My most valuable tool for running multiple healthcare sites: Gemba Walks
Last year, I became the Chief Dental Officer at Tend. I transitioned from being an owner of a small private dental practice to being responsible for five of them. As of today, I oversee clinical operations at 23 Tend studios.
Being a multi-site healthcare manager requires building systems that scale. When I was in charge of my own practice, I could jump in and fix whatever was broken myself — small business managers can do that. They’re present on-site, can observe what isn’t working, and can directly implement the change that’s needed. But when we’re overseeing multiple locations, we have to build infrastructures for quality control, onboarding, mentorship, and much more. These infrastructures have to operate when we’re not there to tinker.
The best way I know how to build these infrastructures is by taking Gemba Walks.
The term “Gemba Walk” originated in Japan. It’s when a manager or CEO actually walks onto the assembly line floor and observes what’s going on. They’ll go up to people and say, “Hey, how’s it going?” They’ll ask their employee about what is working and what isn’t working. Where are the bottlenecks?
It’s humanizing for managers — and humbling. Like the TV show “Undercover Boss,” the CEO will also roll up their sleeves and perform the function of their employees to get their own sense of how things are working. So, if you’re the CEO of a sandwich shop, that means you’re actually in there making sandwiches. Sometimes, you’ve been away from the sandwich counter so long that you’re not very good at it anymore. (This is where the humility part comes in.)
“Gemba” is a Japanese term meaning “the actual place.”
The idea of a Gemba Walk to walk to the front lines of where the actual work happens. Experience it and see the world through your team’s eyes. By doing this, you learn about efficiencies and bottlenecks.
When I was running my small practice, I could observe problems directly — and could fix them directly. But when it comes to multi-site operations, I can’t physically be in all 23 Tend studios at once. The answer is to build systems — for mentorship, for quality control. These systems allow you to maintain your standards, mission, and values at scale.
But if I’m building a system on a Word document, I’m away from the front lines. I can put down a bunch of ideas that sound good, but how do I know they actually work the way they’re intended to? If I’m building a better system for managing inventory, I should start by going to a few of our locations and asking a dental assistant how they keep track of inventory. How do they make sure we’re getting supplies in time, or that we’re not wasting materials?
Gemba Walks allow you to ask questions — and then build your systems.
When a new system rolls out, it’s important for me to do another round of these walks. I found out if the new system is working — is it better than before?
This may seem obvious, but you’d be surprised how many folks build systems away from the front lines, and never go into the field to check their work. If they did, they’d be able to tweak, build, and evolve their systems faster and more efficiently.
Yanique Griffin, RDH, our director of hygiene, put on scrubs and went through the sterilization workflow at one of our studios to ensure that it was a best-in-class system. It’s one thing to look at a booklet of instructions and say, yeah, our team knows the answer. But it’s more valuable to actually find out for ourselves. So Yanique put scrubs on and said, “Show me.”
If I’m doing an analysis on a piece of technology that we’re using, I’ll ask our team members to show me how it works. I may already know the answers, but I want them to teach me. Whether it’s a cone beam, a scan, or a digital impression system, I want to see how our team goes through the process of using it. Are there efficiencies to be realized? I’m not testing them to see if they know how to use it. I’m trying to see if our workflow can be tweaked and made better.
Small business owners can do Gemba Walks — but they’re essential for multi-site operators.
You can’t be everywhere at once. It’s impossible. You won’t be able to physically see when things are breaking down.
But going to the front lines can lead to powerful moments — and can allow your team to flex their skills. Celebrate them for being good at their jobs and taking care of your customers.
In addition to illuminating your systems, these moments can give your teams an opportunity to shine.
