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Unitron Practice Development Series - Measuring Your Way to Success: How Key Performance Indicators Can Help You Reach Your Business Goals

Unitron Practice Development Series - Measuring Your Way to Success: How Key Performance Indicators Can Help You Reach Your Business Goals
Pam Pech, Mark DeRuiter
February 10, 2012
This article is sponsored by Unitron.
Editor's Note: This is a transcript of a live seminar. To view the recording of the live course, register here: /audiology-ceus/course/practice-management-marketing-business-issues-unitron-pd-series-measuring-your-19216

Most of us are familiar with acronyms like SRT, VNG and WDRC, but as the profession of audiology becomes more autonomous and business-centric it's important to embrace a whole new set of acronyms. One of the most important to understand is KPI, which stands for Key Performance Indicator. If you're unfamiliar with the term KPI and how it can be used to improve the efficiency and productivity of your practice this conversation between two experts is a good starting point.

PAM PECH: My name is Pam Pech, and my company is Connecting Resources. Two years ago I started Connecting Resources after many years in corporate America, the last seven of which were with Miracle-Ear. There I was Senior Director of Franchise Operations working with approximately 300 individual business owners. Since then, I have become a Unitron Unite Partner, and over the last year, we have presented 12 workshops throughout the country, working with over 400 individual clinic owners. One of the processes that I use in my company workshops is to facilitate conversations that create awareness, understanding and action. That is exactly what we hope happens through this webinar today. When you talk about key performance indicators (KPIs) and business strategies, it can sometimes get dry and boring. What we want to do is offer a number of different scenarios to help illustrate what we are talking about. In a way that is more interesting and which will resonate with you

So, Our objective today is to help you learn some things that might be new, or to look at so I am very fortunate to have with me today Dr. Mark DeRuiter. I am going to let things you might already know in a different way so that we can help you get through those struggles to reach your goals.

I believe that I have a fairly good understanding of some of the struggles of the small clinic owner, and what you go through on a day-to-day basis. However, another aspect of Connecting Resources is that the "resources" I connect with are experts either in the industry or outside the industry who assist me with these workshops and webinars. They bring hands on experience and different aspects that broaden the subject being presented. him introduce himself, and you will hear what expertise he brings to this webinar today.

MARK DeRUITER: Thanks a lot, Pam. I appreciate that. I am Mark DeRuiter, and I have quite a bit of history in the hearing health industry. I have worked in a large private practice dispensing hearing aids for many years, and I have also spent a fair amount of time working within the hearing aid industry with several manufacturers. I currently work with the University of Minnesota as the Clinical Director, as well as the Director of Graduate Studies. I have a Master's in Business Administration, as does Pam. We hope to share a lot of information today that unites us, and we hope to unite everyone in this process.

Pam, I know there are a few stories you would like to start off with to frame our discussion today, so I am going to pass it back over to you.

PECH: Thank you, Mark. You are right, I would like to share a couple of stories with you, because in doing this, I think it will help illustrate the importance of the mile markers compared to planned outcomes - the topic of today's course - and have the audience get a better understanding of those topics as we discuss them. The stories that I want to talk about are both road trips. I don't know how many of you like road trips, but it is one of the things that Mark and I talk about that we each love to do. I am bringing thisup because there are huge parallels between road trips and KPIs and strategic planning.

The first story happened about the time my daughter was going to school at the University of Wisconsin in Madison. We had heard that a white buffalo had been born in one of the cities near Madison. This was a great, sacred event to the Native Americans, and we had heard that there were many Native Americans from all over North America going to this city to pay homage to the white buffalo. My daughter and I decided that we wanted to go see this white buffalo, but we had no idea how to get there. Because they didn't want a huge crowd, they did not announce where itwas. Our strategic plan was to leave Madison, start heading towards Janesville- the approximate location of where the white buffalo was supposed to be -take the first exit, go to the first gas station, and ask if they knew where the white buffalo was.

The second story is about another road trip with my daughter and my 83-year-old mother. This was a very specifically planned trip that took us to locations that she wanted to see, and we had definite deadlines and booked hotel rooms. We traveled through Zion National Park, Bryce Canyon and the Arches, staying on a very specific timetable honoring those deadlines or we would notmake our hotelreservations.

