This article represents the seventh in a series of articles discussing the 14 Management Principles of The Toyota Way https://thetoyotaway.org/ a book authored by Jeffrey Liker. The principles illustrated in Toyota’s management systems can be applied to improving the efficiency in dental practice operations.
Principle #7, of the Toyota Way, focuses on the development and use of visual controls so that no problems are hidden. It is crucial to know whether the operations are working in standard mode or are deviating from the path that interrupts the flow and pull of the business.
In a dental practice, we work from a schedule that consists of patients’ names and dental procedures planned or considered and the amount of time deemed necessary to complete this work blocked out in 10-minute increments. The required time to complete a process is determined by the clinical team and includes time to prepare the patient, confirm treatment, provide any anesthesia if required, complete the procedure, dismiss the patient, re-prep the treatment room and set it up for the next patient. The dentist's goal is to have seamless and effortless coordination of people, equipment, and supplies to achieve a great dental experience for the patient.
Though everyone on the dental team would prefer a smooth and synergistic day, many days can be chaotic and stressful, causing a less than pleasant experience for all involved. Absenteeism of critical people and lack of knowledge of how things are performed can throw a wrench in a well-planned day.
Not wanting to be found guilty, some workers create a "secret" culture of not disturbing the dentist to not get "blamed and then punished" for errors and not knowing how to do things. They create systems that are covert so that no one knows how they do things. It can get to the point when that key person is absent; the practice comes to a halt.
The Toyota Way, Principle 7, discusses the need for visual indicators so that people know when anything is varying from the acceptable standard. Creating a culture of transparency builds trust and working together as a team.
When the office is in chaos, problems arise and are pushed under until they rise as a crisis. To be in crisis continually, is not where anyone wants to be. During this state, there is a waste in the following areas:
For organization, standardization, control, and harmony, start putting systems of transparency in the practice so that the entire team can see what to do and how to do it.
For instance, in the business area or “front office”:
In the clinical area of the practice or “back office”:
Every system in the practice should be able to withstand personnel changes.
Share the process and goals with the staff and work to build people not replace them. When people are not performing as we think they should be, it is often not the person; it is the system that fails. Build a network of visual guides and build a better team.
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