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Developing a Best Practices Staff

Welcome! This article is part of a Medscape Physician Business Academy course, . Visit the Course Page to take the full course and receive a certificate.


Studies have shown that achieving best practice status is only accomplished in an organization where—from the top down—managers model excellence in their attitude and values, and consistently apply the guiding principles of the company, recognizing every worker's contribution to achieving company goals.

Best practice is not a matter of seeking an award for outstanding performance, but rather promoting the benefits a practice gains when it excels in meeting the needs of the organization and the people within the practice, as well as producing quality clinical outcomes and superior patient care and service.

Best practices staff is accomplished when management develops a workforce that honors, rather than compromises, the organization's core values, respects the leaders and other employees, and consistently apply standards that produce the highest-quality results and achieve optimal performance. They understand their own value and are recognized and supported by their managers.

The goal of using best practices is to develop staff that will represent you and serve your entire practice to the best of their abilities: managers, physicians, other staff, and patients. Early on, through management's example and efforts, they learn to follow your lead and your desire to be among the best. They understand their own value when they are recognized and supported by managers that are professional, fair, and consistent in how they treat everyone else.

Creating an Environment That Pleases Staff

Your practice's environment has a significant impact on staff morale and staff performance, far more than leaders may realize. Culture, work setting, and work tools all send signals to employees about how you, the practice leader, value their role, contributions, and accomplishments.

When the design of the office doesn't provide adequate work space for employees to be efficient and the décor is outdated and deteriorating, how can an employee feel good about coming to work? If you're not willing to invest in technology and other work tools, what does that say about how important it is for staff jobs to be done?

The bottom line: If you are neglectful and give the work environment too little attention, it is easy for employees to feel discounted and believe you don't care about them.

Leaders are responsible for how the entire organization feels about the practice. How well you uphold and demonstrate the guiding principles of the practice will be reflected in the actions of everyone else. If you have a passion for your work, excel at it, and support the core values of the practice, the staff will follow your lead. If you show a kind and compassionate attitude toward the patients, so will they—and you will be on your way to building a high-performing staff.

Building a best practices staff starts with valuing people and demonstrating appreciation for their contribution. Be in tune with staff every day. Be aware of what you can do to make the workplace more efficient and the setting more desirable. Be fair and be consistent with all employees. You can bring out the best in your employees when you are authentic and generous with acknowledging jobs well done. You will be empowering and motivating each person to strive to be the best.

Setting Boundaries Your Staff Will Respect

As much as you want to have open and positive relations in the workplace, you'll also need to set some boundaries for interaction. Clear boundaries are intangible and hard to define. The organizational foundation of the practice, with clear job roles and hierarchy, is designed to create a structural boundary. Clearly delineating staff's responsibilities can guide you in establishing professional boundaries that allow the practice to run smoothly.

Treat staff fairly and, when in doubt, always keep the focus on the needs of the practice.

Treat staff fairly and, when in doubt, always keep the focus on the needs of the practice. Asking a staff member to do personal favors on their time is outside the appropriate boundary. Asking him or her to pick up your laundry or take your daughter to her ballet lesson is not work-related and inappropriate. Once you cross such boundaries, staff can become confused and resentful. An employee may feel it's impossible to refuse such a request. Even worse, colleagues may assume the relationship has become personal—sowing doubt about fairness.

Managers' behavior should never be in question. Using offensive language in a moment of anger in the staff lounge is unacceptable. The same is true for inappropriate jokes. Because you're in charge, a manager or owner's behavior can singularly move the bar on what is considered acceptable—gradually downgrading the decorum in the office, and, over time, even creating a toxic culture.

Seemingly innocent teasing can also be very hazardous, especially since it can be mistaken for flirtation and inappropriate sexual innuendo. These situations place you in dangerous territory, both in terms of maintaining a well-run office and in legal terms. These behaviors are unacceptable and will reflect poorly on you and the practice.

