Content Dam Rdh Print Articles Volume37 Issue4 1704rdhcgar P02

Align decision-making: Dental teams participate in reaching a decision about the practice

April 1, 2017
Dorothy Garlough, RDH, describes how entire dental teams can participate in reaching a decision about a dental practice.

By Dorothy Garlough, RDH, MPA

Decision-making is a huge responsibility within any organization. In a person-centered office, decisions need to adhere to the constitution and focus on what is good for the whole. The concentration is to seek outcomes that will lead to the upliftment of the business and all those who work within the business.

In last month’s article, I laid out the decision statement for a republic of team and pinpointed questions that should be answered before a democratic vote is taken. This article’s goal is to help you see how decision-making can be applied practically to your dental office.

Within a republic of team, the responsibility of decision-making does not rest with one person, but with the team - either the entire team or teams within the team; i.e., the particular departments that will be affected by the decision.

Clearly, not everyone on the dental team has the same knowledge. For instance, the administration staff has a deeper and broader knowledge about how to schedule effectively than the hygienists. The opposite is also true: hygienists fundamentally have more learning and experience about the clinical needs of oral care. Yet, within the dental office, a decision made in one department can impact the other. Perhaps the hygiene team wants to implement a customized recare program that may require creative scheduling on the part of the administrative staff. When this condition arises, decisions should be a collaboration between members of both teams.

Clear communication and transparency are required to understand all the implications about the coming changes. The logistics begin with posting the proposed initiative two weeks prior to a brainstorming meeting. This allows time for team members to think deeply about the proposed change, formulate ideas, and network with others to spark new thought. Everyone will want to gather data and pepper their imagination with novel concepts that will support the upcoming objective.

At the brainstorming meeting, friendly debate and dissenting views should be explored openly with an emphasis placed on possible problems that could arise with different applications. Someone could even be appointed to act as a devil’s advocate with the role to poke holes in the proposal. Looking at all perspectives will seed thinking about new possibilities and help prevent possible loopholes from turning into crises.

The vote is not taken at this meeting, but the following week. This encourages further incubation of the ideas gleaned at the brainstorming meeting, and more opportunity to network and troubleshoot before problems arise. At this voting meeting, everyone has an opportunity to voice his or her developed opinions before the proposal goes to a vote. As in any democratic society, the majority rules and the decision with the greatest support is adopted.

Working collaboratively to arrive at a democratic decision-making model will ensure that the team is behind the decision. Enthusiasm is elevated and the culture in the office is healthy when everyone’s voices are heard. A further benefit is that by empowering team members, the likelihood of the initiative being successfully embraced and implemented increases.

Even staff who oppose the outcome of the vote live by the office’s constitution, agreeing to willingly commit to the majority rule in a professional, flexible, and mature manner and to carry the ruling forward with the intention of giving it their all. Staff members voluntarily agree to this when they sign the constitution, realizing that there may be times that it is necessary to submit for the good of the office. All members are committed to the team.

The leader of a republic of team needs to respect the decision of the team as well. This may not always be easy to do. There could be times when the team is not in agreement with the leader. If it is not detrimental to the health of the business, the leader will suspend control and honor the team’s decision. For instance, perhaps the doctor wants to implement e-mail notification instead of reminder calls to patients, but is met with resistance from long-time staff members who hold the attitude, “If it ain’t broke, don’t fix it.”

In this example, the entire team votes, because patients are making requests to the entire staff, and it is a broad question that affects the workings of the office. In a person-centered team, staff supporting the changes will have the opportunity to present their argument of the benefits of the new system; those opposed will also have the same opportunity. The pros and cons are weighed in a manner that, at times, may be heated but always meets the civility spectrum (the criteria for respectful relationships) of the office’s constitution. The decision-making process is followed over the course of three weeks as outlined above before taking it to a vote.

If the majority of team members agree with the doctor and vote to have the reminder calls suspended, then the administrative staff will willingly adopt and adapt to the new system that has been proposed. However, it may not always be decided to the leader’s liking. Although the leader holds the trump card because he or she owns the business, in most cases it is prudent to let the vote stand and adhere to what is best for the whole staff. The initiative can be revisited in the future, and in the meantime, the leader has earned the confidence of the staff that he or she lives by the office’s constitution.

A leader of a person-centered team needs to be secure in him/herself, leave their ego at the door, and be committed to creating a collaborative culture within the team. They cannot allow their own biases to jade their thinking to the point that they shut out dissenting views. They also must be willing to let attachments go. It does little good to strong arm an initiative that has been rejected by the staff. The resistance encountered will be exhausting and the effectiveness of the initiative will be compromised. The leader should graciously abandon the initiative, at least at this time.

There are also times that the doctor makes the ultimate decision. Just as in any democracy, the leader’s mandate is to lead, sometimes having to make difficult decisions, or perhaps to break a tie or drive a policy that is for the good of the business. A good leader will seek to influence his or her staff members through education, data, and research, as well as make every effort to gain support for the new directive. Being mindful of others’ attachments and demonstrating flexibility will go a long way in building confidence with staff, even when it is in conflict with what others want. The ultimate goal is to base all decisions on what is best for the whole, and uphold the constitution of the republic of team.

The decision-making statement of the office’s constitution is one element of a winning team. Following it will guide the team to make prudent and wise decisions for the good of the whole. Meeting its criteria and the other strategy statements within the constitution will require an investment of thought, energy, and creativity by everyone on the team. The result will be unity, strength, fulfillment, and success for both the team members and the office! RDH

Dorothy Garlough, RDH, MPA, is an innovation architect, facilitating strategy sessions and forums to orchestrate change within dentistry. As an international speaker and writer, Dorothy trains others to broaden their skill-set to include creativity, collaborative innovation, and forward thinking. She recognizes that engagement is the outcome when the mechanisms are put in place to drive new innovations. Connect with her at [email protected] or visit