Practice Profile

Three’s a Charm

Horizon Eye Specialists utilizes three tenets to achieve success.

BY JENNIFER KIRBY, CONTRIBUTING EDITORPHOTOGRAPHY BY SHELLEY WELANDER, SHE.WE STUDIO

“Eat, Pray, Love”
is just one example of the “power of three,” a writing technique of three successive items to create effectiveness and satisfaction for readers.

To create an effective practice that satisfies patients, Scottsdale, AZ-based Horizon Eye Specialists uses its own “power of three”: a customer service-based culture, efficiency, and career development.

1. Customer service-based culture

Horizon Eye achieves this culture by:

• Using a survey to vet job candidates. Following a successful phone interview, Horizon Eye Specialists uses a pre-employment survey from CEB/SHL Talent Measurement. The company has many position-focused assessments available, and Horizon uses a survey that focuses on customer service competencies, says COO Joey Harte. “Those who score within an acceptable range of this service/professionalism survey are invited for an in-person interview,” explains Bonnie Ratcliff, COT, director of clinic services. “If the job candidate does well with this, he or she is invited for a second interview, which is made up of a panel of associates who would be the candidate’s co-workers. This has worked well in determining whether a job candidate is a good fit.”

Candidates who score well on the survey typically do well at Horizon and become long-term associates, says Ms. Harte. “The survey has proven to be a great tool to better understand the candidate’s strengths and opportunities. As a result, the managers really trust the assessment and rely on the information to tailor the interview.”

Robert R. McCulloch, MD, refractive, cataract, and corneal surgeon and president (left), demonstrates laser cataract surgery with assistance from Beth Dew, COA.

• Coaching/role-playing. Horizon Eye Specialists’ 25 technicians are split into four mentor teams, each headed by a seasoned tech who helps to train and develop their team members and lead their teams in breakout training or troubleshooting sessions. This has proven to be an ideal way to get more one-on-one interaction with the technicians, says Ms. Harte. Ms. Ratcliff also spends time with the mentor group developing their leadership skills for their continued growth.

In addition, the practice’s front desk staff, technicians, and surgery counselors role-play common patient scenarios to ensure everyone is on the same page when it comes to customer service, says Ms. Ratcliff.

“The techs, for example, are trained to politely say, ‘We don’t want to keep you from the doctor, so let’s get this testing done’ to re-focus patients who use their appointments to socialize,” she explains. “It works because patients remember their purpose in coming to the practice.”

Another example: When patients take extra chair time, the staff is trained to inform the next patient, offer bottled water, and give him or her the option of seeing another doctor, all of which let that patient know the practice respects his or her time, says Corinna Aviles, director of surgical administration and LASIK counseling. “We find that patients are a lot less agitated when they’re kept in the loop,” she says.

• Patient education. Horizon Eye Specialists staff members undergo training through shadowing senior staff and doctors, staff meetings, online CE and “Lunch and Learns,” at which the doctors and staff discuss an array of eye-care topics, which allows them to gain knowledge about all departments and roles in the company. This way, staff members can pass on this education to patients and be prepared to answer any patient questions, explains Ms. Ratcliff.

“One thing we make a point of doing is converting clinical talk into patient terms, so patients can understand their condition and how a medication or procedure will be beneficial,” she explains. “For example, with cataract surgery, instead of saying, ‘These are the IOL options for presbyopia,’ we’ll say, ‘The Forever Young package is designed to provide you with both distance and near vision.’”

Jay Levin, MD, medical director at Horizon Eye Specialists, adds that the staff works to manage patient expectations regarding surgery and treatment, so the patient doesn’t experience an unwanted surprise. “This means, for example, discussing exactly what the patient can expect from his or her chosen IOL or the Kamra inlay.”

In addition, Ms. Aviles says the practice’s surgery counselors provide financing option education to enable patients to “make their desired surgery/IOL a reality.”

2. Efficiency

To stay on track with scheduling, the practice provides the following:

• Patient questionnaires. The front-desk staff gives cataract patients questionnaires that include questions about how they want to see post-surgery (for example, “Would you mind wearing glasses for distance, intermediate, or near vision?”). In addition, the questionnaires include a patient personality section (for example, “Are you a perfectionist?”). This way, the optometrists, surgeons, and surgery counselors can focus on the IOL options that best fit the questionnaire answers and don’t have to conduct personal interviews that can take a lot of time, says Dr. Levin.

