Meanwhile, another report from Dixon et al. (2011) concludes that general practice has an important contribution to make to improve public health and in reducing health inequalities. However the National Leadership and Innovation Agency for Healthcare (2008) argued that clinical and staff engagement remains a hollow sound-bite, with little in the way of levers, budgets and power to support it, and becomes merely an option to participate in a committee rather than an opportunity to encourage real practical change at a practice level on an ongoing basis.

Dentists and dental practice owners shall be able to identify poor staff engagement in their dental facilities and concluding that their strategy towards improving staff engagement is facing failure and could not depend only on a reward and punishment strategy. It is important to accept the fact that creating an engaging atmosphere where value is given to the ideas of the staff will result in proper communication and staff engagement and give accountability to the staff for self-management.

The style of the organisation enhance by empowering management leadership decisions, improving staff engagement and evaluating the outcomes of organisation performance. According to West et al. (2014), if dentists and managers create a positive, supportive environment for staff, the staff in turn creates a caring and supportive environment and deliver higher-quality care for patients. The need for full staff and especially dental assistance engagement remains a core of organisational success and service sustainability (Naylor and Appleby, 2012, p15).

It is the responsibility of dentists and dental practice owners as team leader to motivate, inform, and communicate openly whilst allowing the staff to contribute through dialogue between themselves and management (Human resources management, 2011)

About the Author:

Dr.Hisham M Safadi (Hisham Safadi ) BDS & MSc Leadership and Management in Health Care Practice form the University of Salford where his Master dissertation was in the effect of Emotional Intelligence on improving Dentistry care in Middle East. He was born and raised in the Emirates of Ras Al Khaimah, United Arab Emirates. Dr.Safadi had start his professional career as a dentist then turn to the field of managing medical facilities and investment management. His main interest is business start-up, leadership and mentoring. Currently he is leading several projects in Manchester that is related to enhance patient experience and improving leadership style through education.

Twitter: @hishamsafadi

@hishamsafadi

References:

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Why Patients Don’t Come Back? White Paper 2015 #patient #business #leadership

patients

Is your practice experiencing a lot of no shows? Are your patients requesting their records be transferred to another physician or dentist? Are your patient’s not coming back? Are your patients cancelling their appointments or rescheduling them then not showing up? If you, said yes then there may be something your practice is missing.

Medicine and Dentistry is a people service industry.  As in any service-based business, it is almost impossible to avoid the occasional disgruntled client who will not return. Sometimes we can even view losing a specific client to be a blessing in disguise. However, we all have the universal desire to build our practice upon loyal clients who refer their friends and family. Physicians and dentists (like most business owners) have blind-spots when it comes to the weaknesses of their businesses, and find it hard to accept that the service their practice provides is not as good as it should be. Physicians and dentist specially working at private sector truthfully upset their patients in a countless of situations that may not be obvious to them as business owners but they would not put up with themselves if they were in the patient’s shoes. Many times patients are not given the attention they deserve because they are viewed as an interruption to our work. They are sometimes ignored, overlooked, or pushed rudely aside as we rush to get back to performing our daily tasks. Whether patients are walking past us in the hall, in front of us, or on the phone, they deserve our respect and undivided our attention. Not only is this for their sake but also to build loyalty which is key for retaining patients. Reasons why a patient may consider leaving or not showing back into the physician or dentist practice are different but I will try to minimize to highlight the most important reasons.

To begin with Running Late .Time is valuable for both doctors and patients. Patients don’t like it if they rush to get to their appointment on time, only to sit at reception area or in the treatment room waiting for their dentist or physician to be ready to treat them. Don’t undertake that waiting for patients is acceptable as part of the deal when they reach the physician or dentist practice. Long wait times happen to be the number one complaint of patients regardless of whether they are visiting the emergency room, a physician office, or the dentist. No matter what a medical office manager does to prepare for patient appointments or visits, wait times can be difficult to reduce to the acceptable “15 minute” time frame. In a perfect world where things nothing go wrong, this can still be an impossible task to accomplish. While we strive to respect our patient’s time, time is one of those elements that can’t be controlled. There are a few ways that can minimize wait times to less than 30 minutes. Such as creating a balance between seeing enough patients that meets the financial needs of the practice but still offers a high level of quality patient care.

