A couple of years ago, Lue and I had occasion to stay at the sleek and modern Sheraton Towers Hotel in Singapore. Upon our arrival, we were greeted by name by a receptionist at a large desk. When we asked how the hotel knew our names, the receptionist replied that since they had an itinerary of our trip, they knew approximately how long it would take us to clear customs and make the trip into the city by cab.
The receptionist informed us that the bellman would accompany us to our room, and that we would be registered there by the floor butler, who would also imprint our credit card. The butler, outfitted in striped pants and tails, was waiting in the room, and she immediately asked if we had any clothes that needed pressing. In fact, we did; we had been living out of our suitcases for about a week. The butler took the clothes and returned them to us within 30 minutes, freshly pressed and on hangers.
The next morning at breakfast the hotel restaurant was quite busy, but the service was impeccable. Water, juice, and coffee were being quickly replenished, the waiters were constantly moving and serving patrons, busboys were quietly and efficiently cleaning tables, and the manager was actively helping all of them. When the manager came over to our table to inquire about the morning's service, I told him that my wife and I had just been talking about the superlative service in the hotel. I asked him what the secret was, and he replied without hesitation, "TQS". That was my cue to respond, "Total Quality Service; W. Edwards Deming". This visibly startled the manager, who asked if I knew of Dr. Deming's work. I casually answered that Dr. Deming was a friend with whom I had studied (well, I had met and conversed with him and taken two of his courses before he died).
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The manager then explained how the hotel had developed a system of performance standards that defined excellence for every procedure. For instance, every glass of water was refilled to within 1/2" of the rim whenever the customer had drunk down to 1 1/2" from the top. Coffee and tea were refilled in like manner. New hires were trained in their respective restaurant techniques for two weeks before being allowed to serve customers. Contrast that with the service received in a small East Texas cafe by a fishing colleague, who asked the waitress for about a one-third-cup refill of his coffee. When she filled it to the brim, my friend complained that he only wanted a third of a cup. The waitress sternly replied, "Listen, buddy, if I could do fractions, I wouldn't be working here."
Instead of simply telling employees to cater to customers or provide good service, the Sheraton Towers, through its standards of excellence, leaves no doubt as to what is expected. Enterprises such as the Sheraton Towers make being a patron an unforgettable experience. If I ever return to Singapore, I want to stay there again.
Orthodontists have the opportunity to establish performance standards in many areas, but most practitioners I know simply give their employees some general guidelines and let them wing it. This may work fine with a particularly conscientious staff, but we can't always count on hiring superlative people, and even these rare folks appreciate having benchmarks against which they can measure their performance.
I don't know of anyone who has worked out standards of excellence for an entire orthodontic practice. Although such a task would require a substantial expenditure of thought, energy, innovation, and time, the reception area might be a good place to start. Performance standards there might include:
- Maximum number of rings before the telephone is answered.
- Maximum length of time callers are kept on hold before being offered a call back.
- Maximum time between the first call and an appointment in the office.
- Maximum time between the records examination and the initiation of therapy.
- Maximum time before someone entering the reception room is greeted.
- Maximum time a patient is kept waiting before being placed in a treatment chair.
- Maximum time before a staff member begins to work with a patient in the treatment room.
- Maximum time between a broken or canceled appointment and reappointment.
Other service businesses, such as restaurants, airlines, and insurance companies, have one big advantage over orthodontists: the delivery of their services does not depend so much on the client's active participation. That problem alone would make it difficult to set standards for treatment delivery--the time and methods required to recement bands and brackets, place appliances, construct archwires, or perform laboratory procedures. Nevertheless, I believe that by combining rational processes with meaningful experience, orthodontists can develop performance standards that will make everything they do more pleasant for patients and less baffling for employees.
LWW