- A successful practice hires well and develops people in such a way that they want to stay for all the right reasons.
- Tailor induction to the new person’s learning style.
- Induction must cover the practice’s history, values and structure; mandatory items; and appropriate job training.
- The appraisal process is a continuous one throughout the year, which culminates in a formal review in which there are no surprises for either employee or reviewer.
In the last two issues, we have reviewed best practice in the critical process of recruiting a member of your team, considering job analysis, job descriptions, advertising a vacancy, shortlisting and interviewing. At the end of the last article, we made an offer to the selected candidate. We now consider how to make a success of the new hire.
In some people's parlance, this process is called ‘on-boarding’, but this is a terrible phrase so I prefer the more prosaic phrase ‘in-duction, appraisal and development’. At the heart of this is a critical metric called retention. Just as we measure the retention of new patients, a successful practice hires well and develops people in such a way that they want to stay for all the right reasons.
There has been much talk recently about ‘employee engagement’. In recent surveys, the percentage of employees who consider themselves to be fully engaged in their company has not exceeded 30% on a global basis. Of the remaining 70%, over 20% are judged to be actively disengaged, meaning that they are effectively sabotaging your practice. Perhaps you can now appreciate the time spent talking about the right way to recruit, and having found the right candidate, ensuring that they remain fully engaged in your practice.
Prior to Day 1, the new employee should have been given their new terms and conditions, their contract of employment, and the myriad of administrative necessities relating to DBS checks, bank details, uniforms, inoculations and so on should all have been dealt with.
Your new employee arrives at the prescribed time; now what? We have heard of situations where the nurse has been given her uniform and told which surgery to go to; we have been told that dentists have been given the front door key, the alarm code, the code for the staff toilets, their shift pattern and told to get on with it. Either of those scenarios would score 1/10 at best.
Induction takes time if it is to have any meaning and for the new employee to be made welcome and to feel valued. As every indi-vidual has a different learning style, it would be inappropriate to direct the employee to a series of binders in which endless policies and protocols could be found. Unfortunately, that happens all too often. Some people are perfectly comfortable learning by reading, but others need to be shown, others like visual learning and yet others learn by doing. If we do not tailor induction to the new person’s learning style, we start off on the wrong foot.
Irrespective of the new hire’s experience, there are three elements of training that need to be covered. Firstly, we need to ensure that the practice's history, values and structure are clearly understood; while some or all of these may well have been covered during the interview process, we need to ensure that the new person has not forgotten them in the intervening period.
Secondly, we need to cover the mandatory items: health and safety, legal and other essential training; do not forget that whatever prior experience they may have had, your practice is unique.
Finally, we need to ensure that the new hire receives the appropriate job training that is specific to their position. A nurse may be a nurse and the core skills may be applicable to every practice, but your nurses practise in a unique way which exemplifies your brand, creates the perfect patient experience and reinforces your own style of teamwork 24/7.
These three processes should take several weeks, if not several months. You need to have a feedback process that on a weekly basis helps you and the new hire to evaluate progress to date and to provide the necessary additional support if required. If your practice has a probation period, usually three months, then you will need a formal monthly review to ensure that your new hire can pass their probationary period.
Too often this process is rushed, incomplete and frankly not fit for purpose, and the resultant chances to retain the new hire are reduced almost to zero.
The word that seems to strike most fear in the minds of practice employees and all those who are self-employed is ‘appraisal’. I suppose this is because appraisals are considered to be a period once a year when your boss tells you how badly you've been doing, why you aren't going to be promoted or receive a pay increase and why you're going to have to work much harder next year.
When we explain that the appraisal process is a continuous one throughout the year and which culminates in a formal review in which there are no surprises for either employee or reviewer, we are usually greeted by expressions of disbelief. But it's true: that is what a good appraisal system should be.
While many have written highly academic articles on the subject of appraisal, the fundamentals are very simple. An employee has a defined job with agreed outcomes and behaviours; the supervisor or manager (who has a similar set of goals and objectives and behavioural requirements) spends time during the year encouraging, coaching, training and educating the employee to ensure that those behaviours and outcomes are achieved. In other words, the job of the leader is to serve the employee, to ensure that they win.
Ken Blanchard, the eminent thinker and author on people and organisations, developed in his book One Minute Manager the idea of one-minute goal setting, one-minute reprimands and one-minute praisings. Each is an obligation on the supervisor or manager to help the individual win, to build on their experience, to recognise when they have not been quite as thorough as usual or when they have done even better than expected. ‘Catch me doing something right’ is a much better approach to on-going appraisal and people management than continuously finding fault; try it.
If we are keeping our people up-to-date with progress in the practice, both business and clinical, and if we are helping them perform at an ever improving level, we are more likely to keep them engaged and motivated always to do their best. When delivered sincerely and regularly, ‘thank you’ and ‘well done’ are really appreciated.
Of course, in any organisation, it is useful once or twice a year to assess formally the progress that is being made by each individual in the team. In the last issue of Dental Practice Manager magazine, Alun Rees explained in some detail how appraisals can be linked to the latest GDC Standards for the Dental Team, and how he preferred appraisals to be conducted on a 360° basis. My personal experience is that the 360° appraisal can be very effective in larger organisations when it can be really valuable to have people who are ‘customers’ or ‘suppliers’ providing useful feedback on your performance.
In smaller organisations, like a dental practice, ensuring that feedback is fact based and unemotional can be more challenging, and while it is still very helpful to have good feedback from colleagues, there needs to be a substantial education and training programme to ensure that it works. Alun raises the important point of how clinical staff are appraised, and in general the answer is ‘very badly’, because the appraisee does not really want to be listening and the appraiser doesn't know how to do it effectively.
The appraisal form should be as simple as possible, and given to the individual to complete in advance of the appraisal. The appraiser must have read the input in advance and must be able to provide all the evidence for his or her own conclusions on the individual's performance. There must be no surprises (except good ones) in an appraisal. If managers have been doing their job properly, any performance weaknesses should have been highlighted and training and coaching provided during the year; if the opportunities for promotion are being discussed, the opportunity for a prior chat about development areas for an individual should have been covered earlier so that the agreed direction of travel is well known.
In a small practice of five to ten people, there is absolutely no reason why the appraisal process cannot be well planned, well executed and of benefit to all members of the team.
Development and retention of our key people is a critical process for any manager or principal. All team members should have a personal development plan which outlines the key goals for the following year, the new skills that need to be acquired, the training plans that will be implemented and the timing of all such events. Any plan that does not include timing and who has responsibility for organising is not a plan but a dream.
In conclusion, recruitment and the subsequent training and development of our people is a fundamental role for managers and principals. The use of systems like that offered by Harrison Talent Solutions, to help us understand our people better, as well as how we can attract them to our practice, how we can develop them in a way which best meets their needs, can be incredibly helpful. If people really are our most important asset, then please take the time to learn how to implement the processes most likely to succeed.
Use the items below to put the ideas in this article into practice:
- Form - Induction plan15.82 KB
- Form - Appraisal log for a dentist17.01 KB
- Form - Appraisal log for a nurse17.47 KB
About the author
Sim Goldblum is an experienced business manager and is a partner in The Dentistry Business, providing bespoke advice and training to dental practices and leading the UK’s only university-accredited dental practice management courses. He is an approved and accredited growth coach for GrowthAcceleratorTM, supporting practices as they expand their businesses, and is a fully trained user and interpreter of the Harrison assessment system.
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