When managers and physicians are consistent and respectful in behavior across the spectrum of the organization, leaders bolster respect for their position, themselves, and the practice. More practically, such conscientious leadership avoids needless, costly conflict among staff and even potential legal disputes.

Be professional in your conduct and attitude. Your actions should conform with office policies and procedures. It's your job to help staff comply. Everything you do at work should be within the boundaries of what is acceptable at the highest level of management and its core values.

Professional behavior doesn't mean you must separate yourself from staff. Engaging staff is an important part of expressing your respect for them, the job they do, and what they contribute to the team. It reminds employees they are part of a team with a shared mission.

But don't confuse being friendly and supportive with friendship. Clear boundaries maintain respect and regard for authority. Foster healthy and respectful relationships, whether one-on-one or in groups of staff, peers, or management.

Investing in Staff

Investing in employees' skills, space, and tools is essential to their—and your practice's—success. Leadership must make providing an optimal work environment for staff part of the organizational culture. It starts by understanding employees' needs and how the workplace affects attitudes and performance.

Evaluate technology tools that can help workers get the job done better and faster. Technology evolves and improves at a rapid pace. Staying current can help your staff improve output while reducing errors. Reviewing and upgrading technology also helps avoid employees being bogged down by tools that are wearing out or approaching obsolescence.

Every 3-5 years, managers should also take a critical look at the ergonomic factors of the job. Discuss workplace needs with your staff and make changes when you identify better lighting, ergonomic chairs, workspace configuration, or workflow that could improve the employee's workday, helping your organization achieve improved performance and best practice staff.

Create an education policy that supports practice needs and fosters staff growth. Decide which positions will receive financial support. For example, is reimbursement limited to managers and licensed personnel who are required to maintain continuing education standards, or does it extend to staff level? Does the support include paid time off to attend? What about tuition and books? Is there a budget limit each year?

To gain the most benefit from education investments, your organization may specify stipulations, such as:

  1. The educational objective must be applicable to employment in the practice once the education or training is completed.

  2. Employee will be required to stay with the practice for 3 (or 5) years after the education is completed or pay back a certain percentage of the cost by the employer.

  3. Expenses to be reimbursed must be outlined and authorized in advance by management each year.

Remember that whatever stipulations you include in your education policy, they should be clear to everyone and implemented fairly and consistently. Also, because investing in employee training can be a big factor in staff morale, consider ways to do it that aren't limited to managers and continuing education units for clinicians.

Promote Education and Upward Mobility

When an employee looks 3-5 years ahead and does not see an opportunity to move up in the organization, the best employees will start to look elsewhere—leaving you in need of seeking a replacement who is unlikely to match up and may even be mediocre. Creating educational tracks within your organization can help avoid this risk.

For example, an employee development program can offer staff upward mobility within their department or the opportunity to seek a position in a different department, where they can build on skills they've acquired at your practice. This type of internal training and encouragement signals to employees that they don't have to leave your practice to advance in their careers, especially when external training and certification are also available.

Build a culture that sincerely nurtures growth, supports continuing education, strengthens confidence and professionalism, and offers employees an opportunity to become the best. This will in turn help your practice be among the best—and help you avoid costly problems, such as staff negativity and turnover.

A Strong Start for New Hires

Your onboarding process is an excellent time to get new hires on the way to best practice performance. These steps help a newcomer connect with the team and get a sense of belonging early on:

  1. Meet with staff to announce the new hire and express your confidence and enthusiasm.

  2. Select a mentor for the new employee. The mentor should be someone who is a good fit for the new staffer to turn to during the first 90 days.

  3. Conduct a facility walk-through, introducing the new arrival to the people she or he will be interacting with on a regular basis.

  4. Schedule a team welcome luncheon during the first week to engage in casual conversation.

These efforts will provide a desirable first impression and make your new hire feel valued and confident from the start.

Managing Managers

When other managers report directly to you, they will lean on you for direction and support. Your job is to be sure they are achieving quality results, expressing the core values of the practice, and supporting their teams effectively.