You might be asking what in the world these road trips have to do with KPIs and goals, and that is where the outcomes of the webinar come in. Our first goal is that after today, you should be able to understand the importance of having a strategic plan with clearly stated goals. We hope you will understand why it is necessary to measure and monitor critical data and specific activities of your business. At the end of the webinar, you should be able to determine which metrics lead to better decisions and improved business performance. And finally, youwill learn the importance of involving and sharing data with the appropriate team members. In short, and as this ties in with the road trips, if you do not know where you are going, you are not going to know what indicators are going to help you get there.

In the case of the white buffalo, you can have a loosely defined plan where you know what you want to accomplish but it isn't in concrete terms allowing you to measure. If that is the case, you have no indicators that would help you We could have driven by the white buffalo and never even known we were there. The more precise the desired goal or outcome is stated, the easier it is to measure your performance against that goal. Which is where strategic planning comes in.

One of the most important things that we will talk about today is the absolute importance of having a strategic plan. If you have no plan, the KPIs are not going to help you measure your current actions to keep you on track to reach your end goal. Any comments on that, Mark?

DeRUITER: Those are all good points, Pam. The only other thing I would like to add is that you need to revisit those goals periodically. Sometimes you get wrapped up in the fires of the day, and the phone starts ringing and the appointments start happening. Sometimes you need to step back and reflect and remind yourself why you are here and what your goals are. How does your data match the goals so you can best achieve the success you are looking for?

What is a Key Performance Indicator?

PECH: I couldn't agree with you more. This quote from Peter Drucker is one you have probably heard: "You cannot manage what you cannot measure." We are going to present you both specific and general information today, but as we get toward the end of the presentation, we will present very specific items that you can consider measuring as ways to measure your progress. If you have a key indicator that says you have sold a certain numberof hearing aids, that doesn't really tell you anything relevant until you know how that measurement relates to the overall goal. Is that number making me money? Is it more than last year? How does that number sold relate to the number of patients who had tests who had a hearing loss? The number sold has to fit into the overall picture in order for you to put a successful/non-successful relevance to the number.

The next obvious question is,"What is a KPI?"

A KPI is just that- a key performance indicator, meaning the measurement of a performance that indicates how you are doing compared to a specific goal.
The second part, which we have just talked about, is the importance of knowing the expected outcome. You are not going to know how you are doing by just having a number. You will need to relate it back to whatyou are trying to achieve. It may be a financial result, such as sales, or it might be an activity. Mark is going to talk to us a little later about processes, because activities are also important to measure. For example, how many appointments did you make from one specific marketing piece? A KPI is a piece of data that you are going to use to make critical decisions and adjustments relevant to what you want to achieve. What this ultimately does is allows you to see if you are drawing closer to your business goals, allowing you to make critical changes in a short period of time.

KPIs help you not only analyze performance, but also to analyze the root cause of that performance, to understand the why it is or is not working. They also provide you data to effectively manage your people and your processes. It can get a little tricky when we talk about processes. For the sake of this conversation today, I am referring to activities that help you perform and create financial results. Mark, what do you think about measuring processes?

DeRUITER: Any kind of process can be very involved. Often what I think about in an audiology practice is what happens from the beginning to end of a procedure. For instance, say you dispense hearing aids. We can think about all the processes that occur from the hearing test all the way to fitting to hearing aid. But then let's drive down even further, from the moment that phone call comes into the office. What is the sub-process there? Who is picking up that call? What training have they had? What data are they collecting? Who reviews that information? What happens next when an appointment is made? When the appointment is made, a sub-process fromthat can be how long the person has to wait to get that appointment. Then how long do they have to wait once they are in the door and in the chair, waiting to see you?

As you can see, we could keep going on and on here with how many people and processes are involved from the moment you have made initial contact with a patient to actually getting the hearing aids in their ears and sending them back out the door, which involves more sub-processes as far as follow-up. The point here is you might want to spend a fair amount of time mapping this out. Start on a very high level and break it down from there. But just as important as the measurement of sales, returns or number of customers/patients seen, is the measurement of the results of your processes. For example, as I mentioned before, how many calls came many appointments set.

PECH: You bring up some very good points, Mark. It does get somewhat complicated when you look at how many things there are to measure. When we look at KPIs, there are a number of things to keep in mind so that you are not bogged down with tremendous amounts of data, not knowing where to start.

