Increase Your Team’s Performance and Efficiency

Sep 21, 2023 | Operations

Achieving your practice goals is only possible if your team is aligned, engaged, and empowered.

When they’re not, targets get missed. Envisioned results seem far away — fewer appointments get booked or an ancillary service’s revenue takes an unexpected hit.

But a business is really a system of systems — how can you find and resolve the performance gap?


Let’s look at this through the lens of a fictitious business, Excellent ENT, encountering a very real scenario.

Over the past six months, its two hearing care providers haven’t sold nearly as many hearing aids, even though the number of patients they’ve seen hasn’t changed.

In other words, their conversion rates have tanked.

But they are both tenured professionals with proven records of success at the clinic.

Excellent ENT decides the solution is to invest in an off-site training to sharpen their skills and help pull them out of their rut.

The providers attend the training and return open-minded and engaged — but their results do not improve. In fact, in the three months following, results drop even further.

So how did this happen, and how can you avoid a similar problem?


Six factors influence how people work. Understand them and you can identify problems, implement solutions, and improve team performance.

Let’s explore each one, plus examples of potential challenges. How would you respond to these challenges?


Structure and Process

Operational elements impact workflow and efficiency, both for the individual and team-wide. For example:

  • Walk-in appointments interrupt flow

Accommodating walk-in or work-in appointments usually results in double-booking at least one patient. You not only impact the provider’s schedule but every patient after the walk-in.

  • Wait times cause frustration

Patients are only willing to wait about 20 minutes before they become frustrated.

Many patients leave before seeing their provider because of the wait, and one in five would switch providers solely because of wait times.

Those same wait times add to provider frustration as well. And a frustrated patient with a frustrated provider doesn’t lead to beneficial clinical outcomes.

  • Insufficient time allotted for appointments

Scheduling based on aspirations, not on actual needs, is all too common.

If an appointment type realistically takes 30 minutes but the schedule only allows 15 minutes, your patients won’t get the best care and wait times will skyrocket.



When resources are missing, insufficient, or too difficult to use, it impacts the performance of the person using the resources. For example:

  • Old equipment

Constantly battling old, faulty, or unreliable equipment saps focus and leads to inefficiency. Not investing up front will cost you on the back end.

  • Disorganized work environment

An unorganized workspace leads to every task taking more time and mental energy to complete.

  • Missing equipment

If there is only one sound booth for two hearing care providers, scheduling hearing tests will be a constant battle.


Information Exchange

Information flows in several directions in a medical practice, and different audiences use it in different ways. This critical piece is often an unseen breaking point. For example:

  • Missing or incomplete patient forms

Assumptions and unnecessary repetition result when any patient touch point doesn’t have all the information it needs.

  • Poor communication

Information sharing among patient-facing staff is crucial — poor communication during patient handoffs in a hospital setting is the third most common cause of death, preceded only by cancer and heart disease.

  • Process changes

Medicine is ever-changing. When it results in a process change, it’s all too easy for it to go uncommunicated or miscommunicated.


Knowledge and Skill

This is where training comes in and where people often look for a solution to a performance problem. For example:

  • Lack of knowledge

Knowledge gaps happen because someone hasn’t been shown, doesn’t understand, or forgot. It’s common but, unfortunately, many hesitate to admit a knowledge gap.

  • Lack of practical opportunity

Knowledge not put into practice is likely forgotten — and keeping skills sharp is critical in medical professions.

  • Lack of ability

Everyone has a limit to what they can accomplish, and that’s OK. But assigning someone tasks beyond their abilities is setting them up for failure.



If people aren’t motivated to do the work, changing their behavior will be difficult. In fact, it’s the most difficult factor on which to move the needle. For example:

  • Conflicting values

Asking someone to do something they don’t believe in makes them feel disrespected and keeps them from being motivated.

  • Wrong person for the position

People are commonly put in roles out of necessity rather than fit. The result is an unhappy, unmotivated employee who won’t perform.

  • Lack of appreciation

People who don’t feel appreciated won’t feel the need to do a good job. And not all employees respond to the same expression of appreciation: Some value compensation; others, a simple “Thank you.”


Health and Wellness

When basic health and wellness needs aren’t being met, poor performance and burnout are the rule, not the exception — especially in a medical practice. For example:

  • Lack of work/life balance

When it’s impossible to take time off for personal appointments or picking up the kids from school, frustration builds and performance declines.

  • No time to rejuvenate

Working in health care is stressful and takes its toll. Making employees feel guilty for taking paid time off is a direct route to a team rife with burnout.

  • Poor mental or physical health

Employees without health insurance or who feel like they can’t take sick time won’t be at their best because basic needs aren’t being met.



Consider the example at the beginning of the article — which of these factors are affecting Excellent ENT?

At this point, it’s anybody’s guess. But here’s another layer of information:

In the six months leading up to the training, the practice hired a new physician. This doubled the number of patients referred to the hearing aid clinic.

To compensate for the increased work, the allotted time for all hearing-related appointments was cut in half.

The answer still isn’t totally clear. To identify the best solution, the next step is pinpointing the root cause or causes. This is what is referred to as a root-cause analysis. Below are the steps for this process.

Step 1: Pinpoint the Problem

In this case, it’s declining conversion. Why is that a problem? Less revenue, fewer patients being treated.

Step 2: Identify the Relevant Data for Review

In this example, it’s key performance indicators, including conversion, average selling price, number of patients, appointment times, types of patients being seen, change in contracts, and the like.

Step 3: Identify Causal Factors

In this example, structure and process are factors — the new scheduling approach has changed things a great deal. Information exchange might be an issue if there was miscommunication about the time needed for appointments.

Step 4: Identify Root Causes

Here are three common tactics for getting to the root cause:

  • Brainstorming

When various perspectives are involved, brainstorming allows for free-flowing ideas and creativity that can positively challenge others’ thinking. It’s effective for diverse teams or groups that are inclined to collaborate.

  • Five Whys

This is a simple, iterative process. Start with the problem, or symptom thereof, and ask, “Why is this happening?” Take that answer and repeat the question. Do it three more times. The result is often the root cause of the symptom.

  • Surveying

Consider this approach when tackling a business-wide issue with myriad possible causes. For example, if you’re experiencing high turnover, an employee-engagement survey can offer insight from those affected.

Step 5: Recommend and Implement Solutions

It’s time to explore options for addressing the issue.

In the Excellent ENT example, changes in structure and process created the problem — but what created the changes in structure and process? The root cause is likely a lack of information exchange about reasonable scheduling expectations.

Much of Excellent ENT’s declining revenue could have been prevented by slowing down to consider why the providers’ conversion was declining and taking the time to communicate.


Learn how you can improve operational efficiency and maximize patient opportunities