Managers don't just lean on you; they model your leadership style, confidence, behavior, and decision-making.

You set the example for how you want managers to treat their staff teams through how you treat yours. Managers don't just lean on you; they model your leadership style, confidence, behavior, and decision-making. Help your managers clearly understand your goals for the practice, and make sure your compensation plans and your feedback help align their goals with yours. Keep in mind that managers may need coaching on how best to develop the skills and capabilities of their staff.

By occasionally sitting in on team meetings, you will get a sense of each manager's style and performance, which will help you understand where they may need more individual coaching from you. This will strengthen their skills and confidence as managers, benefiting them and their direct reports.

To be more organized and systematic about developing your management talent, schedule quarterly leadership training sessions as well as individual coaching. The quarterly sessions can be more formal opportunities to discuss problem-solving, building staff up, how to improve performance, and keeping the team connected. You could approach such topics as how to solve your biggest headache, and perhaps do some roleplaying. Having a guest speaker once or twice a year can be a way to provide motivation and another perspective on leadership.

You can learn a great deal about your managers' performance by observing them in action. Your visit to different departments and talking with managers and staff is an excellent way to evaluate how well things are running while expressing interest and showing that you care about all of them.

This does not negate the importance of conducting formal performance reviews annually, which help your managers understand their strengths, recognize ways to improve skills, and guide them to excel in the future.

Resolving Staff Problems

There are many different personalities, levels of maturity, and habits that staff bring to the workplace. When leadership sets a positive example, staff usually work well with team members and other line staff. At the same time, each person is different and part of his or her background can amplify the things they fear or what makes them feel inadequate or defensive. This can interfere with how well employees work together.

No matter how well your organization functions and how well managers and staff get along, there are bound to be occasional misunderstandings or disagreements that lead to conflict.

Small disagreements and complaints are not uncommon in the workplace and are usually quickly resolved with a respectful dialogue that reveals both sides of the misunderstanding. Conflicts emerge when individuals have different objectives or lack confidence or trust. Failure to act creates greater dissension. Not permitting small conflicts to fester and grow into large problems is a critical skill for practice leaders to develop.

Proactive conflict resolution lessens stress and negative effects on productivity. It starts with applying these principles:

  • Acknowledge the problem: Communicate awareness.

  • Dig deeper: Get the facts.

  • Examine the source: Is there a lack of support or respect, or have there been accusations or abuse? Is their undermining, finger-pointing, or gossip?

  • Meet with each individual: Evaluate the situation and determine the options.

  • Bring the individuals together: Set ground rules and guide the discussion, focusing on the facts. Listen to what is being said and how it is said.

  • State your case: Present your interpretation so that the disagreeing parties get a reality check.

  • Manage emotions: Respect the situation. Maintain boundaries so that it doesn't get personal or result in attacks. Gain cooperation and agreement on the solution.

It is helpful to remember that silence is a powerful tool, especially in dealing with conflict. When you have presented the facts and stated your case, your silence keeps the environment calm while waiting for a response. Newer managers may require additional training or role-playing with peers to master such skills.

When managers attempt to resolve a disagreement with someone they don't manage, turf battles can interfere. It is sometimes difficult to get a staffer's attention and cooperation because you lack authority. When this occurs, problems can be avoided by going to the employee's direct supervisor to get what you need. Do so with a positive attitude, without being accusatory or degrading the staffer involved.

Conflicts can be productive; they can provide an opportunity for communication, creativity, and cooperation. They are an opportunity to focus on core values—and get everyone seeking to be among the best.

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Welcome! This article is part of a Medscape Physician Business Academy course, . Visit the Course Page to take the full course and receive a certificate.


Judy Capko

| Disclosures | January 01, 2019

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Judy Capko

Healthcare Practice Management Consultant, Capko & Morgan, San Francisco, California

Disclosure: Judy Capko has disclosed no relevant financial relationships.