• How to Improve Practice Efficiency with Effective Policies and Procedures

    As busy administrators, we are constantly searching for ways to maximize resources and accomplish more in less time. Clearly written policies and procedures can help us attain greater efficiency by requiring less training time and disciplinary action. While creating these policies and procedures can be time consuming, the benefits far outweigh the work required to get the initial version completed. Such documents establish uniformity, accountability and expectations to create clear lines of responsibility and allow staff to take ownership of their duties. These documents empower our staff, and they empower us as managers. 

    Think about the time we spend answering the same staff questions and the frustration we feel when we hear those famous words, “I was told to do it this way,” or other such statements intended to avoid accountability. We can greatly reduce these scenarios with well-written documents as guidelines for accountability, complete with consequences for noncompliance.

    In times of crisis, staff will seek out something concrete to make sure they are reacting appropriately. It is our responsibility to make sure those documents exist to guide them when emergent or urgent situations occur. This will help good intentions lead to appropriate actions and avoid catastrophic circumstances. Documents of this sort can also help us defend ourselves should a disgruntled employee attempt to retaliate after dismissal.

    Efficiency in the Organization

    Policies, procedures, protocols and job descriptions create efficiency and eliminate some administrative stress in several ways. They:

    • Maximize training time;
    • Minimize trickle-down learning;
    • Set expectations for behavior and conduct;
    • Assist new employees in learning the job;
    • Encourage uniformity;
    • Keep things fair and equitable;
    • Hold staff accountable;
    • Outline duties and responsibilities; and
    • Provide a resource when staff members come to you with complaints about policy.

    Getting Started

    Once you commit to creating manuals, you must develop a template that fits your organization. Depending on the size of your staff, you may want to delegate this to your practice manager. It may be necessary to conduct research, consult the American Academy of Ophthalmic Executives listserv or network with other administrators to exchange ideas before deciding on one that suits your practice’s needs. The format of any manual should include the approval date, department, subject and the name of the approving person, as well as any other pertinent information. Many manuals number policies for reference purposes and to make updating and revising easier.

    Even if your staff is handling most of the manuals’ development, you’ll want to review the action plan and policies before implementation. Physician support and approval is important to the success of this project and staff buy-in, as manuals represent expectations and instructions to be followed on a daily basis. You and your staff should plan on the manual's development taking six months to a year depending on the size of the organization and the details desired. Be sure to include sufficient time to evaluate and approve policies, procedures and manuals prior to implementation. Once the final copy is completed, the implementation process can begin.

    The basic elements needed to complete most manuals are:

    • Job descriptions
      • Physical requirements
      • Duties and skills required
      • Daily, weekly and monthly tasks
      • Anything the employee will be held accountable for accomplishing
      • A disclaimer stating this is not an all-inclusive list
    • Policy manual (must set expectations)
      • Conduct, communication, productivity and disciplinary action
      • Attendance, punctuality, employee classifications and work hours
      • Appearance, confidentiality and work conditions
      • Pay, time off, benefits, leave, etc.
    • Procedures and protocols
      • Should clearly explain how to accomplish tasks
      • Defines who, what, when, where and how
      • Includes scripting

    Note: Procedures and protocols will most likely need to involve staff members who work directly in the area of responsibility to ensure detailed and accurate information.

    Distribution and Maintenance

    Prior to distribution, it is recommended that a labor attorney review your policy and procedure manual to ensure legal compliance. Furthermore, it is a good idea to have your labor attorney review affected areas anytime major labor law changes go into effect.

    It is very important to distribute manuals to the staff as a whole, preferably with physicians in attendance. Use this time to present to the whole group the importance of putting everything in writing for training and clarification purposes. Each employee should be required to read and sign a form stating they have reviewed and accepted the policies and procedures or an acknowledgement. Place signed forms in each employee’s personnel file.

    Review printed manuals annually. However, you can update electronically stored manuals on an ongoing basis. Be sure to change the effective or revised date to reflect any changes. Sections with totally new protocols should be distributed during full staff meetings to make sure everyone is informed.

    Creating, updating and reviewing each manual can be a time consuming and continuous project that requires commitment. However, as long as the policies and procedures implemented are followed, managing processes and associates should become less frustrating and time consuming, creating more time for the positive aspects of daily responsibilities.

    For more information about AAOE products and services, visit www.aao.org/aaoe.

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    About the author: This article is an adaption of the original version, which appeared in the June 2012 Executive Update. It was written by Sandra Curd, MBA, COE, COA, OCS, and Martha Land Young. Curd is the chief operating officer of Professional Eye Associates in Dalton, Ga., and chairs the AAOE board of directors. Young is a practice development consultant with Much, Much More Seminars and Consulting, LLC. As an ophthalmic administrator for over 29 years, she has developed training programs to guide professionals into successfully developing more people-conscious, productive and profitable organizations.