Case Study Implementation
Hello Tin Le,
It is sincerely my pleasure to assist you in your forward progress.
You have supplied me with many numbers, sta s cs and informa on to put this presenta on together.
As an overview, I work strictly on strategic ac ons and very much a empt to remove myself and yourself from the weekly and short term “noise” that can prevent a business from expanding.
The first and most vital step is to have an agreed upon objec ve or goal! Most business have not clearly iden fied where they will travel in the next 5 years.
This analysis is a 5-year expansion plan for your pra ce (or prac ces).
In se ng an objec ve or goal for any business, requires precision metrics and analy cs. I say this as one cannot manager or expand without a proper evalua on of metrics and the business model one is trying to achieve.
I have included a separate “Guide” or “Manual” that gives an overview of the business model for implementa on. This manual is for use by both yourself, but as important, for the person that will be the Department Head of your Hygiene Department, either your Lead Hygienist and/or the Hygiene Coordinator.
In this overview, I’ve chosen to focus the analysis on Sandy as it has greater poten al due to its size, arche ture and loca on. This does not mean Division Street cannot grow or be extremely profitable. I’m simply laying out a plan for Sandy...but the same ac ons and metrics apply to Division Street.
The produc on of your facility at Sandy has a capacity for an annual produc on of 3.2 to 3.6M per year. At this point, due to your 7 operatory capacity, you’ll hit an income ceiling.
The primary objec ve or goal is based on RETENTION of the pa ents coming into the prac ce and this is measured by the increase in the average daily hygiene produc on and the increase in the number of hygiene days.
The accomplishment of expansion has to be envisioned so the staff understand how the prac ce can gradiently achieve the goal. A breakdown of “Departmental Income” is easily understood and brings about agreement.
Sandy averages 21 new pa ents per month. With an average of 8 hygiene pa ents treated per day, every month the prac ce has approximately 3 New full days of hygiene.
The below diagram illustrates one year of Hygiene Department expansion:
To manage a department or a business is impossible without knowing and understanding metrics. Defini on: A Business Metric is a quan fiable measure that is used to track and assess the status of a specific business process. It’s important to note that business metrics should be employed in every area of business to manage specific performance that should be monitored.
Hygiene Metrics are the key strategy to building long term prac ce growth. As such, the below chart shows the standard metrics of the hygiene industry across the U.S.
As seen in the chart, the average hygienist upon gradua on works 4 days per week. He or she works 50 weeks per year, which means there are approximately 200 working days. The average hygienist sees 8 pa ents per day which equates to an average of 1,600 hygiene visits per year.
35% loss of database
35% loss of database
1/2 me hygienist added/year
Understanding Hygiene Metrics and their Role in Expansion
Hygiene Industry Metrics
1. Number of days worked per week 4
2. Number of weeks worked per year 3. Total working days per year
4. Average # of patients seen per day 5. Number of hygiene visits per year
50 200 8 1,600
The most important metric is the average daily benchmark produc on of hygienists in the U.S. The below gives the average daily produc on of dental hygienists across the country. The average is $1,500 per day in a fee for services combined PPO type prac ce. While $1,500 is the average, it is not uncommon for a well managed hygiene department to produce an average daily produc on of $1,750 to $2,000.
Average Daily Production
Hygiene Industry U.S. Average Hygiene Revenue $1,500
Average daily hygiene production per day
Total Working Days/Year
This means that each full me hygienist, working 4 days per week, will generate an average annual revenue of $300,000 to $350,000 per year. Let’s break down the annual produc on to illustrate the poten al growth of any prac ce.
Each day of hygiene per week is equivalent to adding an average of $75,000 per year as a revenue center for the prac ce.
1 day of hygiene per week = $75,000 per year
2 days of hygiene per week = $150,000 per year 3 days of hygiene per week = $225,000 per year 4 days of hyigene per week = $300,000 per year
As seen above, using the standard metrics, a Department Head in charge of the Hygiene Center has the responsibility of:
a. Recovering cancella ons to stop the loss of pa ents, and
b. Adding addi onal hygiene days by retaining new pa ents coming into the prac ce.
This is a combina on of Adding new pa ents to the hygiene department while at the same me Stopping the Leakage of the pa ents pre-appointed (reducing cancella ons).
This combina on results in an INCREASE IN THE SIZE OF THE ACTIVE PATIENTS for the prac ce.
There are 4 basic ini al ac ons to implement and execute for prac ce growth. These ac ons are revenue builders for the Hygiene Department. While revenue is important in any prac ce in terms of improving overall business growth, the primary PURPOSE of a dental office is to improve the overall health and WELLNESS of the pa ent.
Hygiene reten on eliminates future dental work, periodontal diseasse as well as expensive opera ve procedures. In summary, you are establishing the highest possible pa ent care in the industry.