One of the key things to remember is there are lag indicators and lead indicators. This is critical. I recently had an opportunity to speak with a chief operating officer of a company in Phoenix, Arizona, and he said one of the things that he learned that helped them adjust their business practices was looking at lead indicators as opposed to lag indicators.

Lag indicators are things like financial reports that reflect historical informqtion or historical data. The reason they are important is because they give you some historical framework, but by the time you look at your profit and loss statement or your income statement, they may already be 30 days old, which makes you 30 days behind even being aware of anadverse situation where you can begin to work on a solution.

Lead indicators are going to help you make a change more quickly. Mark has examples of lead indicators as well, but basically we are talking about "current state" data, Current state data helps you focus on specific areas and "today" results, so that you can adjust immediately before a crisis happens. Another thingthat we believe to becritically important is for everyone in your organization or clinic to be involved and informed on what is being measured and why...because they participate in executing your plan. They have to beaware of what ishappening on a day-to-day basis. They are the ones who will need to feed you information. Mark, you had a story about a lead indicator, is that correct?

DeRUITER: Actually there are two stories, but they both have the same result. We have a speech and hearing clinic over at the university. When the movie The King's Speech was released, many calls were generated based on theawareness of fluency disorders out in the public because of the movie. Related more to hearing, we have also had recent pieces in our local news related to custom headsets for iPod devices.

Both of these events happened over different weekends. When I came in Monday morning, I was prepared to talk with the staff about the possibility of an influx of telephone calls. We were able to look at the current state and say- if we get more calls, how do we get more staff responding to those calls? The key to all of this was meeting the customers' needs. If you think of the needs of a person, perhaps the reason they are calling is notactually for your services, but perhaps they need a referral somewhere else, and they just happened to find you. So how do you meet their needs, and while you are listening to what their needs are, keep evaluating if those needs fit within your organizational structure, or if you need to be adjusting quickly over time to make room for those slightly different needs instead.

I think the bigger issue, Pam, is getting started and having a plan, because executing something like this without a plan really leaves staff in the dark. I know you want to talk more about that.

Making a Strategic Plan

PECH: Mark, you havebrought up several points that I believe are extremely important. Creatinga strategic plan starts with having clearly defined goals. Remember, if you want to go see a Janesville white buffalo, if you want to get to a certain place on time, or if exceptional customer service is your desired outcome, you have to start with a clearly defined goal, and it has to be communicated to everyone. When Mark became awae of those news stories, he did a good job of communicating the impact it might have on the practice. You , too, may havecritical information brought to your attention. You do not want to miss that immediate opportunity to present that information to your staff. The more input you get from people, the more you will be prepared and the better your outcome will be from a customer service standpoint.This communication back and forth between you as the owner or clinician and the staff is key to working all aspects of your strategic plan.

So who is involved in this process?Everyone who is involved in obtaining the results of the business should be involved in determining and measuring the results. Each person should have key metrics that are relative to their position, because they are the ones that are going to execute the plan and know what is right and what is wrong, what is and what is not working. Knowledge is everybody's business.

Mark has a wonderful story that I would like him to share about how this involvement tricklesdown to people you might not eventhink about. Would you tell us about Wayne?

DeRUITER: Sure, I am happy to. Wayne is a custodial worker in one of the clinics I worked in. One day I walked out into the clinic waiting area, and I saw Wayne on the pediatric side down on his hands and knees. I could notfigure out what he was doing, so I asked him, and he said, "Well, it's a Tuesday, and I know there aremore pediatrics on Tuesday, soI want to get on those kids' level and actually see what they are seeing and make sure that this space is as clean as it can be." I thought, "Wow, what a powerful way to see a person who is completely involved in the mission of our clinic."

He knew what it was we were there to do, and he was looking to not only meet the needs of the adults, but meet the needs of even the very littlest people who came into the clinic. It was clear to him what we did there, and it was clear that he knew he was involved in the process. It is such a great example of how, when you share that information, people can take thatand do the right thing with it.

PECH: I think that is such a wonderful story, No matter what their role, every member, if they believe that they have some responsibility, can contribute to the overalloutcome, and what a difference it makes.

