“Is Doing Better and Being More Careful Actually a System?”: Why Erin Glending’s High Reliability Framework Can Cure Burnout and Transform How Dental Practices Really Work
What happens when a college student working at Barnes & Noble for $7.95 an hour sees a newspaper ad for an orthodontic assistant position (no experience necessary) paying $10/hour, takes the job in Columbus, Ohio, quickly moves into clinical coordinating across four locations, gets the opportunity to open an orthodontic practice from scratch with an orthodontist (and learns everything about designing and managing a practice on the fly), then goes to graduate school for a Master’s in Healthcare Administration (essentially an MBA for managing hospitals), works in hospital-based dentistry associated with teaching hospitals and residency programs, and realizes she can take enterprise healthcare techniques and apply them to private dental practices?
Erin Glending does exactly that, and after starting her consulting company in 2014 while still working in hospitals, she makes the full transition to consulting full-time during COVID when hospital systems became unmanageable, recognizing that private dentists suddenly needed the same systems, protocols, and reliability frameworks that hospital systems had been using for decades. In this incredibly practical and eye-opening conversation, Erin introduces the concept of High Reliability—a system developed in aviation, nuclear power, and the military, adopted by enterprise healthcare, but almost completely absent from dental practice management—and reveals why the difference between a thriving multi-seven-figure dental practice and one stuck at $50K/month production has almost nothing to do with clinical skill.
Most powerfully, she reveals that the entire culture shift of high reliability starts with one radical idea: problems that happen are NEVER people problems—they’re always system problems—which means if you have an underperforming team member or lots of errors, you don’t retrain or PIP the person, you redesign the system so that the error can’t happen regardless of who’s in the room. If you’ve ever wondered why some practices have teams that seem happy, engaged, and energized while others have constant turnover and burnout, why some doctors can work fewer hours and make more money while others work themselves to exhaustion, or what the real difference is between a practice that feels like it’s running on talent versus one that runs on design, this episode will completely transform how you think about systems, culture, burnout, and what it actually takes to build a reliable, sustainable dental practice.
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Key Moments
- 02:00 – Erin’s path to dentistry: Barnes & Noble to orthodontic assistant to practice startup to hospital dentistry
- 05:30 – MHA (Master’s in Healthcare Administration): Learned enterprise healthcare systems and realized they apply to dental
- 08:30 – COVID transition: Left hospital management, moved to full-time consulting when practices needed healthcare-level systems
- 11:30 – High Reliability framework: Shifts focus from “more” (growth/output) to “reliable” (consistent, safe experience every time)
- 14:00 – The core problem: Systems designed for output ignore that people are finite resources who get tired, distracted, and make mistakes
- 18:00 – Reliability vs. performance: If your system breaks when someone is tired or schedule is overscheduled, you don’t have reliability
- 23:00 – Culture shift: Problems are NEVER people problems—they’re system problems (no retraining or PIP, redesign the system instead)
- 27:00 – Golden nugget: “Is doing better and being more careful actually a system? Because when something breaks, if we think we just need to do better, that’s not a system—that’s a hope”
Episode Summary
Erin Glending’s path into dentistry started by accident. She was working at Barnes & Noble in undergrad making $7.95/hour, struggling to pay rent as a student at Ohio State (go Buckeyes). She saw a newspaper ad for an orthodontic assistant position—no experience necessary, $10/hour—and took it. In Ohio at that time, you didn’t need any certification; you could be trained on the job. She was hired by a practice with multiple locations and quickly moved into clinical coordinating across all four locations. Then she had the opportunity to open an orthodontic practice from scratch with an orthodontist—”from the frying pan into the fire”—which meant designing the practice, managing it, doing everything. That experience gave her broad exposure to all aspects of dentistry. But her specialty in enterprise healthcare came from graduate school. She earned an MHA (Master’s in Healthcare Administration)—essentially an MBA for managing hospitals—and learned tons of information about managing complex healthcare systems. She then worked in hospital-based dentistry associated with teaching hospitals and residency programs, which gave her the rare opportunity to see how dentistry coordinates with enterprise healthcare and how it operates at different levels with different goals, policies, and procedures. Working as an operations manager in hospitals (not an administrator), she managed departments, physicians, and staff—frontline leadership work. Because of her unique combination of dentistry background AND hospital operations experience, she became the person everyone went to for dental questions in hospital systems, even though what she really specialized in was understanding how to apply enterprise healthcare techniques to any setting.
The key insight Erin brings from enterprise healthcare is this: people are a finite resource. Humans get tired, distracted, forget things, misunderstand, get crabby. When you design systems that require people to be perfect—to remember everything, to stay focused, to never make mistakes—you don’t actually have a system. You have a hope. And when those systems break down (which they will), you blame the person instead of recognizing that the system itself wasn’t designed for how humans actually work. This is critical: when you have one person or two people making errors, the problem ISN’T those people—it’s that your system hasn’t been examined closely enough to identify the points where things can go wrong. If someone makes a mistake when they’re tired, when the schedule is overscheduled, when the software is acting up, or when they’re distracted, then your system isn’t reliable because it depends entirely on perfect execution by perfect people under perfect conditions. High-reliability organizations proactively identify where systems might break and build guardrails. They also fundamentally shift the culture around problems. The first tenet of high reliability, before anything else, is this: problems that happen are NEVER people problems. They’re always system problems. This means if you have an underperforming team member making lots of mistakes, you don’t retrain them, put them on a performance improvement plan, or “PIP” them. Instead, you ask: why did the system allow this error to happen? How can we redesign it so that error can’t happen regardless of who’s in the room? This shift is huge and it requires strong leadership commitment from the top.