You are establishing a Wellness Center in your Department of Hygiene.
At the same me, the reten on of the prac ce drama cally improves and the revenue begins to climb as stable long term growth.
The four ini al ac ons are covered in the Department of Hygiene Training Manual. Foremost, is having the Lead Hygienist (Department Head), learn the mission statement extremely welll.
Every new and returning pa ent are given the mission statement. The mission statement of the prac ce is placed in recep on as well as every operatory (as illustrated in the Department of Hygiene Training Manual).
Initial Actions for Hygiene Growth
Mission Statement Placed in Office & Operatories
Mission Statement by Hygienist to Every Patient
Daily Hygiene Production Reported Daily
Vivapak Passed Out by Hygienist to Each Patient
The diagram below illustrates Ac on 3, which is pu ng in a daily Hygiene Produc on Monitor. The below monitor is filled out every day by the Hygienists, and turned in to the Lead Hygienist. These are kept in a folder for the week, and all daily monitors (for each hygienist) are added together for the en re week and divided by 4 (the number of days worked by the hygienist). This can also be 2 days, or 3 days or however many days he or she works. This gives a weekly average of the daily produc on.
Hygiene Production Monitor
National Average Daily Hygiene Production:
Mission Statement Given
Care to Sare Card Handed Out
1 2 3 5 5 6 7 8 9
10 11 12 13 14
The weekly average is kept in the folder and at the end of each month, the total of each weeks produc on is added together and divided by the number of weeks in the month (usually 4), and this gives the Department Head the monthly DAILY AVERAGE PRODUCTION.
Each day the produc on is reported the hygienist can compare her own produc on against the na onal average daily produc on in the industry.
The mission statement as well as the cancella on statement, as covered in Ac on #2, is placed on the wall...samples of these are shown on the following pages.
(framed in each Hygiene Operatory)
Doctors & Staff
Displayed one on top the other, clearly visible for pa ents to see.
Doctors & Staff
Cancella on Policy
n each Hygiene Operatory)
Ac on #4 is handing out the Care to Share cards to every hygiene pa ents (the Vivapaks which contain the plas c care to share cards). The dialogue below is used at the end of each appointment with each pa ent. It is vital that every pa ent be given a) the dialogue, and b) a care to share card.
Hygiene Dialogue Distributing the Vivapak
The below “script” is a guideline for the dental hygienist in distributing the Vivapak. The dialogue below is aligned to an overall purpose or goal of the office. The script can be modified to suit your own personal wording....the most important aspect is to “make it your own.”
At the end of the appointment, after the hygienist has made the patients next appointment:
One last thing before you go...as you know our mission (point to the mission statement on the wall in the hygiene operatory) for families, friends and the community is to educate each patient to the level of never needing dentistry in the future.
I’m in charge of Hygiene Education Center....we call it a “Wellness Program” for every patient.
(With a Vivapak in hand) To accomplish our mission we run a community service program called “The Care to Share” program (open the Vivapak while stating this). It is a new patient cleaning, exam and x-rays to begin their hygiene education program. Our doctor donates the exam and x-rays for each new patient...and we do this so we can begin their education to eliminate their dental needs for a lifetime.
(While handing the Vivapak to the patient) If you could pass this along to a family member, friend or co-worker, it will help accomplish our hygiene education mission....and we would love to have more patients like you. I will be their hygienist and the first person they see!
Thanks so much...remember you can always call me if you have any questions or concerns about your dental health.
Have a great day!
Viva Concepts, LLC 1025 N. Brand Blvd, Glendale, CA 91202 (888) 340-1840
Ac ons for Implementa on
Your offices are on a Case Study with Viva Concepts. It is a wonderful journey in educa on to establish prac ce growth through Hygiene Reten on. The Department of Hygiene is the focal point of expansion as this is the only part of the business that deals with reten on of consumers.
As such, there is training of staff, specifically the hygiene team and scheduling/confirming personnel.
The ini al ac ons to begin improvement of this Department:
1. Foremost, immediately appoint a Department Head in charge of your Hygiene Department.
2. Have your department head read the Department of Hygiene Training Manual.
3. The Lead Hygienist is to learn the mission statement and when she has it down very
well then she simply makes a video with her iphone or andriod phone and sends this to the Hygiene Training Coordinator at Viva (Tony Langlely).
4. immediately implement the Hygiene Produc on Monitor for all hygienists.
5. Get each hygienist to learn the Vivapak Care to Share dialogue. When they have learned it, have each video this on their own iphone or android and send it to the Hygiene Training Coordinator at Viva.
6. Send your Department Head to Viva...as she will spend a full two-days doing extensive training. I personally spend 4 to 5 hours, one on one, to give them a complete orienta on on the program so they have excellent undrestanding of what they are implemen ng!!