Another part of this is having team-building meetings. When I have ledteam-building meetings, the ones I have found most effective arewhen everyone can be honest withwhat is working and what is not -without taking it personally. I have been reviewing some research recently about how people internalizeevents. The point of the research is the importance of discussing all impactful events as a team. For example, ifsome event has impacted your business on a large scale, whether it isnegative or positive - taking the time to review it immediately with open minds andnot place blame/credit can truly add value to the process. Ask yourselves, "What did we learn from this? How can we usethis information and work to make it a better outcome or experience for our patients?"

Everyone in your organization plays a valuable role. These people are critical aspects of yourKPIs. You must get everyone's participation and include them in discussions.


Just as in a car, businesses have adopted the phrase "dashboard" to mean having all critical data "gauges" in one place in order to see the overall health of the business at one time.

You can use a mental dashboard to gauge your progress and goals.You may use a certain tool, such as an Excel spreadsheet, to monitor the progress or regression of your goals, just as you monitor the gas or speed in your car. You need those things to help you so that each team member finds some kind of relevancy to be able to relate back to where they are at a given moment in time.

There are three different types of these dashboards, or gauges. The first one is an operational dashboard that monitorsdata on the operations side of the business. It does not go into analysis or management issues quite yet. For example, you want to collect data on how many hearing aids sold on a particular day after a marketing ad runs in the local paper. It simply reports data.

The next type of report is a tactical report, and this emphasizes analysis more than monitoring or management. The tactical report is where you will start to see trends or can make some comparisons between offices, months, years, or sales against budget. This is where you start to analyze more than record data points.

The third dashboard or report is strategic. This is whereyou, as the manager, are going to use this information to make critical decisions. This is where you look at the completed analysis and determine what the next steps should be, but also starting to understand the why - the underlying cause of giving you have the data you have analyzed These are your critical management decisions. The strategic dashboard should answer the question, "Are these reports helping me move closer to where I want to be?"These are going to be helpful when you come to marketing decisions, staffing decisions, all types of information.

Now we aregoing to take a look at some of the key data points you would measure in an operational dashboard relative to employment positions. The first one would be the front office receptionist. Some of the data points that you might be measuring are the number of calls received on a particular day. It could be the number of calls received on any day, but it could alsobe relative to your marketing efforts. Do you see a response come in on the following day, or does it come in later in the week? Another example of anoperational data point would be the number of appointments made for the week. By comparing the number of appointments to the number of calls, you can start to Analyze the effectiveness of the way the call was handled. For example, ;let's say you received 50 calls duringthe week, and from that you made 30 appointments. That tells you 60% of your phone calls are ending with appointments. That is a good piece of information. Now you can focus on what happened to the other 20 calls? Is it a training issue, or were those calls people requesting information only?Did we record enough information about the call in order to make a determination as to how effectively it was handled?These are, again, all data points of monitoring daily activities. These are processes as well as data points that you will be evaluating...especially when it comes to knowing if you are asking the right questions.You can also track data for the provider: for example, the number of tests performed this week, number of hearing aids sold this month orthe binaural rate this week. Mark, do you have any comments on any of those?

DeRUITER: Well, Pam, when I look at the front office, I remember a story about sharing information and making sure everyone knows their role. I can think of one time where I was notvery successful in communicating to each person what their role was. The receptionist was making the call log very efficiently for us by collecting the data and entering it into the computer. I wanted to go into that data and look for some of these ratios over a period of time. I found that there was a 100% appointment rate for the number of phone calls we received, and I knew that could notbe the case. I asked her, "What happened?" and she said, "Well, I deleted all the people who did not make appointments."

That was a critical training issue for me. I needed to communicate what it was we weretrying to measure and why we were trying to measure it. I cannotsay that enough. Make sure everyone on your staff fully understands theimportance of the process and sub-process in which they are working. If you can communicate thateffectively, you can get theinformation you need, accurately. Do not make too many assumptions about what people know. Make sure the job is really clear. Also, in them understanding the purpose of the tracking, they are usually more forthcoming in discussing poor results without fear of "negative impact" on themselves.

