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Staff appraisals promote two-way feedback

Setting up a private practice - phase three

By Karen Crouch
In the third and final instalment of her series on establishing a practice from scratch, KAREN CROUCH details the steps required to ‘go live’ after the initial start-up is completed.

Ok, so you have completed the preliminary steps that convince owners the practice will provide high quality healthcare and return a reasonable profit (reward) for effort and risk in running the new business.

You’ve probably selected a descriptive, catchy name, maybe ‘I-Sight’, ‘I-See-U’ or something more creative.

All administrative and clinical staff have been engaged under relevant employment contracts. Technical equipment has been installed and telecommunications are in place along with fully functioning facilities for administrative, personal and clinical use.

A comprehensive Test Plan was enacted to ensure employees are familiar with their roles and use of equipment. Various manuals and documents have been created and are conveniently located.

The website contains images of the practice, details of services and names of key clinicians. Other forms of marketing (newspaper ads, letter drops, perhaps even an opening day) have been initiated.

"The establishment of a sound corporate governance framework is an important initiative to ensure meaningful oversight of the overall practice business"

Finally, the waiting room is well equipped to welcome the most important people of all – patients – and you are itching to provide best-in-class healthcare supported by a well-managed team.

Best of all, the telephones are ringing off the hook for appointments!

This is the critical point from which all future successes will flow, provided prudent clinical, administrative, practice and business management ‘foundations’ have been thoughtfully established.

While practitioners and support staff inevitably focus mainly on high quality healthcare, as they should, administrative systems often receive less scrutiny as they can be time consuming or complex.

Yet the structure and thoroughness of those very systems are the source of all information and knowledge, including details of the practice owners’ values and culture they wish to instil in the business – the cornerstone of an organisation.

Examples of ‘foundation’ actions that support efficiently run practices are:

Vision, mission and values: While sometimes briefly expressed, they should embody the essence of the business, reflecting the values, principles and goals of owners for employees to adhere to;

Organisation chart: Clearly defined roles and responsibilities including reporting lines, to enable employees to understand the practice’s ‘chain of command’;

Staff management (Human Resources): Detailed job descriptions for every position, provided to each staff member, including measureable key performance indicators, to support performance assessments and enable employees to appreciate key aspects of their jobs;

Staff appraisals: Consistently executed programs to assess performance and serve as a communication channel to promote staff relations with two-way feedback;

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Induction programs: Carefully documented for each position, to ensure new employees are methodically introduced through training materials and job descriptions so they confirm understanding of their roles and expectations of the practice

Exit interviews: Questionnaires, seeking feedback from employees who leave the business, provide feedback on positive or negative aspects of the practice;

Rostering: Procedures for larger practices with complex clinician attendance habits that must be supported by front desk staff. Short notice availability to cover unplanned absences is a necessary part of any backup plan;

Policy & procedure manuals: These mission critical records, are the ‘practice bible’ and should include instructions on all policies and procedures;

Legal: Details of WH&S programs, other medico-legal compliance requirements including ‘case histories’ of incidents that may have occurred during daily operations, whether actual oversights/errors or ‘near misses’, all of which should be included in group meetings, training or ‘work smarter’ planning sessions.

Additonally, there are several practice management operations to undertake:

  • Supplier management program to ensure supplier relationships and cost effectiveness are optimised and that contracts are renewed on time or new suppliers explored;

  • Regular budget monitoring and various performance targets diarised for review;

  • Complaints registers to record patient issues from lodgement to resolution;

  • Delegation schedules clearly defining authorities assigned to any staff, including dual authorisations where applicable e.g. payroll;

  • Securely store staff records, ideally in the hands of the owner.

A sound practice is based on efficiently documented policies, procedures, reference documents and manuals – the foundation on which high quality ‘front desk’ service competently supports healthcare administered by clinicians.

At senior management level, establishment of a well-documented clinical governance program will ensure cooperation and the dispensing of highest quality, well co-ordinated, and consistent healthcare. For larger practices, the establishment of a sound corporate governance framework is an important initiative to ensure meaningful oversight of the overall practice business.

More Reading: 

Part one: Setting up a private practice – phase one

Part two: Setting up a private practice – phase two

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