How does your current clinic’s operation manual stack up to establishing the foundation your practice needs?
As soon as employees are hired, there is a need to obtain more applications, resumes, job descriptions, establish daily office procedures, operating hours, etc. Yep, do not ask to get what you wished for because you just might get it. That said and all whimsy aside, proper systems such as the operation manual must be implemented to ensure that all these work for the purpose of patient retention and acquisition.
The operation manual: establishing a foundation
One of the factors to ensuring that all employees work from the same level is having a foundation. This provides a written formula of policies and procedures that all will work from. Often called an operations manual, the document provides the framework for all employees, from greeting patients to scheduling them to billing them and oftentimes even getting referrals.
The operation manual is a tool kit of your knowledge of your practice and what you do on any given day. Then as the practice grows it will become necessary to implement several new items for both patients and staff. The thing to realize is that every practice is different, so every operations manual is different too.
As they say in retail, to maintain a strong business requires location, location, location. Well, to maintain an efficient practice requires documentation, documentation and documentation. Therefore, there will be no right or wrong in piecing one together. However, the following information will assist you in developing a manual, illustrating some of the vital information to be included, and even provide some sample language so you can use the content to develop your plan:
Purpose of This Handbook — The handbook is intended to be a communications tool to inform employees about the policies, guidelines, benefits and work practices that affect their employment.
Employment at Will — Employment-at-will statements are typically helpful in practices when you want clear lines to denote that employees are hired and terminated at will. There is no contract that requires you keep them, and if they do not conduct their responsibilities they can be terminated quickly. This is a useful statement in the operation manual, especially with problem employees.
Equal Employment Opportunity — Your practice is committed to equal employment opportunity for all qualified persons. This is without regard to race, color, religion, sex (including pregnancy, childbirth and related medical conditions), national origin, ancestry, age, physical disability, mental disability, medical condition, family care status, veteran status, citizenship status, marital status or sexual orientation, to the extent required by law.
Affirmative Action Plan — As a small practice you do not have to have an affirmative action plan. But realize that as you develop new employees and become larger, in some states it may be required. As such your practice will cooperate with federal, state or local government agencies that have the responsibility of observing our actual compliance with various laws relating to employment. Therefore, your practice should furnish such reports, records and other matters as required and/or requested in order to foster the program of equal opportunity for all persons regardless of race, color, religion, sex, sexual orientation, age, national origin, disabled and/or veteran status, or physical or mental disability.
Maintaining a positive work environment
We all know from experience how important a positive working environment can be for doing our best work. Yet none of us can create this environment alone.
We all need to respect one another, cooperate with each other, and treat each other with consideration. The following policies provide important guidelines for maintaining a professional, productive, courteous, safe and stress-free environment:
Dress Code — There should be an appropriate dress code so that patients and alliances can differentiate between staff and patients. There should be name tags as well as a certain uniform so that the practice has a particular look and feel.
Smoking Policy for the Workplace — If required by regional law, state law, or even a personal preference, a compliant smoking policy should be provided as part of the operation manual.
Job Descriptions/Personnel Records — There is nothing as important as listing for every employee and every function a complete description of the job position and requirements. First, the requirements are how employees will be measured for their success on the job. Second, a good detailed description ensures that all understand their requirements so there is less chance to question authority, challenge work and conflict with patient development.
Work Rules and Performance Standards/Standards of Workplace Behavior — It is not possible to provide a complete listing of every work rule or performance standard in an operation manual. Employees who do not comply may be subject to disciplinary action, up to and including possible termination. There are two categories listed here to provide you with some language and understanding for a work rule and standard.
Job Performance — Employees may be disciplined, up to and including possible termination, for poor job performance. Some examples of poor job performance are as follows:
- Below average or what the practice defines as acceptable level of work quality or quantity;
- Poor attitude, including rudeness, or lack of cooperation — this includes dealings with patients, vendors, co-workers, representatives of local, state or federal governments, etc.;
- Excessive absenteeism, tardiness, or abuse of meal or break-time privileges;
- Failure to properly use and care for all practice-owned or rented equipment;
- Failure to perform all job duties, tasks and responsibilities.
Standards of workplace behavior language
Whenever people gather to achieve goals, some rules of conduct are needed to help everyone work together efficiently, effectively and harmoniously. By accepting employment with us, you have a responsibility to the practice to adhere to certain rules of behavior and conduct. The purpose of these rules is to be certain you understand what conduct is expected and necessary.
Additional language includes:
Tardiness And Absence — If you are unable to report to work for any reason, you must call in to the chiropractor or chiropractic assistant before your scheduled time of arrival with the following information:
- If you will be late, you must state why and when you expect to be in.
- If you will be absent, you must state why and how long you expect to be out.
Performance Evaluations — These formal and informal evaluations are required to ensure you get the best out of your staff. It is important that you consistently and relentlessly evaluate staff so that they not only perform at level, but perform higher than expected. Many chiropractors tend to wait for an annual review. One practice I visited with many years ago had a chiropractic assistant for 18 years and had never provided a review! This is totally improper.
Your staff must use the clinic’s standards to place all measurements as well as achieve individual results based on goals. Standards are an individual’s duties and responsibilities, while goals are the result or achievement toward which effort is directed. To achieve these aims requires constant communication (monthly basis) so that performance is continuous.
Disciplinary Form — If staff commit an infraction or violation of any practice policy and procedure it should require some form of discipline. This may include excessive absenteeism, tardiness, insubordination, professional ethics, lack of customer service, etc. The form should include a date of the infraction, steps required to alter the behavior and time frames that ensure revision.
And, finally, once the operation manual is completed, it is advised to have all staff sign and date the policy. This assures that all staff signing have read, reviewed, and are in compliance with all practice policies. Signing the form provides the documentation required in times of conflict and also holds staff accountable for all information contained within the document.
DREW STEVENS, PHD, is the author of Practice Acceleration and over 700 articles on chiropractic practice strategy. For additional information visit his website at drew-stevens.com. © 2021. Drew J. Stevens, all rights reserved.