PROTOCOLS

 

 

All members of staff should please read, sign and date these protocols

 

These are additions and modifications of on-going practice protocols

 

Project management officer

                        Food for thought : Avoid negative People.

 

Minimum 2 surgeries to survive

• 2 surgeries X 6 days = ‘’12 day’’ a week  
• Minimum 6 days a week    
• Target £1K per day.           

Needs – x-ray machine     £3K

Service compressor

Equipment & materials

Dennis to render walls

 

Patient tracking

Each patient attending for an appointment should be tracked as their treatment progresses from start to TCA (to come again) to DTC (dental treatment complete).The tracking should be done by the nurse. The nurse should hence have a list of on-going patients for their dentist and be fully aware of :

• What the patient is having done
• How far their treatment has progressed and
• when it should be finished.

This list should always be accessible to the dentist and reception.

 

Dental lab work

Lab work is not being effective tracked at the moment. Lab work should be tracked from impression stage through when it goes to the lab, back to practice and is fitted in the patient’s mouth. When the impression is taken, the lab docket should be filled by the dentist and handed over to the nurse. The nurse should enter in the surgery lab book the name of the patient, the date and the lab the work is going to and then hand the work over to reception. This lab book will be made available via this link to all members of staff. The lab book is the responsibility of the nurse and she should have it accessible at all times. The nurse should also make sure there are adequate lab dockets  (crown & bridgework (Paul) and denture work (Stefan) available in the surgery at all times. The nurse should work with reception to keep track of the work to make sure it has gone to the lab and communicate with reception as to when it would come back. The nurse has to make sure the work is back at least 1 day before the patient’s appointment. Patients attending to find out their work is not back is not acceptable. Also it is not acceptable for lab work to be sitting in the drawers for weeks and weeks. The nurse should work with the reception to chase up the patient for fit.

 

Patient care

Patient recalls for Private patients should be sent out once a week. This list shoud be compiled 6 months from the date a patient has a check-up. We hope this can be done automatically from the database.

Patient reminders should be sent the day before their appointment by SMS &/or e-mail.

Tis should be done by reception or floating assistant.

The patient list for the following day should be printed out and the cards pulled out the day before. The nurse and reception should be familiar with who is coming in and what they are having done. Please check again to see that the lab work and everything else is available.

NHS appointment cards to be printed saying : ‘Limited NHS appts available. If pt misses 2 appts willno longer be seen in practice’’.

Private appointment cards to have various promotions on them

New Database

This needs to be updated regularly. This is the responsibility of the dentist that their patients both NHS and Private are placed on the base. Each dentist should occasionally check the Dbase (Query) to check the status of their list.

Dentists should also work with reception to send out various sales and promotions to various categories of patients.

 

State of Surgery

The surgeries should remain clean, tidy and clutter-free at all times. This is the responsibility of the nurse. It has a major impression on the patients’ mind-set. The surgeries are not being looked after enough by the nurses. Please take not of equipment, instruments, worktops, floors, windows, clinical and admin waste etc.

 

Waiting room & Reception

These 2 rooms tend to get filled with clutter. The reception should be kept nice and tidy with as much paper as possible being scanned into organised folders and shredded. The reception does not have enough confidentiality as both patient records and confidential papers are common seen left in inappropriate places. There is also too much clutter. The 2^nd desk is the manager’s desk and should be kept completely clear. A minimalist view should be considered in dealing with this room.

The waiting room should be kept clean, neat and tidy. Everyone should see to this.

 

Stock check

This is reasonable but could do with improvement. We have an idea how much stock costs us every month. Our main supplier is Dental Directory. Stock check should be done as such. Every Tuesday the nurse should pick up the list and tick items that need to be ordered and give to reception. Reception will then place the order and keep the list. This list should them be pinned to the order list when it arrives, the value entered on the audit file and then filed away.

We occasionally have deals and offers from other companies. These should be considered.

Admin should please flag up each month we go over budget. Set up £400 SO to dental directory.

 

Implants & abutments

Dental Implants are one of the most lucrative aspects od dentistry. We are doing too few and too far apart. The implant protocol for the practice is very poor:

• Only WT knows and understands the systems
• All dentists and nurses should understand the basic principles, stages and components of dental implants.
• The cases take too long to finish
• Advertising is very poor

The practice has written protocols for dental implants. All members of staff should be trained and conversant with this protocol.

Bills, rates etc

A list of outstanding bills, invoices and rates should be listed and dated. We should have a maximum amount of outstanding debt beyond which active steps need to be taken.

 

Salaries & wages

Salaries to be paid by standing order

Wages to be paid through update of spreadsheets set on PC

Info to be sent monthly to accountant PAYE

 

Audits

Audits indicate practice performance and provide accountability of the business. To be carried out monthly. Last audit was done in February : ( These are a matter of priority as this is main practice barometer. All admin staff should be fuller aware of how it works. A whole day a month should be dedicated to this. Please be fully aware of all documents needed for audit.

 

Daybook check / bookings

‘’1 week in advance’’ policy – It was quite common in the days Ola was running the practice that bookings were (deliberately) spread out thin resulting in very low gross relatively to overheads. This being found out on the clinic day is too late and should be checked at least 1 week before. Fragmented days should be consolidated to save on unproductive Practice hours and money being wasted.

 

Time means money

Each hour the practice runs costs money whether we gross or not. It currently costs circa £13,000 to run the practice. Our only source of income meanwhile is patients. We have to work on the principle of ‘A PATIENT HAS JUST WALKED IN, TELEPHONED OR SENT AN E-MAIL. HOW MUCH MONEY CAN THE PRACTICE EARN OUT OF THIS PATIENT?’ This involves marketing skills, compassion, good chair-side manner and excellent clinical skills.

This involves all members of staff. Please remember the pathway:

                  Marketersà Receptionists àDentists

All members of staff should be fully conversant with their roles as well as those of all other staff.

 

 

Merchandise & Sales

We should as has been suggested by Oksana, restart sales of merchandise such as toothbrushes, paste etc again. In the past a good source of income was sales of Antibiotics, painkillers and mouthwashes. We should reactivate our catalogue and prescription for these as soon as possible.

 

DENTISTS * MANAGERS * RECEPTIONISTS * NURSES *  PA’s * FACILITATORS * PATIENT LIAISON

 

 

Practice meetings

These are a means of expressing and discussing issues in the practice and opening communicating on issues. These meetings should take place at least every 2 weeks if not weekly. They last only 1 hour and practice meeting time should be protected.

 

Policy reviews on Induction list

During initiation into the practice, new staff undergo Induction. Issues covered on induction tend to be forgotten over the course of time as a lot of the issues or often not encountered. This poses as a risk. The issues on the induction list should be covered once a month by all members of staff and documented and signed.

Staff Contracts

We currently do not have any contracts enforced. These will all be renewed and enforced. This should be overseen by Admin. Pls check, CPD’S, Hep B, Indemnity etc

 

Profit & Loss

As mentioned before a constant source of losses the practice running unproductive hours.

We need to set up a regulatory system that makes sure support staff come in only when necessary. This was a major opportunity of staff in the past to illegally profiteer on the practice. The admin officer in charge has to keep an eye on staffing rotas against bookings at least a week ahead. It may be a good idea to create flexibility with staffing hours.

 

 Staff training & CPD

These should be overseen and regulated by Admin. Special reference should be focused on core subjects.

 

Marketing

To sort