When Erin works with practices, she starts with leadership because this is a fundamental culture change, not just a process tweak. She talks with the doctors and managers (or just the doctor if it’s a small practice) about what high reliability means and explains that you can’t do it halfway—it requires going all in. The culture piece is enormous because high reliability creates psychological safety. Once you agree that problems are never people problems, team members feel safer admitting mistakes, asking questions, and collaborating on solutions rather than being afraid of blame. She then analyzes the practice’s data and metrics to identify where things aren’t working well, and this almost always reveals that the surface problem (what the leader thought was the main issue) is actually caused by an underlying system problem. She works with the entire team, recognizing that the people actually doing the work are the experts in that work. Too often, SOPs are written by office managers or leaders who aren’t actually performing the work. High reliability says the person doing the work should be deferred to as the expert for how the system should actually function. This is where Erin often discovers that the written SOP doesn’t match what people are actually doing—and that misalignment is exactly where reliability breaks down. When you have a system on paper and people are doing something different in reality because “yeah, but that doesn’t work in real life,” you don’t have reliability.
Resources Mentioned in this Episode:
- Erin Glending Consulting:Erin’s website with information on high reliability, speaking, consulting services, and contact forms
- Erin Glending’s LinkedIn Profile: Find Erin on Facebook, LinkedIn, and Instagram
- Speaking Consulting Network Summit: Where Erin and Brett met in California
- Last Week’s Episode with Ian McNickle: : Previous Marketing 32 Show episode
- Marketing 32: Performance-based dental marketing agency with growth guarantee
Quotable Moments:
“I got into dentistry by accident—saw a newspaper ad for an orthodontic assistant, no experience necessary, and it paid $10/hour instead of $7.95 at Barnes & Noble. That was my path in.” – Erin Glending
“High reliability shifts your focus from ‘more’ (growth, output) to ‘reliable’ (consistent, safe experience every time).” – Erin Glending
“People are a finite resource. We get tired, distracted, forget things. When you design systems that require perfect people under perfect conditions, you don’t have a system—you have a hope.” – Erin Glending
“If your system breaks when someone is tired or overscheduled, then you don’t have reliability because it’s dependent on perfect execution by perfect people.” – Erin Glending
“The first tenet of high reliability: problems that happen are NEVER people problems. They’re always system problems.” – Erin Glending
“If you have an underperforming person making lots of errors, don’t retrain or PIP them—redesign the system so that error can’t happen regardless of who’s in the room.” – Erin Glending
“High reliability creates psychological safety because everyone agrees: problems are never about blame, they’re about fixing systems.” – Erin Glending
“The people actually doing the work are the experts in that work—not the office manager who created the SOP 20 years ago.” – Erin Glending
“When you have a written SOP but people are doing something different in reality because ‘that doesn’t work in real life,’ you don’t have reliability.” – Erin Glending
“Is doing better and being more careful actually a system? Because when something breaks, if we think we just need to do better, that’s not a system—that’s a hope.” – Erin Glending
Key Action Items:
- Identify your “just be more careful” moments: Where do you hear yourself or your team say “we just need to pay more attention” or “let’s do better at that”? Those aren’t systems—they’re hopes.
- Map your workarounds: Where do team members deviate from written SOPs? Where do they say “yeah, but in real life it works like this”? Those are reliability breaks.
- Look at your data: Where are you seeing consistent problems? Patient attrition? High team turnover? Schedule inconsistencies? These signal reliability issues.
- Start with leadership buy-in: High reliability requires top-down commitment. It’s not a quick fix—it’s a culture shift.
- Reframe problems as system problems, not people problems: When someone makes an error, ask “what about the system allowed this to happen?” instead of “why did this person mess up?”
Episode Sponsor:
This episode is brought to you by Marketing 32—the only dental marketing team with a performance guarantee where if you’re not growing, you don’t pay. Marketing 32 is truly invested in adding value to your practice and working with doctors they know they can over-deliver for. Marketing 32 helps you build the patient acquisition piece of that vision through strategic online presence, content creation, and growth campaigns. If you need help with marketing and growth, reach out at marketing32.com for a quick 15-minute discovery call to see if it’s a good fit.
Episode Transcript:
Brett Allen (00:22)
Hi, Brett Allen here, host of the Marketing32 show, where I connect with leading dentists, dental influencers, and industry experts to uncover the latest and greatest when it comes to helping your practice to grow and thrive. As always, this episode is brought to you by our team here at Marketing32. We are the only dental marketing team that I know of with a performance guarantee that if we’re not helping you grow, you don’t pay. We truly try to add value in all of our relationships.
