Training Your Chiropractic Staff - Now That You Have the Time

Welcome to our first episode of Catch up with ChiroTouch. I'm one of your hosts, Dr. Tami Howard. I'm the training manager here at ChiroTouch, and I work with our clients to help maximize the use of the EHR platform to make their life easier and get their best return of investment on the software.

I'm excited to start this weekly podcast where we'll talk about not only the ChiroTouch software, but also discuss the current state of our profession and share tips and tricks to maintain the health of your practice throughout this challenging time. Tune in every week on Spotify, iTunes, or chirotouch.com/podcast to listen to our latest episodes. In this episode, we're going to be talking about best practices for training staff during these slower times.

With patient volume down, now is a great time to focus on training staff and refining your office procedures. Some of your procedures may have also recently had to shift to accommodate social distancing. So training staff on adhering to those new procedures is important to make sure your entire team is working as a cohesive unit.

Joining me today, I have Hilary Snow, a former chiropractic office manager and currently a ChiroTouch training specialist. In our previous role, Hilary helped to develop office procedures and train new staff.

Hi, Hilary.

Thanks for joining us.

Good morning.

So a while back, you and I were talking about a concept that you used in your office to train staff using ghost patients. Can you walk us through that?

Sure. Kind of the analogy is like a good sports team or any professional. They do a lot of training before they actually start the game.

So the ghost patient process is getting all of those systems down, the flow of the office. How do we greet our patients? What do we do first?

If they fill out paperwork, how do we gather it from them? So when offices have downtime or are training new staff members, in our office, what we would do is we would act like a patient was physically walking through the door. We would greet them like we normally did, and we would act as if we had that patient truly in our office.

We would go through every single process just as if we had that live patient with us. And the doctor also did his part as well. And what it did is it got us kind of the term is a well-oiled machine.

We knew what to expect. We knew how long it would take to do certain things. We also trained in a way where if there was an issue, what if the client or the patient asked something that was out of the norm?

How do we handle those things? So we didn't always practice the perfect scenario. A lot of times we would throw in little hiccups if they had an objection to having x-rays in our office or something along those lines.

And it just helped us to work really well as a team. It's also a fantastic tool to get a new staff member up to speed.

So a patient would basically, you would take like a staff member and act as a patient or we have kind of like Casper the ghost to float through the office?

Great question. So if there's two staff members, then typically one would act as if they were the patient, the other would act as if they were the staff member, the doctor, the provider is acting as if they're the provider. When it's one staff member, you literally could act like it's a ghost patient.

If you have windows, the people that are sitting outside might think that you guys are a little crazy because you're talking to air. But it is very effective. It's a little awkward sometimes at the beginning because it just feels weird.

But once you get into the flow of it, it becomes second nature. So in our office, when we had downtime and we had completed everything that we needed, and we were waiting for our patients, we just would grab one of our cards and we would just walk through the process. We would just do it as a surprise.

We would just act like we're greeting someone. If I was the front CA for the day, I would act like the door opened, I would greet the patient by name, and I would hand the information over to our back CA for them to do their process. They would do the same to me.

So we're always on our toes. We are always ready for that patient to walk through the door. For offices also that are trying to see more and more patients and get more comfortable with that increased flow, working with those patients is a fantastic way to do that.

It creates that muscle memory. How do you handle it if you have five people walking in the door at once? What is your check-in process?

How do you handle that? What about during check-out? So it kind of helps you work through all the potential kinks you might end up with in that real life scenario.

Yeah. I like the idea of not always practicing the perfect scenario. I think that it's probably beneficial to really get your perfect scenario down pat so that when things come up and they're a little bit different than what's normal in the office that you have had normal to fall back onto.

But obviously, looking at what are some of the issues that might come up and how can we think ahead of those and form some kind of a game plan when those issues do come up. Yeah. Are there specific types of kind of unperfect scenarios that you guys used to look at and try to train for?

Some of them are, in the office that I was in, we always x-ray patients unless they had something that they brought in. When you go in and you do the initial report of finance as the assistant going in to tell them what the cost will be for the day, we would work in those ghost patient scenarios if the patient had objective to cost. How do we handle that?

What is the verbiage that we use? What are the options that we have available that we can discuss at that point? A lot of times you may not know even if you verify benefits, what actually will be covered.

And it's always kind of a surprise. So we would work with those scenarios so that we were as comfortable as possible because the more comfortable we are in the process, the more confidence our patients would have in us as a practice.

Yeah, that makes sense. And especially some of those things around financial questions. Obviously, those are some of those conversations that people are a little bit more sensitive to.

So, starting to think through what are some of those things that might come up and how we can get ahead of those in terms of what are the objections we're going to see and how can we think about responding to those objections ahead of time.

Exactly. So, if we've done them in our ghost patient scenarios, when they happen in real life, because there's a good chance they will happen at some point, the more patients that you see, we're already somewhat prepared for that experience. We know what we can and cannot say, what is appropriate at this point in time.

Right. With the way things have changed recently in practices, a lot of practices are instituting new policies. A lot of people are doing things with a virtual waiting room, or they've changed the number of people that are allowed into the office at any given time.

Something that occurs to me is that being able to practice in whatever that new scenario is probably pretty important as well. Were there times when you guys were in your practice where you would go back to this idea of practicing when you made a shift in some type of policy or procedure?

