Reflecting on Your Business

By Tracey Jones / 18 May 2020

Nurse Tracey Jones provides an introduction to the importance of business evaluation when running your own aesthetic clinic

Running an aesthetic business can be both personally and financially rewarding, with many clinics becoming highly accomplished as a result of the strong reputation of their practitioners and services. However, when a clinic is well established with a busy diary, it can be easy to let things continue to run as they are, rather than question what aspects of the business could be improved. 

It can be constructive to critique and assess your current practices, as well as to incorporate more strategic planning in order to stay ahead of the competition and encourage future success. Practitioners should embrace business reflection and evaluation, which can take place at any point, but should become a regular feature of your business strategy moving forward. This article highlights several areas that aesthetic practitioners can prioritise during the review process, both allowing your business to grow, whilst meeting the expectations of the healthcare regulator such as the Care Quality Commission.

Risk

Any business that offers patient care must and should place the assessment of risk at the highest point of priority. Most clinics already place a large focus on this; however, cases reported in both academic literature and the media demonstrate that mistakes continue to occur and cannot be avoided completely.1-5 By reviewing potential risks can ensure that mechanisms are in place to minimise the adverse outcomes should anything go wrong.

Examples of risk factors that need to be considered in an aesthetic clinic might include the collapse of a patient; do you have mechanisms in place to deal with an event such as this, do your team have life support training, equipment on-site or emergency drugs to hand? Or, perhaps another risk factor could be an emergency dermal filler complication such as a vascular occlusion; do you and your staff all have training in this scenario? Do you have an emergency kit that is stocked, in date and available at all times? All your strategies will be deemed as being risk adverse as an emergency has been pre-empted and management planned. Less obvious risks to consider include mechanisms to protect lone workers. Ultimately, the aim for any healthcare practitioner is risk prevention. This can be achieved by ensuring that your service is safe and effective. 

A busy clinic is ultimately the goal, however in any healthcare environment patient load is monitored as risk increases the busier the medical team become.6 To determine where your individual risks lie, you must look at your service from fresh eyes. Examine the service you are providing and if anything goes wrong, question if there is an occurring theme that might be causing this to happen. Do the results from your annual patient feedback survey show any negative trends? Is this data measured and then advertised to your wider team so they are aware? Encourage your team to be open and transparent about any issues they have encountered and provide support should it be required. 

Being open and honest has been a significant thread throughout the National Health Service over recent years and must be integrated into private practice too. Practitioners should assure their employees that reporting mistakes is a positive way of learning. Keeping a risk register, and being honest about what can be deemed as a risk in your service, can be the most active way of evaluating and improving your care delivery. 

Alam (2016) offers a succinct guidance regarding why a risk register is important in healthcare. He clarifies how the underlying causes of medical errors can be related to communication problems, inadequate information flow, human-related problems and inadequate policies and procedures. By examining your own service related to these areas, you can often start to recognise where your risks appear. I would then recommend having a structured system in place where you rate risks and plan your actions to amend them, in order to demonstrate safe practice and good governance.7

Environment

A good standard of care and attention to detail at every stage of the patient journey has proven to be a benefit to any organisation.8 When did you last view your clinic environment with a critical eye? Take a moment to walk the walk of your patients and understand how your whole environment might feel to them. Practitioners should reflect on whether there are areas that they can improve, and question their team to see if there is anything they would like to change. 

Start by entering the clinic through the door your patients use and see how you are greeted by the reception staff. Sit in the waiting area for a few moments and listen to what your patient might hear.9 Is the environment not only pleasant to look at, but comfortable? Are there refreshments in this area and are you telling your patients about your additional services and the positive feedback you have received by other patients? This can all be displayed in the waiting area and is an important feature of any clinic working towards registration with the healthcare regulator as it demonstrates transparency. Advertising your patient feedback enables you to promote your good service to offer assurance to patients waiting for treatment. 

Medicine management and safety

In all areas of healthcare, the management of medicines is one of the most important aspects of a service. Practitioners can be called to account by their employer, registering body and independent healthcare regulator when there are not processes in place to demonstrate safe practice. Therefore, it is imperative for clinic owners to have a system in hand that is both safe and efficient. For example, clinics must ensure that medicines are accounted for at all times; this can be achieved through regular audits and clear documentation when medicines are received and destroyed. 

Safety mechanisms, such as firm security related to the storage of medicines, must also be in place, alongside evidence of training in the area of medicine management. When working for any large healthcare organisation it is an expectation that regular mandatory training will take place, which should involve medicine management. This should also be common practice in a smaller aesthetic clinic.10 This not only assures the healthcare regulator of good governance, but also enables practitioners to put time aside for learning and reflection, empowering practitioners to question and implement change.

Policies, guidelines and continuous learning

Ensuring that the clinic team embraces learning and continues to develop is another area that can often be overlooked. It takes a lot of effort, commitment and financial input to ensure staff remain continually professionally developed, but it is crucial for keeping patients safe as well as for the growth of your clinic.11 

Inadequate or inappropriate policies can result in poor practice, so making an evaluation of your current clinical guidelines, governance and human resource processes should be an important aspect of the business assessment. There should be policies and guidelines in place within the clinic that can be a reference point for the whole team, not just the clinical staff. The administration and reception teams should also be able to access and understand this documentation. Note that lengthy documents do not demonstrate clear guidance, so make it extremely clear and fit for purpose. These should be reviewed annually and updated with any new guidance and evidence.11

This documentation should be clear enough for another practitioner to walk into your clinic, and be able to carry out the service continually being assured that safe systems are in place. The most important benefit of clinical guidelines and policies are their potential to improve both the quality and safety of the care being provided. Alongside policy is team learning, ensuring that all of the team can demonstrate and understand the fundamental areas of health provision, such as safeguarding vulnerable adults or information governance.

Fresh eyes

Assessing and reviewing your risk, environment, medicine management, safety, and policies and guidelines should be the responsibility of the clinic owner or assigned to a clinic manager. However, sometimes it can be hard to constructively criticise something that is so personal and see it objectively, so a fresh pair of external eyes might be beneficial, such as a fellow professional. It can also be useful to invest in an external review of your clinic as this offers an objective report critiquing your service. When appointing a company to critique your business, it would be advantageous to ensure that they specialise in aesthetic medicine, or at least the healthcare sector.

Opportunity for change

It can be easy within the area of private practice to become insular in many areas, which can really impact patient safety and the growth of your business. An evaluation of your aesthetic business can offer an opportunity for positive change. This is especially true when you recruit staff, create departments within the business, appoint managers or directors and become distanced from the everyday running of the clinic. Reflection should be a foundation to any evaluation model, as it is key in highlighting areas that need to be improved.

Disclosure: Tracey Jones is the co-owner of Inspire to Outstand, which assists clinics with CQC registration and preparation for inspection. 

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