Don’t Criticised your Staff in front of Patients .It’s embarrassing for a patient (as well as for the team member) when a physician’s or dentist’s employee is being criticised. Equally, it is a real confidence-builder to hear an employee praised by their boss in front of a patient. There is an old rule of “criticise in private, praise in public” when it comes to providing feedback for staff.

As a practice owner you shall override any Poor Skilled Staff. Many physicians and dentists feel it is not worthwhile spending money on training and developing their staff. They often make comments like “what if you train them and they leave?” Frankly the converse is true…what if you don’t train them and they stay! Having untrained staff decreases the service level provided to patients and add to the stress levels of the patients, other staff members, and especially the physician and dentist.

A number of physicians and dentists feel uncomfortable discussing fees with patients. Physicians and dentists need to remember the adage “inform before you perform’. This is one of the biggest gripes on online review communities, and from the patients’ point of view, entirely valid. There are many times a dentist or physician can’t be precise with their estimation of costs, but at the very least, all patients should be given, a range of fees that their treatment may come to. Patients don’t want their health provider ‘selling’ them anything. Let alone a solution to a problem that hasn’t even been explained to them. And yet many dentists do this regularly when they are charting. Often treatments are charted by the dentist or the physician when calling out to the staff assistant or the nurse, before the dentist or the physician has explained the issue to the patient. Patients typically complain about medical bills being too high much like drivers complain about the gas prices. Unfortunately, there is not much that can be done about either of them. The fact is that medical care costs money. It costs the patients, the doctors, the insurance companies, the hospitals, and so on. Unless a law is passed that provides free universal healthcare to all citizens, medical bills will continue to be a part of our reality. Although, there is no way to satisfy all patients that feel this way, the medical office can reach a large number of patients regarding medical bills through effective billing communication. Simplify patient bills to improve patient understanding of billing and collection materials.

“Not enough time spent with my doctor” seems to be the fastest rising reason that patients don’t come back. Patients are reporting in higher numbers than ever before especially for new doctors. Several studies have confirmed that new doctors are spending an average of 8 minutes per patient. I can understand the patient’s frustration if their physician or dentist is spending only 8 minutes with them especially since the wait time is usually much longer than that. We understand that some of the care patients receive are indirectly related to the patient’s care. So much time goes into documentation, reading labs and x-rays, and entering orders that patients aren’t aware of. All of these are crucial in making sure patient’s get the treatment they need. So how can this issue be resolved? It is important to note that there is nothing better for the long-term dentist-patient or physician-patient relationship, than the patient feeling that the dentist or physician always has time for them. That they are not ‘rushed through’ and given the feeling that the dentist or physician is under time pressure. The majority of patients only visit the doctor once a year, if that. So when they come for a visit, they consider this as their opportunity to bring up every concern they’ve had about their health all year long in one short visit. To the doctor who has a full schedule of patients, he or she may feel the urge to rush through the visit to keep other patients from waiting too long. To the patient who has the opportunity to voice his or her concerns, he or she may feel that they are being rushed or the doctor is uncaring. There are a few ways to avoid “the doctor is ignoring my concerns” scenario. Some physicians and dentists choose to reschedule the patient for another visit to discuss other issues they may be having. The best way is to find out what issues the patient has during the scheduling of the appointment. The scheduler should be prepared to ask key questions that can help determine whether the patient needs a 15 minute appointment or if the patient needs a longer time slot. This way, the slot is available for all the patient’s needs to be met in one visit.

Sometimes patients don’t have a full understanding of what they should expect from their treatment plans or medications. Patients may not know the right questions to ask and often assume what types of results they should expect. Providing patients with a written treatment plan can encourage them to continue whatever method of treatment the physician has ordered. It is important not to talk in technical terms to the patient. Patients would like to understand what is happening in their treatment process, and dentists or physician typically use technical nonsense when explaining treatment and options. The nonsense does little to shed light on what’s happening for the patient and will often confuse them and build mistrust. Patients will be far more likely to understand their situation and trust your solutions if you use simple English!