And we only work with those practices that we know we can help accelerate their growth. So if you’re looking into marketing, need help with growth, head over to market32.com. We’ll have a quick conversation ⁓ and we’ll let you know if we can help you or not. Quick shout out to Ian McNichol. Recently had a great conversation with him on the show. He’s with icon dental partners, they offer a revolutionary new approach to ⁓ group practice and DPOs. It’s
Really, really cool. So you go, you should go check out that episode. Excited to have a new friend of mine on the show today, Erin Glending. we recently met at the ⁓ Speakers Consulting Network Summit in California. She is a healthcare management advisor, consultant, and speaker who helps dental practices uncover the hidden weak points in their operations, the kind that quietly drain profitability and wear teams down.
She draws on her experience in enterprise healthcare leadership and over 20 years in dental practice operations. ⁓ She helps dental leaders and their teams evaluate the systems a practice already runs on and pinpoints where reliability breaks down. So small problems get caught before they cost money, morale, or quality of care. The result is stronger margins, a healthier culture, and a practice that runs on design, not just on talent. Welcome to the show, Erin.
Excited to talk with you. Yeah, this this will be fun. ⁓ I’m really interested in your background in hospital administration and what you bring from an enterprise standpoint into dental ⁓ into the industry. And I want to learn more about and talk more about how you work with practices. So maybe let’s start with your background. Like, how did you get into dentistry? Walk us through that story and ⁓ and what you’re doing today.
Erin Glending (02:09)
Hi. Thanks for having me.
So I I got into dentistry initially a little bit by accident. ⁓ I was in undergrad and I worked at Barnes and Noble. So this was a long time ago when when Barnes and Noble was a thing, when people went, when there was one on every corner. And I was a bookseller. ⁓ and I think I again this was a long time ago. I think I made like seven dollars and ninety-five cents an hour or something.
Brett Allen (02:49)
wow.
Right. wow, okay.
Erin Glending (03:04)
And at a certain point, I was like, this isn’t working. You know, I have rent to pay. I’m in college. I need something better. And ⁓ I found an ad in the newspaper. Again, this is a long time ago. Yeah. Yeah. Exactly. in the newspaper for an orthodontic assistant. And it was ⁓ no experience necessary. You didn’t need to have a license or a certification. this was in Columbus, Ohio.
Brett Allen (03:11)
Yeah.
wow, okay. New dating ourselves a little bit.
Okay.
Erin Glending (03:33)
Because for undergrad I went to Ohio State go buckeyes. And ⁓ in Ohio at that time you didn’t have to have any kind of certification. You could just get trained on the job. And ⁓ it was for ten dollars an hour. And I thought, I mean, there you go. Like that that makes sense. Yeah. Yep. Yeah. So that’s how I got into it. ⁓ I I got hired.
Brett Allen (03:51)
Yeah, quite the jump in pay. Yeah.
Erin Glending (04:00)
by a practice that had a couple of different locations. And I worked as an assistant. And then I ⁓ quickly moved into clinical coordinating ⁓ for all four of the locations. from there I had an opportunity to open a practice, an orthopractice, ⁓ a from scratch orthodontic practice with with an orthodontist. And that was kind of a ⁓ from the frying pan into the fire.
Brett Allen (04:06)
quickly pulled in soon.
wow.
wow.
Erin Glending (04:28)
experience because it was everything right i mean it was designing the practice managing the practice everything yeah and so that was kind of how how dentistry happened for me and then my my specialty and and what i do now in terms of ⁓ bringing more enterprise healthcare ⁓ traits and techniques into dentistry
Brett Allen (04:28)
wow. It organization, yeah. Operations, yeah.
Erin Glending (04:55)
came from ⁓ grad school ⁓ initially. So ⁓ when I was in graduate school, I ⁓ I have an MHA. So ⁓ it’s a a master’s of healthcare administration. ⁓ basically it’s like a business degree for managing hospitals is the idea. So you know, learned tons of great information when I was in grad school and then ⁓ worked in some hospital systems. ⁓ because of my
Brett Allen (05:07)
Yeah.
Erin Glending (05:24)
background, I I was still in dentistry. So it was dentistry, but hospital-based dentistry. So ⁓ associated with hospitals, ⁓ teaching hospitals and residency programs. So ⁓ that was sort of where I I had the the chance to really be able to see how dentistry coordinates with enterprise healthcare.
And and what it looks like when you’re running dentistry at at a different kind of level with with different ⁓ different goals with different policies. And ⁓ you know, I I learned a lot during that time and I was able to really see that you can take those things and you can apply them to smaller private practices too, or you know, even DSO systems. I mean, they’re
Brett Allen (05:59)
Hm Yeah
Erin Glending (06:16)
There are very few DSO systems that are, you know, as big as the Cleveland Clinic. So you know, they’re in in in terms of size, even large DSOs are relatively small when you’re talking about enterprise healthcare.
Brett Allen (06:22)
Yeah, yeah.
Yeah. There’s not many organizations in dentistry that are that big where you get a a corporate environment that’s it’s very much small business or even at most mid size business, right? So yeah. I’m I’m excited to learn more about that with you, talk more about that. ⁓ so how did you get into so what what segued from that world to dentistry? You came back to dentistry?
Erin Glending (06:44)
Mm-hmm.
