Samuel Gruenbaum tells Michelle Rivera about the coordinated efforts this organization takes to ensure top quality care.

Western Dental Services is a large operating business, with close to 4,000 employees and more than 200 offices throughout California and Arizona. Keeping its engines running efficiently is something president and CEO Samuel Gruenbaum and his team look forward to coordinating every day.

Samuel Gruenbaum

“When you have well-trained employees, you not only get efficiency, customer satisfaction, and good delivery of services, but you also get a higher level of employee satisfaction and lower turnover,” Gruenbaum said.

Side by side
The commitment to training spans all levels of the organization, beginning with its doctors in the dental offices. Western Dental provides side-by-side training in which senior dentists spend time with each dentist in the office every month of the year to provide mentoring. The organization also has inhouse and external continuing education courses for dentists and constantly provides information to dentists regarding new developments in dentistry and the delivery of care.

“We audit the performance of the dentists in our offices year round,” said Gruenbaum. “All our measures serve to make our dentists more capable, more knowledgeable, and more effective. Our aim is to make them as excellent as they can possibly be.”

The training focus isn’t only on dentists; X-ray technicians, sterilization clerks, dental assistants, office managers, receptionists, and billing clerks are also included. “It provides great professional development and skills for the employees, taking someone and teaching him or her how to be an effective employee in the dental office. In the process, we get efficient performance in taking care of our patients and administrative needs,” Gruenbaum said.

“When employees are more trained, they become more and more valuable to us. It’s a win-win. Western Dental makes the investment in training and gets the benefits of trained employees with better intentions, and employees feel stimulated that they are becoming stronger and enhancing their own career opportunities.”

Quality management
According to Gruenbaum, Western Dental Services has one of the largest quality management divisions in the US, with an internal quality management department comprised of 30 FTEs who spend all of their time on quality related matters; approximately half are doctors of dental surgery (DDS) and the other half are related professional and administrative staff. The 15 DDSs devote 100% of their time to quality management efforts that include reviewing treatment, auditing, mentoring, peer review, quality management analysis, and utilization analysis. The 15 professional and administrative staff support the efforts of the DDSs and the Quality Assurance Management System (QAMS), Western Dental’s proprietary system for tracking all facets of quality care in its offices.

The department of 30 monitors, audits, counsels, and mentors the quality management activities at Western Dental’s 200 plus offices as well as the quality management activities of the approximately 1,500 independent providers who are under contract with the company. In addition to the team of 30, Western Dental has a team of another 12 DDSs who have the responsibility of overseeing the operations at dental offices. The DDSs are assigned to a handful of doctors in the dental offices to provide side-by-side mentoring every month. “We look at operations and quality as going hand in hand,” Gruenbaum said. “When both work well, patients end up with great care, and the company operates at optimal efficiency.”

For example, explained the chief executive, if a dentist gives a patient a crown and does it efficiently, then the number of visits the patient makes to the office are kept to a minimum. The patient is satisfied that the process has moved efficiently, and the doctor is satisfied. “Everyone is happy,” Gruenbaum said. On the other hand, if a doctor were to have problems giving a patient a crown, it would necessitate extra visits, burdening the patient, creating more work for the doctor, etc.

Captured procedures
To complement its quality initiative, Western Dental’s electronic systems capture all procedures. The information is analyzed on a daily basis through a number of queries and reports to look for compliance for several of its quality management requirements. This is done through QAMS, which is overseen by a professional statistician at Western with years of medical and dental background. In addition, Western Dental audits, reviews, analyzes, and mentors on a constant basis to make sure the quality of care and practices comply with policies, procedures, and guidelines. Every morning, the company generates a number of reports that give information about the operations in every dental office, such as information about patients and employees, the type of care that was delivered, information about office productivity, etc. “We see how the officers are performing on a daily basis in accordance with the measures that we believe represent good performance,” Gruenbaum explained.

This information is distributed to the deepest internal network of operations management who oversee the clinical and operational activities in the offices, and to the quality management department. Using that information, they can identify what areas need attention and can go to those offices and work on those areas to find out why the analytics do not fit the expectations for that office.

“There are so many moving parts in this organization and so many people who are minding each of these parts and making sure the organization operates efficiently on an integrated basis. It’s stimulating for all involved,” Gruenbaum concluded.