Like it or not the public will make judgements of every business based purely on appearance. Your patients view the practice as an extension of you and your clinical abilities.
What judgements will they make of a practice that has a dated aesthetics, equipment, technology or furniture in the waiting room? What association will they make of a practice that isn’t clean or well-maintained?

When we look at online reviews of dentists and physicians another of the most common complaints people have has to do with the fees of the practice. In the absence of a relationship between the patient and the practice, then the only thing that can be measured by the patient is the price. If however there is a relationship and trust has been built between the parties, then patients will drive past many cheaper practices to go to the medical or dental practice they trust. It is imperative that physicians and dentists develop skills and take time to quickly form relationships and develop trust with their patients.

The most valuable people to the medical office is not the physicians, the nurses, or the staff -it is our patients. Without patients, the medical office serves no purpose. Sometimes, the staff of the medical office are so busy performing their job they forget that the patient is the job. Our Most Valuable Patient’s should receive VIP treatment. From the time of a patient’s first visit, the patient should be treated as if they are a celebrity. Greet your patients by first name , Show enthusiasm, smile and be genuine , thank them for coming in for a visit or let them know how glad you are to see them and Escort them to their destination instead of giving directions If they have to wait, offer them a cold beverage. Finally call them a few days later to see how they are doing

Our patients may like us, may think our service is good, and our practice is fine in nearly every regard, but still leave us as they can’t get time during our opening hours to come and see us. Everybody leads busy lives these days, and lack of flexibility and availability can cause patients to look elsewhere, especially in an emergency situation. Unfortunately, dentists and physicians only hear from the patients who keep coming back.Most patients who leave, do so quietly, and without warning. And dentists usually don’t know why.

In conclusion physicians and dentist in private sector or who are practices owners shall work to create 5 Star Service for their patients. It just requires a little more effort in understanding your patients’ desires. To achieve a better patient service experience physicians and dentists need to understand the patients want to feel special. By giving patients a little more personal attention can go a long way in making them feel special. Also, physicians and dentist should also remember to always “be present” with the patient. Patients want to feel as though they are the most important person in the world while you are with them. Another element to enhance patients experience is patients want to know that their physician or dentist honourably care about them. By giving the patient a warm welcome when they enter the office. No matter how busy your medical office staff is, someone should greet them as soon as they enter the medical office. Even if the physician or the dentist can’t verbally greet the patient, getting eye contact with them lets them know you are aware of their presence and will get to them as soon as possible. Patients want their physician or dentist to tackle any issues that arise immediately. If a problem arises with patient, rectify the situation as soon as possible. A patient will remember that you went out of your way to make them happy but if you don’t handle it right away they will remember that too. Customer service is not about getting it perfect, it’s about catering to the desires of the patient. It all comes back to the premise behind the golden rule; treat and provide for your patients in a way that would meet and exceed your own expectations, and watch your practice grow and thrive.

About the Author:

Dr.Hisham M Safadi (Hisham Safadi ) BDS & MSc Leadership and Management in Health Care Practice form the University of Salford where his Master dissertation was in the effect of Emotional Intelligence on improving Dentistry care in Middle East. He was born and raised in the Emirates of Ras Al Khaimah, United Arab Emirates. Dr.Safadi had start his professional career as a dentist then turn to the field of managing medical facilities and investment management. His main interest is business start-up, leadership and mentoring. Currently he is leading several projects in Manchester that is related to enhance patient experience and improving leadership style through education.

Twitter: @hishamsafadi

Read more from the Author:

References:

Hicks, J. (2014). 5 Reasons Patients Don’t Come Back. [online] About.com Money. Available at: http://medicaloffice.about.com/od/patientsatisfaction/tp/5-Reasons-Patients-Dont-Come-Back.htm [Accessed 26 May 2015].

Palmer, P. (2012). Where have our patients gone? The top 10 reasons why patients don’t come back – Prime Practice, the dental management specialists.. [online] Primepractice.com.au. Available at: https://primepractice.com.au/articles/where-have-our-patients-gone-the-top-10-reasons-why-patients-don-t-come-back-167 [Accessed 26 May 2015].

Transitions, O. (2013). When Patients Don’t Come Back. [online] Transitionsonline.com. Available at: http://transitionsonline.com/resources/when-patients-dont-come-back/ [Accessed 26 May 2015].

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