Well, so because I was I was operations management was ⁓ how I worked with the hospitals. So there are two different types of hospital administrators. There are administrators, which are like spreadsheet phone meeting people, and then there are ⁓ operations managers. So ⁓ operations managers are a little bit more ⁓
Brett Allen (07:03)
Okay.
Erin Glending (07:22)
frontline. So you actually have your own departments or divisions. You manage the people in those departments and divisions. You manage ⁓ the the physicians and the the rest of the staff. So that was the kind of hospital leadership that I did. And ⁓ it was within the dental specialty. ⁓ There aren’t a ton of of people who who do exactly what I do.
Brett Allen (07:44)
okay.
Erin Glending (07:50)
Who ⁓ you know, specialize in dentistry and have a background in dentistry, but work within enterprise systems. So it was one of those things where, you know, even if I wanted to like jump into cardio operations or something, it’s sort of one of those things where it’s like, well, but you know about dentistry, right? Because nobody else here does. So it’s, you know, it ends up like that.
Brett Allen (08:13)
⁓ gotcha. Yeah.
Gotcha. Okay. Okay. So it’s okay. So yeah, and I’m I’m eager to talk about real high reliability, kind of what you were bringing from that corporate background into dentistry. Walk us through how you went from that world back into into the consulting space in dental now. Yeah. So so starting your own practice, I guess. Consultancy.
Erin Glending (08:33)
So yeah, I ⁓
I actually I had been doing some consulting work all throughout when I was ⁓ working within healthcare, ⁓ only because it, you know, I I had started consulting wow, twenty fourteen is when I started my company initially.
And ⁓ that was around the same time that I started working in healthcare. And it was beneficial for me because it allowed me to kind of keep my finger on the pulse. Most of what I was doing at that time ⁓ was consulting for dental practices that I had actually worked with in the past or referrals from them and just, you know, kind of ⁓ a project here and there. I moved in back into it full time. ⁓
Brett Allen (08:57)
wow, okay.
Mm-hmm.
Erin Glending (09:24)
COVID. So ⁓ hospitals during COVID, that it was tough. It was a tough time. ⁓ and you know, I think we’re gonna we’re gonna talk a little bit about burnout here in a little while. And that I mean, it I I think you could talk to anyone that worked in a hospital system during that time. And it ⁓ I think I had a really good opportunity to be able to look and say, okay.
Brett Allen (09:29)
Yeah.
Yeah.
⁓ was
Erin Glending (09:47)
Where can I be the most effective and where can I have the most value? ⁓ COVID was a really interesting time for me because since I was already consulting, I did have the opportunity to be able to talk with a lot of ⁓ private practice dentists who all of a sudden had questions about the kind of things that hospital systems have been doing for a really long time because of all of the the increase in
Brett Allen (10:14)
Mm.
Erin Glending (10:16)
you know, regulation or having to work with fewer people all of a sudden, having to kind of ⁓ take a look at your systems and and make them a little bit different. So it became obvious to me that it was just a really good opportunity for me in a a time where I could, you know, pull away from the day-to-day enterprise healthcare management ⁓ and be able to kind of go back into helping dental practices, which is really, I mean
Brett Allen (10:18)
Mm-hmm.
Erin Glending (10:44)
That’s what I love. I I love ⁓ dentistry. And I’ve worked in dentistry for such a long time and so many different ⁓ aspects of it and with with different specialists that to be able to do that and to have that opportunity was ⁓ you know, I I just I feel I feel really lucky to be able to have done what I did.
Brett Allen (11:04)
Yeah.
Yeah. Well that’s great. So let’s let yeah, I’m glad I’m glad you’re in dental too. ⁓ let’s talk about ⁓ how you work with practices and you y prior to the show we were talking about this concept of high reliability and bringing that into dentistry and operations and how you work with teams. Walk us through more of what that actually means and
Erin Glending (11:11)
Yeah.
Brett Allen (11:29)
How you work with practices and maybe even I I guess well let’s start there and then I’ve got some follow-up questions I want to ask you. Yeah.
Erin Glending (11:35)
Okay. ⁓
so, you know, high level, high reliability is it’s an overall system that’s utilized in lots of industries, not just healthcare. it actually, you know, it got its start in ⁓ aviation. It’s used in nuclear power, the military. ⁓ and then healthcare was kind of late to the game, like a little late on the arc actually to ⁓ to get it started. But
Brett Allen (11:47)
Right.
Erin Glending (12:03)
⁓ what it what it is is it’s a a set of techniques and traits that organizations can develop where you start to see your work a little bit differently because the focus becomes ⁓ a goal of reliability as opposed to a goal of more. So an example of that is, you know, in dentistry right now, we have ⁓
Brett Allen (12:22)
So
Erin Glending (12:30)
We have more data than we have ever had before. Everybody’s got KPIs. We’ve all had systems since at least the 90s, right? And everything is based on outcomes. So we build our systems and our goals, the KPIs that we measure, they’re all based on outcomes. So basically, what we do is we build our businesses on output, which makes sense. That’s what you would do if you were running.
Brett Allen (12:32)
Mm-hmm.
Yeah.
