“Systems Thinking” in Orthodontic Practice

by Shadi Samawi

 “We can’t impose our will on a system. We can listen to what the system tells us, and discover how its properties and our values can work together to bring forth something much better than could ever be produced by our will alone.”
― Donella H. Meadows, Thinking in Systems: A Primer

We all want to maximize practice efficiency, simplify management and allow for more time to focus on what’s really important. In that regard, the importance of creating well-defined systems in our orthodontic practices cannot be over-emphasized.

Processes such as patient management and flow – from the moment of the first call – all the way to financial processes, and staff hiring and training, among others, are important issues that should not be dealt with haphazardly or left to chance. Improving workflows in every part of our practice management strategy requires a “bird’s eye” view of the whole picture and strategic thinking in developing “systems” that work to our long-term benefit in practice.

Systems thinking is the process of understanding how things, regarded as systems, influence one another within a whole (Wikipedia). It is a set of habits or practices within a framework that is based on the belief that the component parts of a system can best be understood in the context of relationships with each other and with other systems, rather than in isolation. It is always worthwhile to take the time to sit down quietly and note down any procedure or treatment flow in detail and in sequence, thinking about possible obstacles or problems and finding ways to reduce the number of steps or make them more efficient. With the resulting written (or visual) guide, the big picture will be very clear in terms of how every process relates to other processes and it would become evident as to how one should proceed on improving the whole system.

SystemsEqualEfficiencyAs you can deduce, creating well-thought out systems that are regularly revised and updated results in efficient automation of repetitive tasks, thus much less time and effort would be wasted every day, thinking and doing. As such, focus and better productivity may be achieved.

Some examples from practice.. (there are many, many others)..

1- Patient Flow from The first call, all the way to the bond-up appointment, and even beyond, into the post-retention phase.

2- Staff interviewing, hiring and training protocols, with general practice regulations clearly outlined in writing.

3- Disinfection and sterilization procedures for different parts of the practice, equipment and instruments.

We should not also ignore what we may call sub-systems;  systems within systems, such as clinical record-taking flow protocols (within Patient Flow, above) or the Hand-piece sterilization protocol (within Disinfection and sterilization procedures, above.)

It is always recommended that these workflows (steps) are in clear written form or visually adapted in order to make them easier to commit to memory and turn into habitual processes, and also to facilitate future training of new staff. They should be reviewed and updated periodically in view of any changes in current standard recommendations, especially the sterilization procedures.

The ultimate success and smooth running of our practices depends largely on forming and consistently applying good habits that create efficient shortcuts to repetitive tasks throughout the day.

The power of a focused mind should never be overlooked in day-to-day practice management.