PECH: You bring up a really good point. I know that when we did workshops throughout the country this year, one of the key ah-ha moments for participants was the importance of thefront-office person. I remember asking the question, "How many of you record every call that comes in?" One of the participants raised their hand and said, "Oh, come on. Are you telling me I have to write downevery call that comes in?" I was getting ready for some rebuttal here, and before I even had a chance to say anything, one of the other participants said, "You better, because if you don't, you are not going to know what you have lost." Someone might say to you, "Guess what? I made 10 appointments today," but you do not know if there were 30 other calls they missed instead.

Universally,I have seen the followingin all my years in the hearing industry. I will ask people, "How much training do you provide for your front office?" or "How much do you record or monitor yourfront-office staff's activity?" They answer, "Oh, they are great. They really do a great job. They are really answering the patient's questions, and they are bringing them in." Then, when they start using some type of tracking information where they record the phone call, they find out that there is a lot being said that does not really follow the training that was given. So the front-office person's training and activities are absolutely critical for monitoring so many aspects of the point-of-contact with patients. I think we automatically realize how important the provider is, but that front-office person is really critical, too. They are usually the first point of contact and may be given a new situation to handle almost they can never have enough training and role play.

When we talk about operational dashboards, it triggers alerts to potential problems. By knowing some of the information that we did not see before, like the ratios of calls to appointments, we can glean information that will move us toward a different solution. Maybe the wording needs to be different, or maybe there is more training that needs to be done. It gives you an opportunity to start making changes right away. It allows each employee to monitor themselves. If every person is involved and they have a standard that they need to meet, then there is a way for them to track if they are reaching the goal and contributing tothe higher organization.

It also helps you with recruiting in the future. You might wonder,"How does having these statistics help me with recruiting?" When you hire a new person, someof the questions that they are going to ask are, "How long will it take me to be successful?How long will it take me to sell my first hearing aid? What will my return rate be? What is normal? What are the things that I need to know in order to be successful in this business?" If you do not have data points like this, it is going to keep you from answering those questions appropriately, knowing how to train and even how to monitor those people to know are they on the right track. You also will want this information in budgeting for growth when it comes time to add new staff.

Next is binaural rates. Mark, I think you have a story about binaural rates, too. Is that correct?

DeRUITER: I sure do, and it is a nice way for us to move from the operational to the tactical dashboard. A good example came from my own experience with dispensing, years ago. My binaural rate dropped one month, and we were collecting these data points. We knew a lot of information about our dispensing audiologists in the office. Suddenly the directing audiologist came to me and said, "What do you think has happened here? Your binaural rate really dropped this month." I knew it couldn't be the case. I had not taken vacation days; I was seeing just as many patients. We had this piece of operational data, but somehow it had to be analyzed. Something further had to happen, so I said, "Let me go back here and take a look."

I went back through my patient list, and saw that I had an abnormally high number of people with unilateral hearing loss that month. It was through that analysis that we saw something different was happening, and it was perfectly acceptable. Now, we had solved that issue, but we thought, "Why is that? Is it just a fluke?" Why did I suddenly have more people with unilateral hearing loss than the other audiologists?

This takes us into the strategy part. As we analyzed more, we learned that the receptionist was making executive-level decisions, shall we say. She had received several positive comments from people with single-sided hearing loss after they had seen me, so she decided that maybe I should see more of them because of the positive feedback. So we had to sit back and say, "Wait a minute. Is that our strategy?" Are we going to have audiologists who specialize in unilateral hearing loss or single-sided deafness, or are we going to spread this around and call this a fluke at this point? This is a fun way to think about going from operational to tactical and to strategic.

The question would also be, does this type of appointment scheduling best benefit the patient? If so, do I need to change how I monitor performance of the provider or the compensation structure? How do I make this situation a win-win without it looking like a negative trend on the part of the provider?

PECH: The other part of that story that I thought was fun was thatthis person was trying to make a strategic plan by themselves, and they thought they were doing the right thing. And it was not that it was right or wrong. It was just achieving a certain outcome that was notnecessarily the outcome that you wanted. Having a discussion that evaluated whether that outcome was good or bad was a positive move. This is what happens when you start recording data and looking at why trends happen over time. People are making decisions, and you want that. You want them to be empowered, because they want to contribute. But, as the manager or owner, you need to look at all of those data points and discuss it so that everyone feels like they are contributing and hitting the mark.

