EFFICIENCY

Efficiency looks at how cheaply something is done. The focus is cost. The intention is to save money, time, or effort regardless of quality. To become more efficient, people must simply lower costs. Efficiency measures productivity at the individual process level, regardless of the collateral effects of the decision (Box 27.1). It often requires conforming to norms. In this way, the process is no worse than others in the industry. It examines internal, technical issues. The result is to improve profitability by working harder and quicker.

In a dental practice, efficiency comes from doing procedures correctly the first time, without remakes. If this does not happen, not only does the practitioner have the cost of additional materials, staff, and lab charges, they have also lost the additional production they could have had during the time spent on the remake. Clinical decisionmaking is the prime factor that increases clinical speed.

EFFECTIVENESS

Effectiveness looks at how well something is done. Here, the focus is on the benefit or outcome of the process. The intention is to improve quality to a higher level than the individual process, thereby raising performance levels. It measures how well the job is done or the correctness of a product or service. Effectiveness, then, is a quality measure, not a cost measure. It examines external, strategic results. The outcome of effectiveness is improving profitability by working smarter.

As an example of the difference in a dental practice, a practitioner can be more efficient (lowering costs) if they use a foreign lab. However, they may be less effective in crown and bridge work because of more remakes and lower patient satisfaction. So here, effectiveness trumps efficiency. Using the foreign lab costs less, but the practitioner is not doing their job as well. Simply doing something less expensively does not necessarily lead to more profit. Dental practitioners must ensure that they are efficient and effective in all office decisions.

WHAT DETERMINES CAPACITY

All the management decisions the practice owner makes in the office affect capacity.

NUMBER OF OPERATORIES

The number of operatories has an obvious and essential effect on a practitioner’s ability to see patients. However, the practitioner must ensure that proper staffing levels support the operatories. Without staff support, seven operatories will not let a practitioner see more patients than one operatory. The additional six operatories become nothing but expensive waiting rooms. Generally, practitioners assign one chairside assistant to one operatory. The assistants are responsible for chairside assisting during patient procedures, set‐up, break‐down, and disinfection of the operatory between patients.

OPERATOR SPEED