Why Metrics Matter To A Dental Practice

Posted by Weston Lunsford on Oct 8, 2019 11:08:07 AM
Weston Lunsford

As dentists and practice owners scramble to keep up with an influx of high-tech hardware and software solutions, it’s important to reflect on how all of this exciting innovation impacts the health and quality-of-life of your patients. One need only flip through any current dental-related publication to see evidence of how technology is transforming both the clinical and business aspects of dentistry. Adding “shiny new toys” to your practice can be tempting and may even create a false assumption that doing so will automatically improve patient care or practice performance. However, it takes careful research, patience, and even some trial-and-error to find the tools that will measurably impact the health of your patients and practice.  

According to Lisa Philp, RDH, in a recent article in Inside Dentistry, “Dental practices face the continual challenge of trying to balance a high-performing team, patient satisfaction, and quality dentistry with new technology—all while being productive and profitable. This balance doesn’t happen by accident: it requires a hyper-focus on the metrics and strategic actions directed at performance indicators and systems.”

In this article, we’ll explore how a dental practice owner in Texas used technology to hone in on the metrics his practice needed to solve problems affecting both patient care and team performance.

Principle #1 - Spend time identifying what your current key issues are. Don’t focus on a solution until you have enough data to validate your concerns.

 Although he loved dentistry and especially the work of caring for his patients, at one point, this doctor dreaded coming to work. Not because he’d gotten tired of those patients or because of a difficult team member, but because he’d grown increasingly frustrated with the business side of owning a dental practice. He knew he had problems in a number of areas, including a high number of unscheduled patients, a team that struggled to understand what performance indicators they were supposed to be paying attention to, and an overall lack of team collaboration and energy, yet he felt powerless as to how to resolve these issues. He felt a constant tension between practicing dentistry and managing a business, an experience shared by many practice owners. Other team members felt similar frustration. They didn’t know where to get the important information they needed to improve and, even when they were able to find it, they were untrained in how to interpret and act upon the data.

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As this doctor searched for a solution to address these issues, he wanted to be sure it would be compatible with his patient-centered approach to dentistry. He wasn’t interested in yet another tool or software or process. The solution needed to directly impact the health of each patient, which he felt confident would happen as he and his team improved their business systems and processes. He took inspiration from how large corporations – “real businesses,” as he called them – used data to identify what was happening and also to develop systematic approaches to improve performance.

Although the process of discovering the cause of his problems was at times unpleasant, it was a critical part of finding real solutions. He knew things needed to change in order to better care for his patients. Instead of focusing only on what had happened, which he couldn’t change, he instead began to formulate an action plan for how he would reach his goals. This doctor had taken an important first step in examining his practice’s current performance before proceeding to find a solution.

As stated in the American Dental Association’s 2019 Guide to Quality Measurement Guidebook, “Healthcare providers work hard to deliver skilled, thoughtful care. Measures pave the way for providers, showing where systems are breaking down and where they are succeeding to help patients get and stay well. Measurement forms the basis of evaluation and has become one of the foundations of current efforts to improve healthcare quality.”

When something isn’t working, our understandable instinct is to want a quick, easy, and affordable solution. No one wants to spend a lot of time and money fixing something that’s not working. However, such solutions rarely exist. For this doctor, the process of discovery came through the following sequence, which required patience and rigorous effort:

  1. Facts: Identifying where his practice was performing well, and where they were falling short. This provided him with a position on a map. He had the facts.
  2. Meaning: He then needed to determine what these facts meant in relation to patient health and practice performance. If patients were canceling scheduled appointments and not rescheduling them, what did that mean for their well-being, and how did that impact the health of the practice?
  3. Feelings: Using this data as a starting point, the doctor and his team discussed how they felt about where they were and what it meant. This dentist understood that in order for anything to change, he and his team would need to make an emotional connection to what was happening, and then decide what needed to happen.

Principle #2 - Evaluate solutions through the filter of patient care. Ask “How will this new device or software help me to improve the health of my patients?”

After completing his practice evaluation, this dentist chose to partner with Dental Intelligence, a web-based practice analytics company, to discover the gaps between his team’s goals and current outcomes. After doing so, he soon realized that if something isn’t measured, it doesn’t grow. For owners who are also practicing clinicians, it can be challenging to separate those duties, especially for a solo practice. The pressure to pay attention to everything is constant. Having a data-driven solution that removed this hurdle and empowered the doctor and his team had an immediate impact on the health of every patient.

 One of the areas where they saw this impact on patient care was in their daily huddle. As they began using the Dental Intelligence-designed morning huddle, they were able to see not only who was on the schedule for each day but also diagnosed treatment that wasn’t scheduled, or family members that didn’t have a scheduled next appointment. Seeing this data daily allowed the team to have healthy conversations around how they were performing and to then discuss what they could do to positively influence the health of these patients.

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Dr. Chris Hoffpauir, owner of Winning Smiles Family Dentistry

Having all of their practice data aggregated and knowing how to accurately interpret and then act on what the doctor and his team were looking at had a measurable impact on their patients. By seeing these key performance metrics each day, team members gained new insights into what was actually happening in the practice. For example, as they were reminded daily about key metrics relating to practice profitability, they were more likely to focus on collections.

The lead hygienist added that since they began holding an effective morning huddle, they could now see where they were doing well and where they might still be struggling. This was very empowering. Their morning huddle became much more patient-focused as they saw more clearly what each patient needed. Team members could now see all of the needed treatment in one place, enabling them to think about treatment planning, case presentation, etc. for that day instead of wasting time locating that information—often without success.

Principle #3 - Implement your chosen solution and then commit to frequent, thorough evaluation of how it is impacting patient care and team performance. Understanding which performance metrics matter and why they matter is especially important.

 Another way this practice saw an impact on their patients was from assigning follow-ups to specific team members. As they took ownership of these each day, they saw a direct correlation to the number of patients on the schedule and the type of treatment they provided to those patients.

Instead of trying to find unscheduled patients in their practice management software or by recording and tracking them manually, they now had an easy-to-use, intuitive system for following-up with patients. Before implementing this system, they’d been using a manually-created unscheduled treatment list which meant patients sometimes waited weeks or even months to be contacted for a new appointment. This new system allowed them to schedule exactly when to follow-up with each patient and also made it easy to involve more team members in that follow-up. This made everyone accountable and also allowed them to capture what was discussed with the patient, each time someone spoke with them.

Sometimes dentists may disengage when they hear someone talking about data, numbers, KPIs, and metrics, thinking “What does any of that have to do with the health of my patients?” This is understandable. But as this doctor and his team discovered, knowing what was really happening in the practice and which patients were falling through the cracks directly impacted patient health and team performance.

Measuring numbers in your practice is important, but insufficient. As this dentist learned, data may tell you how many of your new patients rescheduled treatment, but not what can be done to improve that metric. Or, you may know that case acceptance is low, but not what can be done to increase it. The insights happen when your team discusses the meaning of the information, how you feel about it, and what your plan should be for acting on the data. This is when the value of those metrics is fully realized.

What are the numbers in your practice that most need attention? Do you know? Are you paying attention to those metrics, and more importantly, focusing on a plan for improving them? Rather than trying to fix everything at once, start with one or two things that you can measurably impact. Spend a few minutes each day looking at them, discussing them as a team, and planning for how you will improve. Setting goals around these areas is also a wise approach. Metrics matter because those numbers represent patients. It’s as simple as that.