the preparation of the clinic’s staff for the client

“All I know is that I know nothing.” (Socrates)

Márcia R. F. Campiolo

To have in the clinic a well prepared team is extremely important for the success of the healthcare professional.

If we consider the service in a tight way, starting from the moment the client calls to get an appointment till his exit from the clinic after receiving the needed care, we will observe that during a great part of the steps and time of the service, this client will be directly in contact with the team members.

We can have daily in a clinic a variety of situations which involve good and bad service care walking side by side in the daily clinic’s work. Therefore, we can take as an example the following situation: the doctor had given a good service care for the client, but some member of the team failed in his mission of also giving a good care in the other service areas of the clinic.

At this moment it was established in the client’s mind a fragmentation of his perception regarding this service, once it was partially satisfactory and partially unsatisfactory.

Then, these information are processed, forming a concept about the healthcare professional and his clinic, and also his decision of continuing or not to be a client of this clinic. We can say that a negative perception has a very heavy effect in the client’s evaluation, interfering intensely in his decision.

This is a very particular characteristic of human beings: what is bad in one relationship usually has a greater fixation capacity and effect in the memory than the good events when it’s time to assess relationships. This happens with people on a daily basis in general.

It is common for us to hear someone feeling unjust by the other saying:
- I have always been so good for him, I’ve helped him in everything he needed, I’ve been a good friend and now he doesn’t want to talk to me just because of a tiny thing I did and he didn’t like.

This above event, sure it’s not a general rule, but it is relatively frequent and it obeys an internal logic of the “values” and “perception of the other” system that individuals apply among themselves inside a society.

So, this same dynamics of operating perception also happens within this logic with respect to the received service care in medical clinics.

This leads us to the conclusion that, in each stage of the service care to the client deserves a special attention. All the areas are important and must work in harmony aiming to be a high standard service, in all its stages, without existing “fluctuations” or “ups and downs” in the service pattern.

Thus, to provide the right conditions so that the team prepare itself adequately to this professional activity is a measure that deserves special attention in the clinic’s management, which certainly brings positive results for the clinic, once it:
• Straightens edges and solidifies concepts
• Prepares the individual to overcome difficulties.
• Gives strength and self-confidence in the work.
• Can determine change in behavior in the search for better results.

The clinic’s team should be cohesive, work having common objectives, be well trained, and motivated to work. Thus, so that we can track paths which lead us to meet these objectives we must know better the following areas related to the management of people in medical clinics:
1. Team work
2. Training, development, and continued education
3. Motivation for work

Team Work

Most of the medical clinics have small structures, with small groups of employees. Inside of such structures, the individualization, establishing rigidly designed functions, does not constitute a good working policy, since small teams requires in most of the time multi-functionality and intense cooperation among its members so that efficiency is achieved.

Brian Clegg and Paul Birch, authors of the book “Team Work – Motive and Energize Your Team Now”, give us the following definition: “team work supposedly combines the talents of individuals to generate more than what is possible when each individual is taken separately.”

We live in a world of great competitiveness where individuality is a striking feature present in it. The biggest fear of individuals referring group work is the fear of seeing the individual talent being buried or dissolved inside the group’s result. That is, it wasn’t “me” it was the “group”.

The human being by nature seeks to be recognized and valued, as a way to for him to feel good about himself with respect to the group.

If this aspect is not well understood and administrated by the clinic’s leaders certainly can undermine potential good results of team work.

Working in team requires from people attitudes and stances within the working sphere, which needs emphasis in some aspects such as: motivation, division and assignment of tasks, integration, and respect which are fundamental for the group’s success.

The equilibrium point between the individual and the whole collective doesn’t depend only on the individual characteristics of each team member, but also in the way the local leaders conduct the working processes inside the clinic.

The leaders should encourage and value the individual who work inside a collective process, he should impose a good working pace and provide conditions which improve the team’s motivation. This way, there exist certain procedures inside clinics that will favour these conditions, such as:
• Book time for periodic team meetings.
• Present, whenever possible, working “missions” for the group.
• Use efficient communication methods.
• Exercise sharing leadership and delegation of responsibilities.
• Encourage the group to accept each others differences as a way of respect and enrichment of the group.
• Visualize and maximize the use of the potentials of each team member.
• Avoid comparing the employees to a family, but to a “cohesive, cooperative, collaborative, friendly, working team which works with a mission, with common objectives”. The family concept is different in many aspects from a working team.
• Recognize the work and talent of each individual of the team.
• Overcome adversities through understanding and using as a source the learning and growth of the individual and the whole collective.
• Help each other so that each one is responsible for his actions so that he doesn’t impair the group’s performance.

Use team meetings as an opportunity to:
? Orientations
? Compliments
? Discuss and learn with the problems that happened in the clinic.
? Feedback for the group’s actions.
? Know closely how the employees’ motivation is doing.
? Reaffirm the team’s idea.
? Discuss complains and compliments received from the clients.
? Suggestions to improve the clinic’s dynamics.
? Problems with the clinic’s functioning that should be solved.
? Reaffirm the values and the clinic’s mission.
? Know and alleviate group and individual conflicts related to work.