Erin Glending (12:58)
a bank or a retail store or you know anything like that. The difference is dentistry at its heart is a ⁓ a high-stakes industry. I mean it is there i if if things don’t go well ⁓ things really don’t go well and that’s true of ⁓ you know all of those other high-stakes industries that that we mentioned that are
Brett Allen (12:59)
Mm-hmm.
Yeah, yeah. Yeah.
Erin Glending (13:26)
really ingrained with the idea of high reliability. So it isn’t ⁓ it isn’t something that’s really part of the the regular nomenclature of dentistry. We don’t go around talking about, you know, utilizing high reliability systems. That isn’t something that we do be because nobody’s telling us that we should. It it exists, it’s there. We just don’t talk about it.
Brett Allen (13:42)
Yeah, that yeah. Yeah. Sure. Well yeah,
and we’ve had guests on the show where we talk about ⁓ you know, sanitization, OSHA requirements and keeping everything in check so that you’re you’re you’re organized and yeah. But yeah, this taking it to the next level of not only do we have a system but
Erin Glending (13:59)
Mm-hmm.
Brett Allen (14:08)
is the system optimized to its best, right? That’s kind of what you’re talking about.
Erin Glending (14:12)
It is. And there are ⁓ there are some things that are not ⁓ intuitive really that are kind of part of it. So when we say the word reliability, we just we think of that in terms of, that means you get the same answer every time, you get the same outcome every time. And obviously that is the crux of it. ⁓ but it happens when when you really do utilize the techniques of high reliability and continuous quality improvement.
Brett Allen (14:27)
Everything. Right.
Erin Glending (14:39)
You’re doing it in ways that are really interesting. So what you get is ⁓ instead of developing systems and goals that are primarily for output, that are primarily for growth, for example, ⁓ you sort of shift the way that you look at what you do. And you start to at its core and the way that it’s utilized in other industries.
Brett Allen (14:42)
Yeah.
Erin Glending (15:04)
You really start looking at things in terms of ⁓ overall safety. That’s where it came from. It came from ⁓ the idea of safety. So you have obviously, like you mentioned, infection control and that kind of thing. This is different. This is more about how you actually do things. So it’s not necessarily about making sure that you have a sterilization system. It’s about how you design that sterilization system in order to make sure.
Brett Allen (15:10)
Okay.
Erin Glending (15:32)
that there isn’t too much pressure on the people that have to do the system. Because when you put too much pressure on people, people are a finite resource. And we do people things, right? I mean, we’ve all seen the memes. People be people in. And we we we forget things, we get distracted, we misunderstand, we get tired, crabby, you know, and
Brett Allen (15:37)
Yeah.
Yeah,
Yeah.
Erin Glending (16:01)
And when you don’t have systems that allow people to be people, ⁓ they don’t work as well as you want them to. Even if it looks like you’re getting the output that you want, ⁓ there are probably somewhere along the line some negative ramifications of that.
Brett Allen (16:06)
Mm.
Yeah, yeah. I can I can see that. If you how are we getting the most out of our people? ⁓ not just from a systems and process standpoint, but where
y you’re you’re leveraging their skill set in a way that every everybody’s getting better. The the whole system’s getting better. Yeah.
Erin Glending (16:37)
Yeah, exactly.
And and you also have ⁓ an idea when when you really get into this and when ⁓ when you have leaders, because this this sort of thing, it it has to start from the top. Leaders have to be the ones that ⁓ that get on board with it. ⁓ when you look at industries like ⁓ like enterprise healthcare, for example, hospital systems, that sort of get on board is institutionalized.
Brett Allen (16:50)
Yeah, just use them.
Erin Glending (17:03)
It it doesn’t even come from the leaders within a hospital system. It comes from, you know, the government. It comes from payers. Exactly. There, you don’t have a choice. It’s that this is what you’re going to do. You’re going to ⁓ follow these protocols. You’re you’re going to ⁓ have these things in place. You’ll have these entire departments that focus just on reliability. And it’s because it’s coming from the outside.
Brett Allen (17:09)
It’s the industry. Yeah, that’s just how it is. Yeah.
Yeah,
Erin Glending (17:30)
And I think in
Brett Allen (17:31)
yeah.
Erin Glending (17:31)
dentistry, it’s easy to think that that’s not necessarily true because we don’t have, you know, there’s no kind of accreditation body in dentistry that’s saying, hey, let’s talk about ⁓ how reliable your systems are. Let’s look at your level of quality improvement. Let’s really take a look at what what’s happening in your practice and how you’re actually performing. There isn’t really anybody that
Brett Allen (17:57)
Mm. Yeah.
Erin Glending (18:00)
Everyone is aware of that that does that. But we do have those kind of external pressures and they come from patients, right? I mean, they come from patients, they come from team members. So if you have a practice where you have a lot of patient attrition, there is a reliability problem there. If you have a practice where you have lots of turnover, it’s a reliability problem. And it
Brett Allen (18:08)
Yeah.
Yeah.
Yeah, yeah.
Yeah.
Erin Glending (18:24)
It’s
not necessarily reliability in terms of can I trust you? It’s it’s a little different than that. It it’s more ⁓ reliability in terms of do people feel continuously safe in this environment? So, you know, if I work for you, do I feel like I’m being supported or do I feel like I am a tool to get you the output that you’re looking for? That that’s kind of the difference.