Corinna Aviles, director of surgical administration, counsels a patient on cataract surgery.

Technician Cathy Lorts, COA, performs dry eye tests on a patient.

David Rockwell, OD, presents to Horizon Eye Specialists staff members at a “Lunch and Learn.”

• Dry eye clinic. In recognizing that dry eye disease patients take longer to evaluate than those who present for cataract or refractive surgery evaluations, Horizon Eye Specialists opened a dry eye clinic roughly one year ago where they refer patients for diagnostic testing.

“We developed a protocol of testing for dry eye disease suspects and cataract patients,” says Jeff Girardin, OD. “The techs perform all the work up, such as tear osmolarity testing, meibomian gland photos, etc., and I assess the tech’s findings, perform corneal staining and meibomian gland expression, explain to patients evaporative vs. aqueous-deficient disease, and how the treatments I’m about to prescribe will benefit them.”

• Scribes. By employing scribes, Ms. Aviles says they enhanced the practice’s efficiency because techs and doctors aren’t “bogged down” with writing during pre-testing and the exam.

“Our doctors, in particular, are able to focus more on the exam and the conversation — looking for pathology, talking about options, etc.,” she says.

• Skill set focus. The staff supports one another and, therefore, the efficiency of the practice by focusing on their strengths:

• Front-desk staff tackle administrative duties, such as answering the phones, billing and the collection of patient histories;

• Techs perform pre-testing and start the patient education process, often planting seeds about refractive surgery and IOL options;

• Optometrists oversee the dry eye clinic and perform comprehensive exams pre- and post-cataract and pre- and post-refractive surgery;

• Surgery counselors reiterate and firm up the ophthalmologist’s recommendations, select dates, times, and locations of the surgery, and make sure patients understand how to take their eye drops prior to surgery, if prescribed;

• Ophthalmologists perform surgery.

“The important point of emphasis here is I wouldn’t be able to do what I do and see nearly as many patients without our staff,” says Dr. Levin.

• Cross-training. While staff members have their skill sets, Horizon Eye Specialists also cross-trains staff to prepare for staff illness, vacations, and high-traffic days, says Ms. Ratcliff.

“Having the ability to help each other and fill spots is key to staying on schedule,” she says. “We have a part-time surgery counselor, part-time tech; we have techs who are trained to take over at the front desk, and techs trained to scribe.”

3. Career development

Horizon Eye strives to keep employees who are engaged and, therefore, will stay at the practice long-term. They want patients to continue to receive education from those they’ve gotten to know and trust. To accomplish this, Horizon Eye affords:

• BSM Distance Learning (BSMConsulting.com). All staff are required to take these online courses to ensure their eye-care education and skill levels are current, says Ms. Aviles.

• Annual credit toward continuing education. Horizon Eye offers technicians $200 and pays their time up to 10 hours for job-related CE of the staff members’ choosing, such as attending a regional meeting, says Ms. Ratcliff.

• Field trips. The practice pays for select team members to attend ASCRS and AAO meetings yearly. They are selected by Ms. Ratcliff, Ms. Harte, and the practice’s CEO, Mike Trier, to attend. The practice chooses employees who demonstrate excellent job performance and those who take on additional responsibility.

“Everyone who attends these field trips knows they’re not totally free because attendees are required to educate their co-workers on what they’ve learned through a presentation at a ‘Lunch and Learn,’” Ms. Ratcliff says. “The staff likes it. It energizes them to share what they know.”

Robert McCulloch, MD (left) applies LipiFlow activators on a patient with assistance from Bonnie Ratcliff, director of clinic services.

Horizon Eye Specialists’ dry eye team (from left to right): Suzette Crackel, COA, Cathy Lorts, COA, Jeffrey Girardin, OD, Steven Eklund, COA, and Marina Gulyaev, technician.

Conclusion

Horizon Eye Specialists’ focus on customer service-based culture, efficiency, and career development programs is an ongoing effort, says Ms. Aviles.

“We have staff meetings to reiterate our mission of second-to-none patient care, senior staff constantly evaluates the time spent by each staff member to ensure efficiency; staff education never stops, and we make a point of recognizing staff members who have made positive contributions to the practice,” she says. “All of these efforts are geared toward providing patients with excellent experiences.” OP