In addition, the following group concepts should be present in any work inside the clinic:
? The functioning of the service can be compared to a “chain”, where no link can be broken since it constitutes of a cycle where a single weak link might impair the work as a whole.
? Each person of the group should adopt the attitude of being in a team and not an isolated individual.
? The team works as a sport’s team group, where the individual talents are important and recognized, but they can only function inside a team concept, that means, the team achieves good results. We don’t say: “Ronaldinho won the Brazil game”. We say: “Brazil won the game and Ronaldinho played very well”.

Training, development, and continued education

Happy is the man that shares what he knows and learns from what he teaches. (Cora Coralina)

The learning process accompanies us throughout our whole life, since the moment we are born, preparing us for survival, for the social living, for life itself.

In the professional area, learning prepares us to a competent professional exercise in our professional activity.

The concept of training should involve a broad process where includes the opportunity for personal development. In addition, training should not be a tight and isolated process, but it should be a part of a continued education.

Commonly we see people attending training courses in a given subject, but when they go back to their daily work they don’t apply the knowledge and information given during the course.
This makes us reflect on what leads a professional to incorporate, or not, the new behaviors and knowledge in his daily occupation.

So, in reality, a training process aims a change in behavior. What we expect from people who participate in training is to learn, get informed, and change.

This is not an easy goal to be achieved, since to change, the individual needs first to accept this change as positive to his life.

Investment in education and training an employee provides conditions to transform his potentials into concrete professional actions.

Another observed aspect within medical clinics is that employees are often sent to attend different courses, especially in the service care field, but the clinic’s administrator, who in most of the times is the own doctor, is not prepared to new service care concepts. In this case, the employee will probably be discouraged to participate in new courses involving this issue since he knows there is no direct applicability in his work.
The preparation of a medical clinic’s team can be divided into two major knowledge areas.

Each member of the team must be carefully prepared for his work in clinics. The equilibrium in the preparation of these both areas is what is going to provide to the employee the necessary conditions for an efficient performance in his work along with the doctor.

Serving the client
“Service care” is a very complex area which, today, it is found to be very developed regarding the tools needed for the service care professionals.

Dominating these technical tools of service care allows the professional to gain the security needed for the development of his work as well as his potentials.

Any service technique in reality shows the paths, the conductions, and the instruments that the professional might adopt in order to provide a better performance and also to increase the probabilities to obtain the client’s satisfaction with the given service.

The techniques in general are developed starting from theoretical principles linked to the psychic functioning of individuals, applied to specific service areas.
The following areas are included in the list of the basic knowledge of the service tools:
? Perception
? Human Behavior
? Motivation
? Expectation

In the service care, we try the maximum as possible to achieve the customer’s satisfaction with the service given, in these areas, directing to applicability.

For instance, in a phone service, the auditory perception of the client is the main object of attention. So, the used techniques seek to maximize the probability of obtaining the client’s satisfaction through this perception area.

In the reception, there exists a plurality of perceptive elements in action which makes this process more complex. The higher the number of variables and people involved, the more complex the process becomes increasing the difficulty to obtain success in the service.

Thus, to provide the employees with staff training courses is essential to dominate the service care area so that you have in the clinic employees who are prepared for their work, and therefore, with more conditions to be motivated, because the technical unpreparedness is a discouraging factor.

Basic knowledge of the medical area in which it is inserted
Today, in Brazil, the concern with the preparation of the staff which works with the doctor has increased.
This concern has among its reasons the following points:
? The importance of the staff members to know the basic vocabulary and concepts in the medical field he works.
? Nowadays, the client tends to be better informed, and with this it increases his demands with respect to the doctor’s staff.

Another aspect that should be clear about this issue is that me doctor’s auxiliaries must only receive the information for a good performance of their work, always keeping an eye on the ethical limits, which is up to each doctor to establish, manage, as well as supervise its correct use.

The technical preparation and development of the employee potentials can be done through various measures which should be applied in an integrated and continued manner so that they reach efficacy.

Introductory Training
When recruiting a new staff member, the first step is to introduce him in the new working environment. For this it is necessary to adopt measures which permit this new employee to locate himself in the environment, to get adapted and to feel welcomed. For this, we can:
? Inform in the first day of hiring the new employee, everything which is allowed or not.
? He must be taken to know the facilities and the clinic’s staff.
? Explain everything, including what is obvious.
? If possible, charge someone of the team as a “support” especially during the first days of work, someone he can turn to, someone who introduces him in the group.
? Provide conditions so that the new member receives training and necessary instructions for a satisfactory performance of his work.

Courses and Trainings
To direct the staff to attend courses outside the clinic, with content appropriate to the working needs in clinics is important for the employee since it:
? Shows that the recruiter is interested in the training of his employees.
? Provides to the employee opportunity to recycle, upgrade, and develop his potentials.
? The clients like to know that doctors and employee are attending courses and events relating to their working field.