Brett Allen (18:51)
Yeah.
Yeah, it’s less it’s less focused so much on the goal of like checking a box and more focused on like ⁓ quality of experience maybe for the patient and things like that. Yeah. Of like what how is this all contributing to the outcome for the patient versus okay, I’m just doing this because this is what’s in the system. Yeah.
Erin Glending (19:05)
Yeah, it’s ⁓ you know
Well, and
and you look at so when you have a system, for example, that ⁓ has a lot of steps in it, and someone is ⁓ expected to do that system either when the schedule is exactly perfect or when the schedule is overscheduled because maybe you had an emergency or something didn’t go well. ⁓ when that when a person is expected to do that complicated system.
Brett Allen (19:20)
Mm-hmm.
Erin Glending (19:41)
just as well in either situation. you don’t have a system where anyone’s going to be happy at the end of the day, right? The person who has to do it, they’re not going to feel great about it because the system wasn’t designed for the time when things aren’t exactly right. And there will be a patient who is going to end up with not a great experience. Or, you know, and that’s best case scenario. We we work in a high risk
Brett Allen (19:58)
Yeah, yeah.
Hmm. Yeah.
Erin Glending (20:10)
field there there
could be other things that could happen too. But ⁓ the idea is we identify within our systems places where maybe something could go wrong, where there might be problems. ⁓ we do that proactively. And by doing that, we support not only the people that are doing the work, but also the people that are experiencing the work too.
Brett Allen (20:37)
Mm,
mm, I like that, yeah.
Erin Glending (20:39)
And it,
you know, at the end of the day, it gets us where we want to go anyway. We want systems that create output. We want higher production. We want higher collections. Happy people get you there. Happy patients, happy team members.
Brett Allen (20:50)
Right. Yeah. There’s leading indicators that that contribute.
Yeah. Well so so let’s talk about that deeper a little bit. Like when you’re working with a practice, what’s it like? What’s your process like? How do you identify these things? How do you help implement ⁓ I we’ve had numerous consultants, dental consultants on the show. Everyone’s got we were talking about this, everyone’s got their unique
Erin Glending (20:55)
Exactly.
Brett Allen (21:14)
method or approach and some are better at specific areas than others and how they work with practices. How do you work with practices? What’s it like to work with you? And walk us through that.
Erin Glending (21:24)
So most practices now have systems, right? if you don’t have any systems, like you’re really behind. But most practices do have systems. It’s been decades that we’ve been talking about that. ⁓ and for me, just like any other consultant, we get called most of the time because something isn’t exactly right. Because, you know.
Brett Allen (21:32)
Yeah. Yeah. Yeah, yeah, yeah.
Erin Glending (21:50)
Somewhere along the line, someone within that practice feels like they need a little bit of help to get where they’re going. Or in in my case, a lot of times it’s because it feels like things are just harder than they should be. ⁓ that’s exactly what I do. So when it feels like you’re just working harder than you really should, when it feels like your days are getting longer, when it feels like
Brett Allen (21:54)
Mm-hmm.
Erin Glending (22:16)
you ⁓ aren’t getting the results that you’re looking for, that’s where reliability, which is what I help practices do, that’s where that comes in. So ⁓ I mentioned, you know, earlier when we were talking that that this really is kind of a top-down approach. So because it is a very different way of thinking about the work that we do and a huge shift in terms of what we think our goals are.
Brett Allen (22:22)
I don’t think it’s my top company.
Erin Glending (22:42)
And how we approach our work, it really does have to come from leadership. So most of the time when I work with practices, ⁓ I do start with the ⁓ the leaders of the practice. So sometimes that is dentists and managers or supervisors, depending on the size of the business. ⁓ sometimes if it’s a really small practice, it’s just the doctor.
And we kind of start out talking about exactly what this means. If if you decide that you want to work on high reliability, ⁓ you you kind of gotta go all in on it because you can’t do it halfway. And and the reason for that is because there is ⁓ there is a there’s a culture piece to this. There is a huge culture ⁓ piece where
We talk a lot, you know, I’m sure you’ve heard or had people on that talk about psychological safety and how it’s it’s such an important thing right now. So one of the benefits of high reliability systems is psychological safety. And the reason is because kind of the first tenant before you even get started on anything else is an agreement that, like from day one, you have decided problems that happen.
Brett Allen (23:37)
Uh-huh, easy.
Erin Glending (24:00)
Are not problems that people have created ever. They’re never people problems. So it’s a shift. And for most businesses, for most practices, you know, you maybe have a person that’s underperforming, a person who makes a lot of mistakes, a person where maybe there’s a lot of errors. And historically, especially in dentistry, you’ve looked at that as an opportunity ⁓ for that person.
Brett Allen (24:03)
Mm. Yeah. Yeah.
Erin Glending (24:27)
Right? Maybe you retrain that person.
Brett Allen (24:27)
Yeah. How do we grow person,
retrain them? Yeah, yeah. Yeah. Yeah.
Erin Glending (24:31)
Yep, you put them on a performance improvement plan, right? You pip them, something like that. ⁓
when you start shifting to high reliability, you realize pretty quickly that that can’t be the case. Because the entire purpose of high reliability is that if I’m with a patient or if you’re with a patient, that patient gets the exact same experience. So
Brett Allen (24:56)
It’s independent of
the yeah.