Now we are moving to the tactical dashboard. This is where you are analyzing the data. You are not just collecting points of information, but now you are starting to compare those data points and you are usually looking at them over a specific timeframe. You are looking at all types of different things to give you some analysis as to how to make your decisions atthe next level.

One of the tactical KPIs is the provider's closing rate month to month. As Mark was saying, he drilled down to a different level and looked at the binaural rate of sales. What was happening to that rate? Were people not coming in? Was it a new product line? Was there some training that needed to be done to improve the binaural rate?

Another tactical KPI that will bring you a lot of information is the addresses updated from month to month. This could be an indication that your front-office person has more administrative work to do, as Mark mentioned before. When more phone calls come in, do some of the more routine, clerical functions fall behind? It is actually quite important that your addresses are updated, for marketing, follow-up and billing. There is a lot for you to review. However,if can give these standards to the people, they can monitor themselves and feel like they are contributing.

Next is return rate from month to month. What factors affect your return rate: training, products, price, buyer's remorse? What is actually driving this return rate? You should evaluate your average selling price quarter by quarter. Is the change related to training, product, promotions? You should also review accounts receivable or outstanding sales on a monthly basis. This is something that I think a lot of owners forget to look at. Your receivables are critical to your success and your cash flow, and if it is something you forget to look at, along with insurance billings completed, this can have a huge impact on your cash flow and bottom line.

Again, all of these are examples. You can do any of these month to month, quarter by quarter, and week by week. It is totally up to you, but they are meant to give you information to help you look at your business and where it is going and why. Mark, did you want to add anything to that?

DeRUITER: In a large practice, you can look at whether you need to add a person to be on top of accounts receivable. Some practices may find value in that. I know in the practice I worked at, that is where we ended up. We had a dedicated person to monitor accounts receivable continually as a full-time job, which actually paid for itself and then some from a cash-flow perspective.
PECH: That is an excellent perspective, and I had notreally thought about addressing that, but I think, especially in small clinics, people tend to do what they love to do, and if you love to sell, if you love to work with the patient, then you need someone to do the administrative side of it. If you are more of amarketing person, then you need to have someone balance you, but Mark is absolutely right. Sometimes when it comes to the accounting aspects, it may merit a full-time person. Not having one can seriously impact your financial well-being.

In summary of tactical dashboards, they create questions and allow you to analyze root problems. It is not just giving you data, but it is comparing so that you can look at why those things are happening and what you can do about it. It allows you to explore relevant and timely situations before they get out of control. It gives you multiple perspectives and various levels of detail. Depending on how you track and what systems that you use, whether it is computerized or a pencil and a paper, it isgoing to give you the detail that you need.

From tactical dashboards, we move next to strategic dashboards. This is where you are managing your people and your process. This gives you a larger scope and overall impact. In other words, now your decisions are going to cover your overall business results. Some of the things that you aregoing to be looking at include your total revenue, year-to-date. These are critical performance indicators that tell you the health of your business and what changes you need to make intelligently and quickly.

Your product mix is important, because you are going to look at this in terms of the average selling price or the training that is needed per product. Are there certain products that are always being sold, some that are notbeing sold? Are they too complex for your providers? Your product mix is going to be a critical aspect of analyzing your business.

Your return rate, obviously, is going to impact the number of dollars and units that your clinic is generating. Many people do not realize that if you reduce your return rate by just a small percentage, the amount of revenue that that adds both to your top and your bottom line is substantial. What is your goal for profitability percentage? That isgoing to vary according to your sales. How do you control your costs? At some point, if you are controlling your costs in the best way possible and your profitability percentage is still small, that means you need to focus on the top line. There are some things you can do by cutting costs, but ultimately the bottom line is going to be impacted greatly by the top line, so that is where you need to start looking at your decisions.

We already touched briefly on the importance of cash. Without the cash, you cannot do the marketing, and you cannot hire the people. You cannot do the things that you need to keep a healthy business. Some of the KPIs you will be looking at on reports include your receivables, daily sales outstanding and your total units sold. These are going to help you manage your people and your processes so that you are maintaining financial health.

If you went to any of the workshops that Unitron did through the year, you heard Brian Taylor. He has also written about this in some of his articles, but there are three areas that most impact your revenue. Number 1 is, "What is driving my office traffic?"If you look at the factors that impact how many people come in the door, they are the same things that are going to make a huge difference in your revenue. Number 2 is your average selling price, as we discussed. If you could reduce your return rate by one percent, what a difference you would see in your revenue ?Number 3 is number of units sold.

