STAFF MANAGEMENT - The 4 Times to Hold Staff Accountable

Confronting an employee is tough to do and easy to avoid.  A dental practice is an intimate environment and there are few places to have a confidential conversation without everyone else knowing about it.  That being said, WE are the ones who benefit or suffer from the behavior and performance of our staff. And how they behave and perform is directly proportional to OUR willingness to hold them accountable for the standards we set. 

So, how DO we respond to poor behavior or mediocre performance?  What are we willing to let slide? What are we willing to confront?

Do we react with “silence”, ignoring the issue, hoping it will go away? Or do we react with “violence”, internalizing our frustration for a time until we eventually lose our temper and overreact? Or, do we handle each situation with timely and effective communications, addressing any issue as it arises with calm diplomacy?

One of the essential skills of a leader is the ability to hold someone accountable in a face to face discussion – it’s the ability to “confront” the issue when someone breaks a promise, doesn’t meet our expectations, or is simply behaving in a way that is contrary to what we want for our practice.

To be most effective, I’ve found that there are FOUR SITUATIONS in which we should engage in accountability discussions with staff.  They are:

Situation #1 - “PERIODIC COACHING SESSIONS” (“Staff Reviews”)

      These formal staff performance review sessions should be conducted three times a year and are the foundation for all future discussions. They clearly outline any expectations you have for improvements in job performance and personal behavior. Without them, your staff may be unclear about exactly what is expected of them, making the following three situations even more difficult.

Situation #2 - “ON THE FLY DISCUSSIONS”

These are issues that must be addressed immediately for a behavior that:

1) you personally observed and

2) is a clear violation of what was discussed previously.

EXAMPLE:  A chairside assistant was asked to improve how she “communicated with patients and parents”, and you just observed her being insensitive about a young patient’s discomfort when inserting the archwire.

Some things just can’t wait! – If the patient is still in the chair, you know that as soon as he walks to the front desk, he’s going to tell his mother how much the assistant hurt him and how little she cared.  You’ve already shared with the staff that, in this practice, “we are always sensitive to the needs of our patients and that, at every appointment, as best we can, we make it a pleasant experience.”

So, the Expectations are clear, and the violation is clear and observed. 

So, what do you do?  Well, at the earliest chance, (with the patient still in the chair) you discreetly ask the assistant to “help you with something” (away from the chair) and remind her of how you want the appointment to end.

Here’s how the conversation might go:

1. DESCRIBE THE BEHAVIOR that you observed & be specific

“I noticed that he said it was hurting and you told him, ‘No it doesn’t’”.

2. DESCRIBE THE REACTION of the patient

“I got the feeling that he was upset and didn’t think you cared”.

3. DESCRIBE THE IDEAL

“What I’m hoping is that he can leave the appointment feeling that you do care and you are doing everything to make him as comfortable as possible”

4. REASSURE THE ASSISTANT

“You’re usually good about making sure the patient is comfortable”.

5. KEEP THE REMEDY FUTURE FOCUSED and don’t scold her for what happened– no one can change the past, only the future. So, say something like:

“Let’s see if you can get the patient in a good mood before he leaves. Thanks”

A good assistant who had a temporary lapse of judgement will usually go out of her way to have the patient in a terrific mood before he leaves the office.  (And you won’t have to talk to his mother later when she calls and tells you that she “doesn’t want that assistant working on him again!”)

Situation #3 – “END OF DAY DISCUSSIONS”

Some things don’t have to be addressed immediately but can’t wait until tomorrow.  If you wait till the next day, the specifics of the incident become less clear and the discussion breaks down into a disagreement as to what happened.

EXAMPLE #1: While you were working at the chair, you overheard a chairside assistant refusing to help another assistant who needed her assistance.

During the last review, you discussed with offending assistant that she’d been rated low by her peers on her “self-giving attitude”.  So, at the end of the day, you speak to her privately and gently remind her that this was probably one of those instances that she was being perceived as not being “self-giving”.  

It’s sometimes surprising how a little more self-awareness can turn someone around.

EXAMPLE #2:  You overheard one assistant being rude to another.

At the end of the day, pull her aside, describe what you heard, and calmly remind her that, “In this practice, we always treat each other with ‘courtesy and respect’”.

Situation #4 - “FORMAL DISCUSSIONS” outside of the Periodic Coaching Sessions.

At times it’s necessary to have a lengthier private discussion with an employee about a single serious violation or another instance of a previously addressed chronic issue. 

EXAMPLE #1 (acute incident): a clinical assistant walked to the front desk and casually asked, “What the fuck are you guys doing?” in earshot of patients in the waiting room. 

EXAMPLE #2 (chronic issue): An assistant (who had been previously warned) once again had a conflict with another staff member. 

In these discussions, the office manager is present and what is said is well documented.  Sometimes, the staff member is already on probation, but in every instance, they’re fully aware that their recent behavior has been well below the standard for the office.  Often, the employee must be warned that one additional incident like this may result in dismissal.

FINAL THOUGHT

Occasionally, one assistant will confide in you that someone is doing something you disapprove of “behind your back”.  The worst thing you can do is to go and confront the offending person about it.  If you do, things will blow up when she wants to retaliate on the person who “told on her”.

Instead, find a way to personally observe the behavior and THEN address the issue.  That way, you can avoid all the staff conflict that can erupt when you take someone’s word for what happened.

For more guidance, the book, Crucial Accountability (2^nd edition of “Crucial Confrontations”) by Kerry Paterson and others is especially helpful with this issue.  It presents an effective way to have a face-to-face accountability conversation that is candid, open, honest and respectful and, during which, problems are resolved and the relationship benefits.