Erin Glending (24:58)
Yeah, it’s it’s completely independent of what the person is doing. What that means is
that if you have one person or two people and there are errors, you don’t have a reliable system because you haven’t looked at that system close enough to be able to say, okay, wait, here’s this point where if it isn’t exactly the right person in the room, if the schedule isn’t, you know, exactly full to the level that we expect.
Brett Allen (25:10)
Mm-hmm.
Erin Glending (25:27)
If the software isn’t working exactly like we want, something could and and will go wrong. If you haven’t done that, ⁓ then you’re not to the point of reliability. So it is ⁓ it’s a shift and it can be hard at first. So it starts with leadership. So ⁓ I initially start meeting with the leaders, and depending on the practice and what their overall goals are,
That might go on for a while. We might have a number of meetings before they get to the point where they’re really comfortable bringing in the rest of the team. ⁓ we analyze kind of the the areas of the practice where maybe they’re having trouble. ⁓ data and and metrics overall are one of the best tools for me.
Brett Allen (26:06)
Yeah.
Erin Glending (26:12)
and and for practices really generally to be able to see where things maybe aren’t going the way that they should, you can get a really good idea of where something is probably not as reliable as you’d like it to be. We typically start there, ⁓ whatever the the main focus is for the leaders. They can identify really quickly, okay, this is where we really want to start. And then that’s generally what we start to look at.
Brett Allen (26:13)
Mm-hmm, mm-hmm.
Erin Glending (26:38)
The interesting thing is as we start looking, it almost always becomes something else. There’s there’s actually really another thing that is unreliable that is resulting in the problem that you have. And we’re able to find those. ⁓ the the best part about when I work with practices is when we are able to have the entire team involved. ⁓ one of the one of the main
Brett Allen (26:51)
Right.
Erin Glending (27:03)
traits of high reliability organizations is the idea that it’s the people who are actually doing the work that are the experts at the work. So that’s another thing that’s a little bit different in dentistry and another reason why we start with leaders, because most of our systems were not written by the dental assistant that’s doing that work.
Brett Allen (27:26)
The person
who’s yeah, it’s yeah, yeah.
Erin Glending (27:29)
And so it’s a shift to to really be able to say, okay, wait. So it isn’t the office manager that was a dental assistant 20 years ago who’s gonna write the systems and tell everyone how to do it. It’s the person who’s actually doing it that we’re going to defer to as the expert for how this system should work and how it really works. ⁓ you know, there’s so many good examples of this because how often
Brett Allen (27:51)
Mm-hmm. ⁓
Erin Glending (27:57)
Do you and this probably even happens in in your business? It happens everywhere because it’s not just healthcare, but it’s, you know, you have an SOP and maybe you’re training a new person and you’re training them on how to do it. And you hear somebody and they’re like, Well, yeah, but generally in real life, it looks more like this, you know. Like that, it can’t, it can’t go that way. If if that’s what it looks like, if you have a system.
Brett Allen (28:03)
Yeah. No. Organizational behavior. Yeah. Yeah.
We don’t really do it like that. Yeah, yeah, yeah, yeah.
Erin Glending (28:26)
system and you have written steps, but those steps aren’t what people are actually doing, you are inherently unreliable.
Brett Allen (28:34)
Right, right. Yeah. We have a yeah, we have a c one of our core values is fixed processes, not people, which is all around this idea. I didn’t even know this concept of high reliability, but it’s all about if we have the right processes and systems in place, including for hiring the right people, training them, then it’s really not about the people anymore. It’s about are we following the process? ⁓ and it’s not
Erin Glending (28:36)
Енсунару Лейтер сам бредан.
Brett Allen (29:01)
We don’t have to make it personal anymore. It it’s it’s really, you know, are we optimizing for following the process the right way? And or if the process needs to be improved. Yeah.
Erin Glending (29:08)
It exactly. And it’s yes,
and that’s exactly it. And I think that ⁓ you know, it’s one of the things that I think we get stuck on, especially people who are the creators of the systems. So whoever it was that, you know, put their blood, sweat, and tears into the creation of your SOP manual, if there are people who are now saying, yeah, but I don’t think that works.
Brett Allen (29:35)
Yeah. It’s an ego thing. Yeah, yeah, yeah. Sure.
Erin Glending (29:35)
That becomes a, you know, you’re like, yes, it does work. It absolutely works. If you do it the way that I tell you to do it, it absolutely works.
And and that will happen. And so this.
Brett Allen (29:45)
But I can see the challenge
of like when it comes top down process written versus a collaborative approach of bottom up, like working together of like, well, I’m the person who’s actually doing this and I see lots of problems with it. Yeah.
Erin Glending (29:57)
And it gives you an opportunity
too to be able to say, okay, wait, as we’re going through, and it it can be ⁓ it can be a little onerous, right? The process, because you really do have to go through every single thing, every single thing you do, every single step. And you have to say, all right, wait. If we ever work around this step, why are we doing it? What, what’s the circumstance?
Brett Allen (30:08)
Yeah.
Mm.
Mm. Yeah.