What are the results of your marketing campaign? This is where having an open mind, not feeling insulted that your great idea did not necessarily work, and considering how long you tried the campaign come into play. Listen to the people who handle the phone. Are they getting questions about your marketing campaign? What are some of the things you could improve that would help the results? Do not hang onto it for too long a period of time. If it is not working, do something different.

The next measurable factor is customer satisfaction. Mark and I were talking about this, and this is sort of an obvious, but unusual statement. Customer satisfaction is actually a lag indicator.

By the time you get the report back that tells you that your customers are not happy, it is a lag indicator. It means that you have now got to figure out why this occurred after the fact and do something about it. The more involved you are with your patients, the more you have contact with them - the more that data become Current Data The more you are involved with your people, your providers, your front-office people andhear what is being said, see what is happening, looking at your statistics, that is going to help you make that a lead indicator before it gets too late.

Are your staff trained in a way that is consistent with how you want your patients treated when they walk in the door or are helped on the phone? Observing these things in your staff can impact how they are trained. Be a mystery shopper and call the clinic yourself or have someone you know call. See how they are treated over the phone.

The last two KPIs for strategic planning are hours of operation and location. Mark, I think you had a comment about a survey that your patients did relating tohours of operation.

DeRUITER: Actually,a friend of mine, who is an audiologist, surveyed her patients about her office hours. She changed to 11-hour workdays 3 days a week with one half-day, and found that she was actually able to see many more patients in those early morning and late afternoon and early evening slots than before. She found out that information by surveying her patients and asking, "What do you value most?"What they saw over and over again was that the patients valued the times the audiologist stayed late or came in early to help with their hearing aids. That helped them strategically make a change that actually impacted the revenue in the unit.

PECH: That is an excellent tool.

In summary, the strategic dashboard will help you improve your decision making, and it will help you feel comfortable that the decisions you are making are right decisions. It helps you optimize your performance in a timely manner. It is not too late before something gets out of control. You can start making decisions on current issues instead of on things you found out a month after they had already happened.

These dashboards help you steer your organization in the correct direction toward your goal. They keep all your employees aware of the company goals and their current state. In summary, we cannot manage what we cannot measure, just as Drucker said, so it is important for you to look at your statistics and know how you can manage based on facts. It is really important to start with a strategic plan with clear goal expectations. The right information is vital to effective execution.

If you do not have correct information, you are not going to be able to execute appropriately. Metrics must be established, prioritized and communicated. Everyone needs to know what is going to be measured, how they contribute individually, and how it is going to impact them and their contribution. Have the right information at the right time. Find a single, clear way to communicate this information. Decide how you want to present that information and how often. Do you do it on a regular basis? Do you do staff meetings? Do you have one-on-one reports? Also consider how comfortable your staff are with sharing information with you, especially when it something negative. Do they feel that comfort in being able to know that they can talk to you and get it worked out? Finally, performance management is everyone's responsibility. Mark, do you have any closing thoughts?

DeRUITER: My main closing thought is that if you are not currently collecting this information, it might feel very overwhelming. You might be asking yourself where to begin. I would encourage anyone who is not collecting this information or is only collecting a small amount of it to go back through this presentation and see howyou can collect similar data points, and then decide how you want to evaluate them. You can look at return rate by week or by month, but it is all the same data; it is just the window in which you are looking at that information. It honestly does not have to be as overwhelming as it might appear here, but you do haveto sit down and figure out what is most important to you in the moment, and then start collecting the information.

I found that once I start doing this and breaking down the data, it leads me to want other information. Get with the right people who can supply you with the information you need, whether that is with current staff. Keep in mind you may need to add or replace staff to meet your needs.

PECH: Absolutely, and that is such an important point. As we said at the very beginning, one of our outcome expectations for this is action. Take the most critical issue you see today and find out what you need to do to change that. Get your people involved. Start today.

This webinar was brought to you by Unitron. For more information on KPI dashboards and practice management, please contact Brian Taylor, Director of Practice Development and Clinical Affairs at
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Pam Pech

Mark DeRuiter

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