In addition to improving patient care and satisfaction, cross training can help combat staff burnout. “Answering phones all day can be difficult; people can be mean and rude when they don’t have to look at you in person,” says Dr. Werschler. “Cross training helps create a more positive work environment when implemented as a natural occurrence of someone’s daily, weekly or monthly job duties. It’s no different from the provider’s schedule where one day you do surgery, the next day you have all injections and so forth. Cross training can be instituted a bit more formally, where every Friday, for instance, the receptionist goes over the medical records and helps catch up on medical record requests instead of answering the phone.”
Another benefit of cross training is that it brings additional sets of eyes to each position, which may allow employees to see flaws in the established routine or ways to perform the tasks more efficiently. It also encourages staff to be-come more knowledgeable about the practice as a whole. “Everybody that works in the business should have a reasonable understanding of what the business does, how it does it and why it does it,” says Dr. Werschler.
The first step in implementing cross training programs is identifying areas where you need more help. At RenovoMD, training more employees to help with scheduling has boosted patient retention. “Now, we have more flexible scheduling and patients don’t have to wait for a certain provider or staff member to get them on the books,” says Dr. Casello.
Morley recommends getting together with staff to look for any “hiccups” in your own practice. For example, “Are patients being put on hold when they call because you don’t have a backup plan for the phones? When they come into the practice, is there a line because no one’s cross trained for check-in?” she asks. “Everyone has been to a business that doesn’t prioritize the customer experience—and you don’t go back! Cross training provides patients with consistency and continuity, and that reads as authenticity. When a practice provides that high level of care, its retention and referrals skyrocket.”
She encourages owners and staff members to sit in the waiting room of the practice once a year for half an hour during the busiest time in the clinic. “Just watch what happens. Walking through your practice as a patient and experiencing what happens when the office is busy is an invaluable lesson,” says Morley. “Find out what happens when you are slammed, and observe how the team man-ages it. Is the patient experience any different on a crazy day from it would be on a nice quiet day? It shouldn’t be.”
Once you’ve identified areas where you need backup or extra help, make sure that each position has a detailed, written job description. Morley calls job descriptions and written protocols “playbooks.” “It’s what the person does daily, weekly and monthly, and their backup should be trained to follow that playbook,” she says.
Dr. Casello has created protocol playbooks for every position at her practice, and also offers more formal training. “We have books with protocols in them, and the staff also attends a lot of webinars and classes,” she says. “Frequently I arrange on-site training with a nurse or clinical trainer, especially with new machines or techniques.”
Written protocols are important because patients will notice if different staff members use equipment in different ways, and may question the quality of care. “Standardizing the work and clarifying the protocols related to each treatment is important to ensure quality,” says Deborah Walker Keegan, PhD, a healthcare consultant at Medical Practice Dimensions.
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