Absolutely. Anytime there was anything that we changed, no matter how small and minute, we would work through practice patients. We would work through more and more ghost patients as possible.

We had a goal that we would set every day. How many patients do we want to see today? How many people do we want to serve?

Then we would look at what we have scheduled, knowing that our office at least had a good amount of walk-ins. We'll say, okay, well, how many people at the end of the day do we want to serve?

Right.

Okay. We came up with our number, we would write it down. As we're working through the day, we're working on ghost patients so that we're able to meet that number, so that we're used to seeing that number of patients.

Any tiny little shift in our processes or procedures, we wanted to get comfortable with as quickly as possible. We would start practicing immediately, whether it was even the slightest change in how we address the financials, or if we changed our documentation process, had different paperwork. If we had anything different that we did, we would put it into practice right away.

Right. Yeah. I know with the recent changes that a lot of offices have instituted, having some type of a screening process for patients.

So that part of that might be that they need to then take some of that information and also plug it into their EHR system. So oftentimes, we'll see recently, it's coming up a lot, is that they may have a CA that's doing a screening of a patient. But maybe what they're doing inside of ChiroTouch is actually setting an alert to remind the CAs, these are the questions that you need to ask, these are the steps that you need to take.

So when a patient does check in, it pops up and reminds the staff, do these tasks using those ChiroTouch alerts. Or when they bring the patient back to the provider, going in and documenting in the provider all in one, these are the questions that we ask the patient in terms of screening them before their care. But most likely needing to practice that a little bit, because this is all really new for offices, needing to take some of these screening measures and document all of those pieces as well.

Absolutely. Yes. Another thing like you're mentioning with the alerts, if your office is taking advantage of our self-check-in process, you have the ability to set up a group alert for every patient that uses that self-check-in to notify you maybe of any symptoms that they may be having outside of the normal ones they would come into your office for, or anything that could potentially be an issue, especially right now.

Right. Yeah, definitely. Yeah, I think that training staff, especially while things are slow and as things shift, it's really important for offices to get back to some form of kind of standard operating procedure.

We've all had to shift a little bit in the way that we do business, in the way we take care of patients, in the way that we process patients. And so practicing that through with this idea of a ghost patient, I really love that idea. And seeing where they're getting caught up, is the staff asking the right questions of the patient when they walk in?

Are the providers getting in and documenting in their notes what they need to say about the efforts that they've taken to ensure safety in the office. So I think that this idea of ghost patients is incredibly relevant right now for making sure that we train on new procedures. But then also like you were saying earlier, as we're kind of like slower, just getting that kind of groundwork and that foundation laid for this is what a normal perfect scenario looks like, right?

Where there's no objections, there's no issues going on. And then that kind of taking that up a notch and saying, well, how can we think through and plan in advance for the things that might come up where we might have objections to care or finances. So, yeah, this is all really great information.

The other thing that occurs to me that might be really beneficial as people are changing things in the office especially is you and I talked a while back about this idea of this like pre-flight checklist. And so talk to me a little bit, talk to our listeners about that pre-flight checklist.

Sure. So, you know, again, the analogy is any good pilot goes through the pre-flight checklist no matter how many times they've flown because it helps you catch things that you may otherwise take for granted. So in our office, what we had is we had a front office, a front CA and a back CA checklist and each one had separate duties and they would initial them as they went throughout their day.

And not only does it hold staff accountable for completing certain tasks, it's also a good reminder because we get distracted. A patient walks in and we're in the middle of trying to do something. And so it helps keep us on track to make sure that we're doing the right things right to keep our practice focused and moving in the right direction.

Wonderful. Yeah, I love that idea. Just keeping track of what we're doing, especially when things are changing, and even when things are remaining the same, just good to have those reminders.

Sometimes it's easy to let something slip through the cracks if we don't have a guideline set out for those.

Right. And we had daily, like AM and PM duties, we would have weekly, bi-weekly, and monthly. So certain things were done and we had a schedule for everything basically.

So we always knew when to expect certain things were completed. And again, we're always signing off on what we've done.

Yeah. Especially the monthly. I feel like when I am in my conversations with practices that oftentimes I'll find that they've got it down when it comes to the daily tasks.

Right. And then as we kind of move up in our time frame, this is where things start to slip. Or when I get to the weekly and the monthly things, like I'll have conversations with practices.

It's like when was the last time you ran your AR and checked that over? It's like, what's an AR? And so it seems to kind of slip a little bit further as we go down that process.

So I like that. You know, you're kind of looking at that not only at the daily level, but looking at that at the weekly level, looking at that at the week, the monthly level, maybe perhaps something that needs to be done on a quarterly basis, but making sure that there's some accountability that those have been taken care of so that everybody is holding to what they're supposed to be doing. So, right.

It's very easy to forget things, especially if you're not doing it daily. Like you mentioned, the bi-weekly, the quarterly, the monthly items, you don't do them every day. So it's really easy for them not to be right at the top of your list of things to do because you're not used to doing them every day.

Yeah, absolutely. Well, thank you so much, Hilary, for these wonderful tips and tricks to help our users and our listeners manage their practice during these unprecedented times. Thank you all for catching up with ChiroTouch on our first episode this week.

Next week, we're going to be having Dr. Brian Blask and Dr. Kelly McClure on to share guidelines on how to stay fit while staying home and recommendations of tools to help you stay connected with your patients. Have a great week.

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