In addition, inside the own clinic periodic meetings can be scheduled to evaluate the work, exchange ideas, experiences, discuss complains and compliments of the clients.
In these meeting it also can be scheduled small presentations from the doctor(s) of the team about a specific theme which contributes for the professional improvement of the staff members.

Another possible aspect that can be addressed in meetings is the failures and mistakes that happened, which may serve as a source of learning for the entire group, so that it doesn’t happen again. In this case, you should be very carefully in a way not to expose depreciatively the responsible for the mistake in front of the group. This procedure must be conducted in such a way not to be a punitive connotation, but to be a rich learning source.

Another alternative is to hire a professional or company specialized to manage closed courses, custom-made for the clinic.

The clinic’s manager should try to bring up all the reasons for training the group, and having these data as a base, program ways to provide access to courses and trainings for the team, which will allow the growth and preparation of the group, and will certainly bring positive results to the clinic.

It is very important to have a process constantly in progress, happening in a continued way inside the clinic. The staff will never be totally ready; it can always be better prepared. No professional can be considered totally ready, he can always learn and develop more.


Motivation for work

We talked a lot of motivation, about being motivated to work.

This subject is very complex since it involves individual specificities, as well as environmental conditions which surround the individual.

So, we can say that the determination of motivation occurs through a set of intrinsic and extrinsic conditions which, in the case of work, will determine the will, the commitment and energy invested in the performance of the professional activities of a certain individual or team.

Here, we will talk about the extrinsic factors, that is, the environmental working conditions which may interfere on the motivational state of the staff members of the clinics.

The leader, or leaders, is responsible for a great part of the problems or solutions of a working staff. It is up to the leader to structure and operate the internal gear of the working relations in one clinic.
We must remember that, even in clinics that have specialized managers, the doctor himself as the major leader of the enterprise is of paramount importance.

This fact has made doctors to invest more not only in medical training, but also administrative, which allows him to understand better this universe, giving him better conditions to administrate his clinic, once unprepared leaders lead non structured working environments, where it is hard to keep a high motivation level.

So that we have a better comprehension about this subject, the table below outlines, in a general form, the conditions present in workplaces which has a direct relation with the state of motivations of employees. (see table 1)

Table 1

By using the above table we can note that there exists a series of elements coexisting and interacting among themselves constantly.

These elements isolated from each other are not auto-sufficient to understand the motivation of work; they must be analyzed and understood within the set of elements.

Thus, for instance, a well remunerated employee can still be not motivated in his work, because he would like to do another type of duty which he believes to have the potentials to do it and/or not satisfied with the leadership.

By the given example we can see that the control of all elements which surround the clinic’s staff is an extremely complex task. The clinic’s administrator must try to reach the best possible results through having equilibrium in each of these areas.

Regarding the above table, we can point out some helpful tips for the daily work:


Professional Perspective:
? Provide conditions for training and development
? Observe and evaluate the potentialities and progress of each member of the team in order to provide conditions to take new roles and responsibilities inside the clinic.
? Place carefully the new hired employees in occupations which are adequate for his traits and personality.


Working Environment:
? In meetings, thank and acknowledge in front of the group the performances and attitudes of the employees.
? To delegate is important, and it can be seen as a demonstration of trust.
? Listen always to suggestions and complains coming from the staff, trying to find solutions or readdress the presented issues.
? In the case of incorrect attitudes from the employees try to guide him in an appropriate place with respect and discretion in the way of dialogue.
? Leaders must not adopt explosive behaviors, say what they want and regret later.
? Have periodic meetings with the team.
? Value the work of all the members of the staff in their different functions, demonstrating a spirit of a cohesive team, where everyone is important for the clinic’s success.


Clinic’s Rules:
? When creating new rules of what is allowed or not in the clinic, try to present and discuss the subject in meetings.
? In the case of new employees, apply efficient methods to inform them about the clinic’s rules.
? Try not to strict too much the rules of the clinic so that you don’t create a hostile climate without flexibility necessary to ensure that the team members do not feel themselves “military” established prisoners.


Remuneration:
? Be careful when giving uniform rises. One should, whenever possible, try to evaluate the salaries as a whole and individually.
? Be in tune with the market’s salaries, establishing this as a routine measure since the market is always fluctuating.


The Workplace:
? The workplace should be a pleasant environment, “light” and tranquil.
? The lightning should be adequate to the work and people who will be in the environment.
? Adopt and guide employees regarding the necessary measures for the team’s safety.
? Purchase appropriate and comfortable furniture according to the physical traits of the employees, adapting to the individual and not vice-versa.
? Take care so that the climate conditions of the environment are pleasant.
? Position the screens in such a way to provide comfort for its users.
? In the case of employees who exercise static activities (repeated), provide orientations related to the procedures and care needed to avoid problems arising from the side effects of this type of work.
? Evaluate carefully the hiring of people who live in very remote locations away from the workplace.

Of course that the above items do not describe all the requirements with respect to the extrinsic conditions to the individual, which are present in the work and interfere in the employees’ motivation, but they are points that certainly deserve special attention from those managers who desire to have an integrated and motivated staff team.