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Consider the following practices, Practice A and Practice B, I am about to describe.
Practice A’s routine procedures are in writing, and these reference materials are easily accessed when a question surfaces. Practice B’s procedures are all in people’s heads, and the operational integrity of the practice degrades every time a staff member leaves.
Initial training at Practice A is formalized and intensive; new staff are competent in their jobs before being allowed to operate critical systems. New staff at Practice B are “thrown in the deep end of the pool,” and it’s sink or swim. As a result, marginal staff leave prematurely and have to be replaced, and critical areas that take longer to learn can be handled poorly.
At Practice A, retraining to refresh old skills is continuous; tests are used to assess and help correct skill deficits, and career advancement is skill-driven. Retraining at Practice B is not continuous, and even if skills are initially conveyed, they degrade. No one is responsible for following up to make sure tasks are still being done correctly, and staff raises are handed out without regard to objective skills. Get the whole story