Who is Sweeping Your Sidewalks?

I am going to share a secret with you.  Sometimes, my practice does not run as well as it should.  But when our performance is slipping, I like to know as soon as I can that we need to start getting our act together.  So we set up some "Smoke Alarms" to let me know ASAP that we may have a problem. One of my favorite smoke alarms is an un-swept sidewalk.

Our office is set up so that the staff uses a sidewalk beside the building, to get into the backdoor.  It is a narrow space between the building and a small retaining wall.  We have trees around our office and the wind blows every leaf and piece of trash from a one mile radius to our sidewalk, where it piles up.  If we let it, the trash piles up and it looks bad.  Luckily, our patients never use this sidewalk, so who cares if it looks bad?

Well, I care.  I don't like walking through trash piles to get to work, so we have added "Sweep the sidewalk" to our daily checklist.  Simple enough.

These facts are all very important in the overall management of my practice.  Because a dirty sidewalk is almost always a sign that something else is wrong.  I am going to spell out three problems that are pointed out by a sidewalk that doesn't get swept:

1 - We are not completing the checklists:

We have checklists for everything.  Our exam checklist has items such as Smile, Introduce self to Patient, Ask them to Follow.  In our business, it is the little things that matter.  In addition to our exam checklist, we have daily checklist, room opening checklist, meeting checklist and closing checklists.  All of the little things are listed because they matter.

Every item on every checklist needs to be completed, big and small. We are typically good about the big things, but sometimes forget the small things, like sweeping the sidewalk.  So if we are not sweeping, what else are we not doing?  Smiling? VA's? Asking for Referrals? Taking the deposit to the bank?

Whenever the sidewalk is not being swept, you can bet there are other things being skipped too.

2 - Not training the staff as completely as we should:

We have three steps to our training: 1) Watch me 2) I watch you and 3) I slowly fade away.

Our biggest training weakness is to walk away from someone before they are fully trained.  We even train proper sweeping of the sidewalk.  Everybody knows how to sweep, so if we are going to be weak on any part of our training, we will be weak on training of sidewalk sweeping.

Since our sidewalk extends into the parking lot a little bit, all new sweepers stop sweeping too early UNLESS someone showed them where to stop sweeping.  When sweepers are stopping short - time to re-visit our training program.

Again - Wouldn't you rather know your training program was getting soft when you are teaching sidewalk sweeping and not dilating pupils?

3- We may be losing our "Teamwork" mindset:

Even with the level of attention we seem to give our sidewalk sweepers, it remains a task that no one fights for.  Never once has anyone said, "Who swept the sidewalk?  It was my turn today! No Fair!" It is actually one of those tasks that everybody hopes someone else will do.  It is on a checklist, but sometimes the day gets away and it hasn't been done.  We had a chance before patients showed up, and while the last patient was in the optical for 30 minutes.  In other words, we have had plenty of opportunities, but have not taken advantage of them. When we are acting like a team, we are communicating well and planning ahead.  We are ready for our patients and we look out for each other.  We take care of the hundreds of tasks that must be accomplished every day - including sweeping the sidewalk.

When we aren't working together as a team, we let the little things sneak up on us and the undesirable tasks get left for someone else to do.  Anytime the end of the day comes and the un-swept sidewalk causes us stress, it is time for us to visit our communication and teamwork.   If we are whistling while we are sweeping, we are acting as one.


For us, an un-swept sidewalk is called a smoke alarm, because it is annoying but it is telling me that smoke is in the area and there may be trouble.

It is a good one because we all walk on that sidewalk every day and since we keep it clean, we notice when it is not.  Smoke alarms make a loud, obnoxious noise that bothers anyone who hears it.  The noise is a problem, but it is not THE problem.  You probably have a "pet peeve" in your practice.  There is probably a good way to turn it into a Smoke Alarm.  Let me know if you have one that works for you.

In upcoming blogs, I will talk about other smoke alarms and how to set them up and how to make a big deal out of a small problem.