Building a Culture of Follow-Through

You often hear us talk about the importance of systems, protocols and that they need to be written and reviewed routinely. The lack of protocols creates a culture of confusion and frustration since not everyone is completing tasks in the same manner, time or with the same expectations. However, before we can talk about systems, checklists, or protocols, we need to talk about something more important — standards.

Every dental office I know says they are patient focused, they want excellence in their practice or they strive for accountability. And yet, excellence is not built on intention, it is built on follow through. Which stands to reason that one of the most important protocols that can erode a culture is incomplete follow through.

This includes: 

• A treatment plan not signed.

• An insurance claim not submitted with the proper documentation.

• A patient’s call not returned.

• A supply order not placed.

• A conversation not finished.

Individually, these may seem small. Yet collectively, they define the culture of the practice.

Follow-through is the discipline of closing loops. When we don’t close loops, co-workers feel uncertain and patients lose trust. Incomplete tasks can quietly and potentially cost your practice thousands.

• If you are responsible for sending out claims on a daily basis, yet skip a few days because you are too busy, doesn’t that cost the practice money in delayed reimbursement of those claims?

• If you are the person responsible for presenting treatment plans and financial information to the patient, yet you forgot to have the patient sign the treatment plan, are you putting the practice in jeopardy of losing revenue if the patient doesn’t pay because they ‘didn’t know’ that they would have to pay on the date of service?

It means:

• If you say you’ll call a patient — you call.

• If you commit to sending a pre-authorization — it’s submitted.

• If a concern is raised in a team meeting — it’s addressed and revisited.

• If the doctor delegates — the task is completed and reported back.

When I walk into an office and ask ‘who follows up on overdue recall’ or ‘who places the supply order’ and the answer is ‘we all do’ then I know that there is no clear ownership with those (and possibly most) tasks. That also means that everyone assumes that someone else is handling the responsibility of that (and most) tasks.

Follow through is truly about ownership. 

Our favorite moto is: 

EVERY JOB HAS AN OWNER

High performing teams don’t allow there to be guesswork on completion of any task - they confirm by knowing WHO the owner of that task is. Nothing lives in the gray zone. 

For instance: Becky may be the owner of the hygiene schedule, yet that means that others can help her to achieve the goals of a productive hygiene schedule. And most of the time, that is the case - hygienists pre-appoint the next visits and anyone answering the phone can schedule a hygiene appointment. However, when I want to talk to someone about why the hygiene schedule looks the way that it does - I’m going straight to Becky. 

So how do you build a culture of follow-through? By avoiding phrases such as: 

• ‘I thought someone else did that’; 

• ‘I don’t know who was supposed to do that’  

• ‘We were too busy to do it’ 

and forming a team of owners who instead say: 

• ‘I’ve got it’ 

• ‘I’ll handle it’ 

• ‘Here’s the update’ 

This is the standard that changes everything. It shifts the practice from being reactive to being disciplined and less stressed and very reliable. Each team member knows exactly what they own and they perform better. Expectations are crystal clear and job descriptions have no vagueness.  Leaders will watch the team rise to the standards that are set out, which empowers the team to excellence. 

The offices that rise to meet their goals of being patient focused, achieving excellence in their practice and have defined accountability are the ones that have made a decision that many avoid: they stop tolerating loose ends. They stop excusing inconsistency. They stop confusing busyness with effectiveness. They build systems that define ownership and they close the loops - every time. 

In my opinion, this process lends itself to less micro-management. The manager or owner doesn’t need to be over everyone’s shoulder since they all know what they are responsible for and report back to management with efforts toward goals on a routine basis. 

If you would like help with creating this important aspect to your culture, please feel free to contact me: denise@GTSgurus.com. For your convenience I have create a team training hand out to get you started on creating your Follow Through Standard.

The Follow-Through Standard

If you want to elevate your office quickly, start here:

1. Assign Every Task to One Owner (not 3) One task. One name. One deadline.

2. Use Visible Tracking Systems

Whether it’s a digital task board, routing slips, or daily huddles — tasks should be visible until completed. What is visible gets finished.

3. Close Loops in Meetings: End every meeting with:

   1. Who is responsible?

   2. By when?

   3. How will we know it’s done?

4. Normalize Reporting Back (eliminate ‘I don’t know’)

Completion should include communication:“Dr. Smith, the pre-auth was submitted.”“The lab case has been confirmed.”“The patient has been scheduled.”

Silence creates assumptions. Reporting builds trust.

5. Audit Gently but Consistently (stop normalizing We’re too busy)

Randomly check:

• Outstanding claims

• Unscheduled treatment reports

• Call-back logs

• Incomplete chart notes

Not to catch mistakes — but to reinforce standards.

The Bigger Picture

Follow-through is not a task management issue. It is a cultural issue that leaders tend to neglect. Dental practices that master follow-through:

• Have stronger patient retention

• Experience fewer internal conflicts

• Maintain steadier cash flow

• Build teams that trust each other

The best offices are not the busiest.They are the most disciplined.

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Denise Ciardello, Consultant

Denise is co-founder of Global Team Solutions. A professional speaker and published author, her enthusiasm and knowledge about the dental profession has helped many dental teams. She brings experience, insight, and creativity into her management style, along with a sense of humor. In a profession that can cause anxiety in some dental employees.

Denise’s consulting approach is to partner with doctors and team members to help them realize the dream of creating a thriving, successful practice.

Denise can be reached at: denise@gtsgurus.com