Erin Glending (30:24)
When is it that you’re having to do a workaround? When is it that maybe
there’s a mistake here? ⁓ when is it, what does it look like? Who’s involved? How many people? Is there a time of the day? All of that. And you really kind of figure it out so that you can build guardrails. ⁓ and you know, when you and I met, like you mentioned at ⁓ the Speaking Consulting Network meeting, I talked about ⁓ about burnout.
Brett Allen (30:31)
Mm-hmm.
Yeah. Yeah.
Yeah.
Erin Glending (30:54)
And about
how high reliability ⁓ can really cure burnout for teams. And it’s it’s exactly that reason. Because if you can if you can create a system where people don’t have to remember or pivot or plan or reorganize, exactly, it’s ⁓ it’s just so much easier.
Brett Allen (31:00)
Mm-hmm.
Ad l ad hoc, ad lib, yeah.
Mm-hmm.
Erin Glending (31:21)
All of a sudden,
you can just do the work that you’re supposed to do. You can do your job instead of doing your job. And then also the job of in the second, right now in real time, figuring out how to fix your system.
Brett Allen (31:34)
Well, c
being that creative can be so draining because you’re constantly having yeah, yeah, yeah, yeah. I g I get it. Well, this this has been I mean, we could go on and on. And I and I can tell that working with you could I I I can see that this is a deep thing that can really have a big impact for I bet if you look at these practices that are multi seven figure, you know, three, four, five million a year in production.
Erin Glending (31:38)
Yeah.
Yeah.
Brett Allen (32:00)
They’ve got this under control and they’re really doing this well. We look at these practices where the patient experience is is way better than the, you know, the solo practitioner that’s having a hard time and is it’s you know, the ceiling is fifty thousand a month in production. Like there’s there’s a difference and it’s it’s team, it’s leadership, it’s reliability. And so I I would encourage everybody listening to reach out to Aaron.
To have a have a one on one conversation to see how she can help you. Cause there’s way more here I can tell that can have an impact for the practice. But we’re out of time. ⁓ before we go, I always ask everybody, what’s that one gold nugget? That piece of advice that if they you know, if they could implement this, if they could have this epiphany, what is that thing? It it doesn’t have you know, it’s not it doesn’t have to be a huge thing, but
What is that thing that would really help them?
Erin Glending (32:53)
You know, I would say first thing to think about to get started is really the idea of is is doing a better job, being more careful, paying more attention? Like, is that a system? Because when when something is breaking down and we think to ourselves, we have to do better at that, is that really a system? Is that working? Right.
Brett Allen (33:05)
Mm.
Hm. Yeah. How many times do we say that? We need to improve that. And
yeah, what happens? Yeah. Yeah. We need to be more careful. Yeah. Yeah, that’s great. I can think of many parenting moments where I’ve said that. ⁓ Okay, that’s that yeah, goes yeah. It’s ’cause like kids managing kids is like and
Erin Glending (33:16)
Right. Or we just need to be more careful.
Yeah.
There you go. You you can apply high reliability to literally everything in your life.
Brett Allen (33:37)
You know, we’ve got teenagers now. Most of you know, they’re all teenagers, but that, you know, we’re all humans. Like we’re grown up kids, right? And so it’s like, what can we put in place to help us actually do better? ⁓ that’s great. I love that advice. ⁓
Erin Glending (33:52)
And you know, I think some some people are really good at just doing this naturally. ⁓
I think that’s that’s why I do it. That’s why I feel so passionately about it, because I naturally think this way. I am a recovering perfectionist. So I’ve I’ve spent my entire life going through and figuring out, okay, wait, but how could this fail? Okay, wait, how could this go wrong about everything? So it’s it’s easy for me to do it. And ⁓
Brett Allen (34:01)
Mm mm.
⁓ yeah.
How could this be better? Yeah.
Erin Glending (34:21)
You know, I think once you learn ⁓ the traits and you learn how to implement it, it it truly can impact everything in your life, not just business.
Brett Allen (34:31)
Yeah. I I wish we had more time because I was I was gonna ask have you heard of this concept the highly sensitive person by Elaine Aaron? This this book. It’s not that you’re super sensitive in terms of like high maintenance. It’s like you are super aware and constantly analyzing and you you talk about perfectionism, ⁓
Erin Glending (34:38)
Yeah, yep.
Mm-hmm.
Brett Allen (34:51)
Anyway, everybody, th this has been an awesome conversation. thank you so much, Aaron, for coming on. How do we how do people get in in touch with you ⁓ to learn more about working with you or just explore what that looks like?
Erin Glending (34:53)
Ha ha ha.
best way to get in touch with me is through my website, ⁓ eringlending.com. Super easy to find. There is ⁓ any, you know, speaking and consulting can all you can reach out right from that site there. It has a lot of good information about high reliability, about the things that I really touch on too. It’s a good tool.
Brett Allen (35:10)
Nice.
AaronGlending.com. Okay, we’ll put that in the show notes. Thank you so much, Aaron. This has been a great conversation. thanks for coming on.
Erin Glending (35:31)
All right. Thanks for having me, Brett. It was nice.
Brett Allen (35:33)
All right, everybody, until next time on the Marking 32 show. Have a great rest of your day and a great rest of your week. Take care.
