How staff learn or why policies and procedures don’t seem to work

Nothing has frustrates me more than introducing a new process at work, or streamlining an existing process. Why haven’t staff followed my very comprehensive, written procedures!

Since starting SmartDentist I have gained a greater understanding of what Policies and Procedures are good at; how to make them better; and what they wont do for the practice.
The following hints and learnings aim to help others who have suffered similar frustration. Consider:

  1. What Policies and Procedures are good for
  2. What Policies and Procedures wont do
  3. Better printing of Policies and Procedures (SmartDentist)
  4. Great understanding about our staff and how people learn

What Policies and Procedures are Good for!

1. Making sure AHPRA doesn’t ‘get’ you! Yes you need an Infection Control Manual (made of policies and procedures) because the Dental Board requires one. In Q’LD you also need policies and procedures so you have an Infection Control Management Plan. Dentists don’t really learn about this aspect of practice management in University yet we are legally responsible for what happens in our dental practice reprocessing. Practitioners benefit by considering creating a set of policies as worthwhile learning tool. The procedures used by your DA might not be correct or efficient. (The way we were shown in the past is the greatest predictor of what we do in the present. ) A good set of policies can help a practitioner understand and streamline or update procedures. They are a great insurance policy guarding against the stress of the loss of a knowledgeable staff member.

2. Having a procedure where everyone does the same thing the same way. Not only is this a safety precaution but it means life actually becomes easier for everyone (saving time and money). Established policies can sit on the SmartDentist website (untouched) until a new staff member needs them as a teaching aid. It is very handy to have good written procedures in case a significant staff member leaves. These need to be refreshed every so often. DON’T expect staff to look at these policies once everything is running well.

3. Performance management. When there is a communication breakdown or dispute about staff actions there needs to be formal written procedures in place in order to evaluate future staff actions or performance. Staff cannot refuse to do something that is reasonable, part of their normal work or customary. In regards to infection control practices, a staff member can not engage in conduct that causes serious and imminent risk to the health and safety or a person or the reputation, viability or profitability of a business. Of course staff would need adequate counselling, education and help to undertake their performance tasks. (see below – How staff learn)

What policies and procedures wont do

  1. Policies wont work without work.
    Policies and procedures should be living documents of excellence /efficiency. Often people are just too busy doing the job they have been given to actually question the processes of the job. Give some time to considering if processes are necessary and are efficient. Not every policy needs changing, not every task needs explaining but some processes will need more complex explainations or reviewing. Each policy review is the opportunity to get rid of old fashion inefficiencies or streamlined procesess.
  2. Written policies and procedures wont save a practice from workplace disputes. Just because you have a policy in place doesn’t mean you can discipline someone for not following it. You need to educate, tell, do and find out why they aren’t doing something. Workplaces are gigantic relationship centres and relationships require work and tolerance and give and take.

Better printing of policies and procedures (SmartDentist)

In developing better policies it can be helpful to consider what you find useful in instruction manuals. Many people only use instruction manuals when they can’t work out how to use the system or object. Instruction manuals that include relevant pictures are easier to follow and instruction manuals written in short point form are easier to read.
Hence it has been found that most used policies /procedures are:

  • short
  • easy to read
  • and help staff when faced with an uncommon process or problem

Consider developing two different types of policies. One could be for practical use and one for legal requirements or complex justification (e.g. infection control policies).
We only print policies if they have instruction for unusual or stressful processes, or if constant reminders of their content need to be seen by staff.
[For example I have the following policies located at our reception: Start of Day Reception; Middle of Day Reception; End of Day Reception; Payments and Hicaps.
These are separate laminated, two-sided documents printed out from SmartDentist. I have found longer policies are best divided into 2 separate policies (if they need printing and laminating). When a policy is updated it is easier to simply change a single sheet of paper.

How to print more useful polices from SmartDentist
Each SmartDentist policy has a small icon next to the name which reduced the “guff” off the policy. It also has the date on the top of the policy.
(Guff = resources; links; National standards etc. When submitting for accreditation please include the “guff.”)
Using the icon to gain a shorter version of the policy will also print better lists and save paper.

How our staff learn

Most of our staff are kinesthetic learners. They learn by doing. Learning should follow the following sequence – Tell; Show; Do; Review…and do this over and over again.
Do you know that changing a habit generally takes two months? That is two months of constant persistent reinforcement – do and review; do and review.
We communicated changes via:
1. Staff communication book
2. Verbal communication
3. Emails from SmartDentist – using basic communication form or the policy communication.

Consequences :- If there are no consequences for not changing, learning will take longer and reinforcement will need to be more persistent and regular. What consequence can staff introduce to remind them of the need to make procedural changes?
Self-care: – Find a mentor or supporter to encourage and reminding you about 1) your own inability to change 2) about the great things the staff do everyday without instructions!