Does an employee calling in sick create a melt-down in your practice? And what happens when your insurance coordinator informs you that she will be leaving for two weeks due to a family emergency? Do these examples leave you with a queasy feeling because you know that similar crises can happen to you? If so, you are probably not cross-training your staff. Let’s look at the why and how of cross-training and see how it can help your practice.
What would have made the difference in these situations is if a cross-training system had been in place. Cross-training is so important in keeping a practice on an even keel when staff members have to be out or are terminated. There are many rewards for practices that implement a cross-training system:
- A cohesive team – Cross-training allows for the opportunity for staff members to see the full picture. They are basically walking in each other’s shoes. This improves understanding of the different roles and the varied problems connected with each role. There will be far less of “the grass is always greener” attitude and that will create a more tolerant posture throughout the office.
- A smarter and more efficient team – When a staff member has to train another staff member, the trainer has to really think about what he/she does. This close job analysis can lead to more efficiency for the trainer because he/she will have to look at all aspects of his/her job while teaching it. The trainee is in the position to evaluate the job with a fresh set of eyes and offer new ideas. Communication will increase, problem-solving will occur, and a sense of trust will develop. This, in turn, leads to more self-confidence, greater knowledge, new skills, and a staff that feels more valued.
- Reduced boredom – Performing the same duties day after day, even when staff members enjoy their jobs, can often lead to a sense of boredom. Cross-training provides variety: a change of pace, a new set of problems to deal with, interaction with different staff members, and it fires up their creativity which allows the staff members to stretch. If you implement a cross-training program, where cross-training takes place at periodic intervals, you will allow this process to happen more frequently and you will be letting those creative juices flow.
- Practice flexibility– In Jim Collins’ book “Good to Great”, he talks about the importance of having the right people in the right seats on the bus. Presuming that this is the case in your practice (and it should be), you need to be prepared for the empty seat. Cross-training gives practices the flexibility to keep the seat filled. When an employee must be out due to sickness, vacation, etc., or if the position is terminated, there will be another staff member who is prepared to handle the duties of that job. If a key employee terminates, you will not be completely at a loss when cross-training is in place. Although understaffed, you will still be able to function while managing to keep your patients happy and your bottom line in good shape.
IMPLEMENTATION
The question now is how to implement a cross-training program. The implementation should not be rushed into. The steps outlined below offer a guideline for implementation:
- If your practice does not already have job descriptions in place, then begin that process. Get the staff involved and have each member create their own. Even without a cross- training program, having a set of job descriptions for each position is vital to staying functional when an employee leaves and new employee training must take place.
- When hiring new employees, ask questions that will reveal if the applicant can multitask. Multitasking is essential to cross- training. According to Gail Garfinkel Weiss, the senior editor of “Medical Economics”, “Cross-training starts with hiring the right people – folks who can multitask, want to learn new skills, and can shift gears quickly and effectively.”1
- Schedule a staff meeting to introduce the plan to the staff. Explain the benefits of adopting this system. Assure the staff that you are not just trying to get them to work harder but are, instead, being proactive in avoiding practice crises when employees are out. Tell them how proud you are of them and that you know that they have the talents to handle this well. Possibly consider some sort of reward or compensation for a job well done when this system is in place and working.
- Ask for volunteers. Many employees look for chances to better their situation and this can be a good way to do that. The likelihood of success for cross-training is much greater when the cross-training involves this type of individual. Not everyone may be receptive to cross-training and, if an employee does not want to do this, don’t force it upon him/her. It will impact on the effectiveness of the training. New employees should not be a part of cross training until they are comfortable with their own job duties.
- Each participating staff member should only be cross-trained in one position. The plan cannot be effective if staff members are trying to learn too much. Ask for staff opinions on who should be paired with whom but also consider your instincts in making the decision. In addition, certain jobs require licensure or certification. In the case of certification, review the job description to look for those duties that can still be performed without the certification and let those tasks be the ones learned. Hygiene positions, because they require licensure, will be the only jobs that cannot be cross-trained at all. Try to find a hygiene temp agency or a part time hygienist who can fill in on short notice for him/her when the hygienist will be out.
- Once the decisions on pairing have been made, provide each participant with the job description for the job that they will cross-train in.
- Make a plan on when to start and try to do this during periods that are not too busy. Some practices have predictably slower days than others. If this is the case, schedule cross-training on those days. If this does not apply to your practice, then just schedule it. If it is not scheduled, it will probably not happen. Do not do everyone’s cross- training on one day. Divide it up so that it will not impact negatively on the practice.
- Begin the process with job shadowing and gradually work into job exchange. Be patient with the staff during this process.
- Make discussion of the cross-training system part of all subsequent staff meetings in order to evaluate the process and make recommendations for improvement. Let staff members give feedback on their experiences. Take this opportunity to recognize their achievements and the contributions that they are making to the practice. Staff morale will be greatly increased.
With a cross-training system in place, those dreaded situations are not such a problem anymore. The day will run much smoother and you will be proud of how well your staff manages. So get started now – you never know when that phone will ring.
1”The Benefits of Cross-Training Staff”, Gail Garfinkel Weiss, Medical Economics, www.pmandr.com, 4/14/2007.