Written by Deborah Dopson-Hartley, RDH Friday, 31 January 2003 19:00
Time is the one thing that is equal in all of humanity. How one chooses to spend that time, however, is not.
KNOW THE DAILY GOALS
The scheduled daily production goal and the scheduled for next hygiene visit goal should no longer be the only considerations in a hygiene day. Today’s progressive hygiene departments have daily sales presentations and sales acceptance goals that we are responsible for as well.
THE AFTERNOON HUDDLE
At the end of the day have a mini afternoon huddle with the doctors, hygienists, and scheduling coordinators and analyze each patient to see who did or did not schedule, and why. These are very valuable numbers, and everyone should be tracking them. They will reveal staff members’ strengths as well as weaknesses.
REVIEW PATIENT CHARTS WHILE AUDITING THE COMPUTER
Even though this course of action takes time, it is the best time-saver the hygienist can do to prepare for the day. It could be done during downtime or at the end of the day. The information remains fresh in your mind when you do it before the day begins. Reading through the progress notes while reviewing the charts allows us to be familiar with patients before they are seated. It allows us to gain accurate knowledge of what patients will need in hygiene services for the day. For example, the type of hygiene therapy, updating the periodontal charting, which radiographs or photography might be necessary, whether the patient is due for their annual examination, or whether the exam will be necessary because of an already known chief complaint made during confirmation. It also alerts us to some of the other possible time pitfalls, such as the need for premedication or the use of nitrous oxide. Reviewing the patient’s treatment plans and reading the progress notes for past chief complaints, concerns, or comments by both the doctor and hygienist allows both to formulate a presentation that is collectively well focused. The hygiene team will then know in advance what could or will be needed, such as a bite adjustment setup, imaging through a consultation, or possible work-in treatments like sealants or bleaching. Auditing the computer by updating the patient’s real treatment needs gives an accurate projection of the daily production goal and treatment. Instead of using the computer program’s generic codes as your guideline, type the needed treatment, like BWX, Pano, 4910, Exam.
The patient’s name and information from the audit should be transferred to a sticky note and written in black ink to indicate preexisting treatments. Save room for the patient’s current chief complaint or for case acceptance, which should be written in a different color for easy recognition. The sticky note is given to the doctor before he/she leaves their treatment room so they can be familiar with all treatment needs and know what has already been discussed. This in itself will make the exam time quicker, more efficient, and effective.
THE MORNING HUDDLE
This is the next best time- saver, and is absolutely necessary for everyone on the team. It averts stress by effective communication and sharing what we learned from the audit and the phone calls too. It is with this information that treatment rooms are delegated.
Have all rooms equipped, stocked, and supplied for whoever needs to use them. The old protocol of “my room …my stuff” should no longer be acceptable as the norm, not in today’s high-paced, high-demand environment. Rooms are where income is made through production. Empty rooms should be considered overhead.
PROPHY POLISH THE CORONAL SURFACES FIRST
Polishing first with a mild and effective prophy paste compound before the scaling procedures will ensure that you will work in a cleaner, healthier environment. This prevents the massive transmission of bacteria from entering the patient’s bloodstream. It saves the time normally spent rescaling and repolishing tenacious stain, and reduces the hand fatigue commonly associated with heavy-handed stain removal.
ORAL HYGIENE EDUCATION, COMMUNICATION, AND INSTRUCTIONS
Education means taking something that is simple and making it seem more complex. Communication is about taking something that is complex and making it sound simple. Let’s use flossing as an example. For many, flossing is the key, but instead of being the answer, it’s the solution. Few patients are interested in a solution until they truly understand the problem. Once patients comprehend the problem, they will own their disease and will want to know what they can do about it.
The controlled application of topical anesthetic followed by thorough rinsing throughout the appointment allows for a more comfortable and accurate periodontal probing and scaling. As always, check the medical history for prior allergies, and be alert for any current reactions.
Hand instrumentation should be an important part of your armamentarium because it enables you to feel every surface on every tooth, confirming that the roots have been properly cleaned and planed. It also allows you to feel for decayed surfaces, marginal breakdown of older, worn restorations, and areas of sensitivity. Many times patients will feel these problem areas at the same time as the therapist, which opens the doors to communication about treatment. It also allows you the flexibility to educate and communicate, to help influence the patients into understanding, accepting, and owning their dental disease. Hand instrumentation helps make communication easier and more patient-friendly by overcoming the distractions that occur from the combination of the noises from the use of ultrasonic instrumentation, water, and suction.
Scripting—the study, discussion, and internalizing of words and phrases to use (and words and phrases not to use) along with all the reasons why—is the ideal way to ensure consistent five-star service in your practice. Scripting can and has improved the service, profitability, efficiency, and harmony of countless thousands of businesses. How can a staff member or any of us be expected to “wing” answers on the spot? Studying scripts means studying the reasons behind the scripting. You can’t have one without the other.
PATIENT CD ROM EDUCATIONAL SYSTEM
The hygiene appointment is near completion, the hygienist has found the problems, addressed the patient about probable treatment options, the doctor has confirmed the treatment plan, and now the hygienist must find the time to write an accurate treatment plan in the chart and pass it to the appropriate front desk coordinator for the last final touches. This is where an educational system such as CAESY is invaluable; it provides an educational service to the patient while the hygienist completes the tasks necessary before releasing the patient.
Counting time isn’t nearly as important as making time count. Learning to take advantage of time to its maximum is essential to arriving at your destination in a timely manner, and making the journey an enjoyable one. The point of exploiting time is not to cram more responsibilities into the day, but to use the time we have more effectively, so that it is not squandered but is invested in the people and projects that are most important.
Ms. Dopson-Hartley is widely known for being the most profitable hygienist in the country. As a full-time, hands-on, practicing hygienist for 26 years, she works her own successful business program that not only increases her own hygiene production to over $23,000 per month while working only a 3-day work week, but is instrumental in her ability to help influence and promote ideal comprehensive aesthetic and restorative dentistry for her dentist. For more information on her consulting, seminars, and advanced workshop training series, call (813) 985-5516 or visit her website at DeborahHartley.com.
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