The Challenge of Team Building During Operational Change

By Marisa Munoz-Parada, Practice Administrator

Efficient operations form the solid foundation on which successful practices are built. Implementing operational change can often create fear, anxiety, and resistance among clinicians and staff. This uneasiness further affects the practice’s ability to “team build” and create and maintain a healthy practice culture. Although team building and operational change appear to be in opposition, they can be successfully integrated and achieved with care from both the office administrator and the clinic’s owners.

When I began my tenure as office administrator in 2012, I had the opportunity to experience this challenge firsthand, implementing needed operational change while maintaining, improving, and refining our healthy culture of team building. I quickly realized that many “best practice” protocols were in place. Front office procedures, business development programs, and clinical practice metrics were efficient—developed by lessons learned since the clinic opened in 2008. In spite of these protocols, a lack of efficient EMR and billing software use, weak clinician billing practices, documentation, and follow-up on cancellations needed attention or in some cases, complete overhaul.

We began by establishing the culture of absolute teamwork and purpose. Christoph Lueneburger, a Harvard Business Review contributor and sustainability expert, states: “When a company communicates its purpose [a pledge to do the right thing] and demonstrates a strong commitment to it, the company becomes a force for good and creator of value for all stakeholders, especially employees.”1 We achieved this goal with frequent and effective communication and operational changes reflective of our mission—fine-tuning, polishing, and building our teamwork “mojo” one operational change at a time.

We demonstrated the importance of every job function to employees by educating all staff on how lack of purpose on one employee’s part could negatively affect all others. This often became humorous when front office staff shared their daily work experiences with clinicians, although it brought to light the need for care and purpose with our individual actions.

As expected, this took time as well as patience, but the information provided to the owners, clinicians, and staff relieved the fear of change and fostered the team building culture that we were striving to achieve. In a sense, we became more vulnerable but were able to work together and move forward with the solutions.

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Although I can cite many examples, one stands out: accountability and follow-through on the part of each staff member. In the past, many changes were implemented only to fail because of inconsistent follow-through by the staff and poor accountability monitoring by the administration. Staff grew to expect it. Accountability and team building waned and the operational change fell away. Looking back, this was not only a disservice to our practice but also to the employees who were receiving mixed messages about our culture and what our expectations were of them.

We corrected this by returning to several processes that had fallen victim to complacency and reintroduced them with a new fervor to appropriate staff. As the administrator, I (along with the owners) made sure all questions and issues that arose were addressed immediately to ensure success. Staff members became more engaged and proud of their accomplishments and those who were at the top of their game were rewarded with small incentives such as gift cards and recognition throughout the practice. We all had a purpose and were each an important link in the chain. All in all we have made tremendous progress.


1. Christoph Lueneburger, Harvard Business Review, website / Published December 3, 2014. Accessed April 2015.

Marisa Munoz-Parada is practice administrator for Rozina and Smith Physical Therapy in Upland, California. She can be reached at

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