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Understanding where breakdown happens within a training program will help you identify where potential problems reside.
An interesting topic has come up this week at our practice, as we continue to improve our hiring processes. We have a recent hire who is struggling to keep up with the work load. I took a step back and asked myself why. Is it a lack of skills? Is our training adequate? Does she not like the job? If so, is she deliberately performing poorly to force the practice to fire her?
In order to solve any problem, you really need to break it down into its main components. Let's start with lack of skills. I reviewed the employee's resume, work history, pre-interview test scores, and one-on-one interview results. They all looked good, supporting the decision to hire her. So, next I looked at her training. Is the staff member who performed the training the best person for this task? I'm not sure at this point. I know the trainer has a lot on her plate, and performs several other tasks that are substantially distracting. But, how can I tell for sure if the training process is as solid as it could be?
I sat down with my team and we broke our training steps down even further. We thought about tools that can be created to assess whether the training is adequate, or if the trainee's memory and task retention is adequate. Here's what we came up with:
1. Make sure the trainer has covered all topics of the position within the allotted two-week time frame.
2. Create a quiz to be given at the end of the two-week training period that covers the basics - office location (directions), office hours, phone/fax number, phone greeting, running a credit card, scheduling appointments, etc.
• The quiz should include multiple-choice questions and short essay questions (written answers) for the best results.
• The trainer should keep documentation throughout the two-week training period and sign-off on each procedure once it is adequately addressed and satisfactorily performed.
• Reviewing the results of these two documents will evaluate if the trainer did her job and whether the trainee retained the information.
• Once the new employee reaches her new office, any items on the quiz that were missed should be covered at the new location.
3. Continuing training should take place via hands-on tasks and review of previous training.
4. Create a 30-day quiz that covers more in-depth topics now that the trainee has had the opportunity to perform the job tasks.
• This quiz should include topics like insurance verification, payers that you are contracted with, posting monies collected at time of service, explaining quote of benefits to patients on their first visit, and explaining the difference between a PPO, EPO, HMO, etc.
• If the trainee misses these questions, yet was signed-off on those topics with the trainer, it could very well be a red flag suggesting the new employee cannot retain required information.
• Review quiz results with the new employee and the trainer, focusing on subjects that were missed. Remind the employee that she felt confident enough with the provided training that she agreed to sign-off on that topic.
5. Create a 60-day quiz that requires written answers only, and goes in-depth about your practice, your healthcare staff and their positions, the art of patient scheduling, and more complex insurance issues that may arise.
• The employee must re-take the 30-day quiz prior to taking this quiz and fully pass.
• The 60-day quiz is your opportunity to release an underperforming employee who is still under the 90-day probationary period, if you feel she is not retaining necessary information. It allows you to start your job search earlier and lets the new employee know why she is not a good fit for your practice.
• We have 20 questions for each quiz and really focus them on the practice, staff, scheduling rules, and insurance information.
If this seems like too much work, think about it this way: How much will this employee cost you if you keep them past a 90-day probationary period and they still cannot retain basic information? Most good employees at a front- or back-office job should be able to get the basics down in two weeks, and the remainder within 30 days. Yes, there will be exceptions, but this is a good rule of thumb to follow.