Setting Hygiene Production Goals
Add practice value by capitalizing on this important revenue stream
With the first half of 2013 almost complete, it is the perfect time to examine the goals set forth in a practice’s annual plan for hygiene department production. If goals for the year have not yet been set, it is certainly not too late—hygiene production goals can provide a tremendous value to the assessment and management of a practice, no matter what time of year they are created.
First and foremost, production goals should be set as a team. As Ken Blanchard stated in Situational Leadership, “Leadership is something you do with people, not to people.” This is particularly true in setting goals for individuals who work as part of a team.
It is also important to gather historical facts about the hygiene department to serve as a baseline, which should include last year’s actual production for each hygienist, the number of days worked, production per day, procedure mix, unfilled hours, and fees. These statistics are the essential for evaluating past hygiene production.
Assess Strengths and Weaknesses
Analysis of these data is essential for understanding both the positive and negative factors that are impacting production. If the numbers are down, resist the urge to blame everything on the economy, and instead take ownership of what you can control. Taking stock of your own systems—ones that are working well and ones that need attention—will involve everyone in the practice and will help to clarify the actions needed.
For example, consultants at Pride Institute are finding a common issue throughout the country: broken appointments in hygiene and procrastination of care. Although this is a multifaceted problem with no silver bullet solution, your team must examine all of the systems and problems that can impact unfilled hours.
A number of strategies can help decrease the number of unfilled hours, including maintaining an active patient base and having the right number of hygiene days (1 day for every 200 active patients is a rule of thumb); building value for the hygiene appointment through clear communication of the patient’s condition; developing excellent verbal skills to strongly encourage the patient to honor appointments; pre-appointing for the patient’s next visit; having contact with the patient between appointments (eg, e-mails, e-newsletters, social media); and implementing an effective reminder system.
Set Realistic Goals
For the next step, you will need both the total office production (TOP) goal and the anticipated dentist production goal for the year. The difference between the TOP goal and the dentist production goal will be the hygiene department goal. It is important to establish the dentist production goal first, as this goal has a greater potential for increase than the hygiene goal.
Hygienists must anticipate the number of days they will be working for the year, excluding time out of the office for vacations, continuing education courses, and holidays. Dividing the hygiene department goal among the hygienists is the next task. To find the daily goal for each hygienist, divide the hygiene department goal by the number of days worked.
There are other considerations and questions to ask when determining this daily goal, however:
• Are all hygienists producing the same over time?—New hygienists in a practice might not be able to produce what veteran hygienists can. There may also be hygiene subspecialties within the practice or diverse abilities that can significantly impact production goals, such as the ability to administer anesthesia, preference by pediatric patients, or a specialty in periodontal treatment.
• Are some hygienists seeing new patients whereas others are fully booked with patients of record?—New patient case values are often much higher because of untreated periodontal disease, whereas established patients may have more stable periodontal needs.
• What was the average daily production per hygienist from last year?—This is significant because you must base any increases on historical achievement as well as new opportunities.
• How much more can the daily goal be increased realistically?—A goal that is set too high out of the starting gate could lead to disillusioned team members who immediately ignore the goal, thinking it is a pipe dream. Goals should stretch team members, but not discourage them.
• Should the goal be the same throughout the year?—The best technique is to establish quarterly incremental increases related to the specific actions that are needed to achieve the goals.
The answers to these questions is where the “rubber meets the road” in goal setting.
In discussion with your hygienists and other team members, determine what training and continuing education courses are needed and what new procedures should be provided. In addition, think about how verbal skills can be improved, how communication during patient debriefs and handoffs to other team members can be improved, and what system enhancements can be scheduled. Possible improvements can include an increase in fees, increased use of the intraoral camera, an improved protocol for handling cancellations and no shows, a new courtesy reminder system, enhanced data gathering for periodontal assessments, an improved patient education system with visual communication and subsequent electronic communication to patients, and scheduling hygiene appointments in the hygiene operatory.
Assigning some of these actions to each quarter of the year will align the specific improvements needed with each quarter’s increased goal. In general, incremental increases in daily goal per quarter per hygienist should be between $20 and $40.
Follow these steps and you will have a working document to assist you in setting clear, realistic goals that involve and engage your team, are achievable and timely, and make a measurable impact on the practice’s bottom line.
About the Author
Mary Lynn Wheaton, RDH, is director of consulting at Pride Institute in Novato, California. She joined Pride Institute in 1999 and has 30 years of experience in all aspects of dental practice management. Wheaton serves as the consultant team leader at Pride Institute and specializes in practice development, team building, group interaction and customer service.