PATIENT’S OFFICE JOURNAL Any information or patient communication should be documented in the patient’s office journal. CONTINUING CARE REPORT Continuing Care Report is run on the 20th of the month or whatever day is close to this. Here is how to run the continuing care report Open continuing care from the scheduler. Pick “Views”, temporary view. (‘Continuing Care Views setup’ lets you set your own custom template) In the “type” field pick the type of recall report you want (prophy, perio, etc.) Then in “Sched. Apt” pick “ only WITHOUT” Then Select your desired date range, then click OK. Reports to print monthly: Prophy, child prophy, and perio CONTINUING CARE POSTCARDS These are sent out on the 15th and 31st of each month. The cards sent out on the 15th are for patients who need to make appointments for the next month. The postcards sent out on the 31st are for those patients who have existing appointments, and this serves as a reminder. CONTINUING CARE WITHOUT APPOINTMENTS Sent on the 15th of the month Office Manager, Letters and custom lists, CC no Appointment, EDIT 2 Fields 47
“Appointments” (Change date) and “Continuing Care” (Change Date), Click OK, then Create. It will pull up word and then load postcards in the feeder (not drawer) white side up, and click Print. Do not save changes. CONTINUING CARE WITH APPOINTMENTS Office Manager, letters and custom lists, continuing care, continuing care with appointments, edit, change date to desired date range ( 1-15th, 16th-31st) Click “OK” click “Create /Merge”, OK Put postcards in feeder white side up (not drawer). Never save changes. HOW TO E-MAIL AN X-RAY Open Dexis and select image to be sent, drag it to the export file folder, and a popup window will open where you can select additional images and chose to do so—either as an individual or as a set, x-ray will go on the desktop, open the e-mail, add attachment, and select the images to attach. Send e-mail. Then Delete the image from the desktop after e-mail is sent. CHARTING PAYROLL HOURS On Mondays -- Pull the payroll report on each employee and put the daily hours worked on the monthly calendar with the weekly totals listed on the left. On the day before payroll is to be called in—Dr. Lind and the front desk person go over the payroll sheet so that all of the totals are correct, and Dr. Lind will call the payroll in to the payroll specialists the next morning. If we have a temporary employee for the day, the front desk person will call the hours in to payroll and place the gross amount and net pay on an envelope and give this to Dr. Lind so he can make a voucher check for the temp employee. All temp employee’s need to fill out a W-2 before we can call the payroll in for them. Only Dr. Lind can change the rate of pay for an employee. 48
WHAT TO SAY IF A PATIENT IS LEAVING THE OFFICE – ALWAYS LEAVE A STICKY ON DR. LIND’S DESK WITH THE PATIENTS NAME AND ADDRESS AND WHY THEY ARE LEAVING THE OFFICE. HE ALWAYS SENDS THEM A PERSONAL NOTECARD. I am very sorry to hear that you are leaving our office. Obviously that is the last thing we want you to do. It really helps us improve our service to our patients if you would tell us why you are leaving Dr. Lind’s Practice. Was there something we did or didn’t do that made you make this decision? We really value your opinion and will take what you tell us to heart. Thank you for sharing this information with me. We have really enjoyed having you as a patient, and if we can ever be of service to you, please do not hesitate to call us. We want to wish you the best of luck. ASSISTANT DUTIES GREETING THE PATIENT How we speak to our patients when we bring them to the operatory, during the procedure, and at the checkout at the front desk. When we bring a patient to the back operatory. Pick up the routing slip, the health history update, new health history, treatment plan sheet, and consent forms or whatever forms apply to that patients appointment. Take these sheets and walk to the lobby and greet the patient, then bring them to the operatory where we are set up for them. Place a patient napkin on them and give them safety glasses, adjust the headrest, and if we are doing a procedure requiring anesthesia, ask them if they would like to take Tylenol and or Advil before the procedure. For longer procedures, ask them if they would like to watch a movie or listen to music. 49
Then ask them if they have any questions about the procedure being done today. If we are doing a composite, explain to them that they need to avoid colored fluids for 48 hours on anterior teeth and 24 hours on posterior teeth. If we are going to use a rubber dam or an optergate, explain what it is and why we use it for the procedure. During the procedure – ask them if they are comfortable, do they need additional suction, and reassure them that the procedure is going well. When we are finished, the assistant and the Doctor show the patient what we have done and let the patient know that everything turned out great. We then give them post op instructions to take home after the procedure. If anesthesia was used or a crown delivered, let the patient know that Dr. Lind will call them that evening to make sure they are doing well. Answer any questions they may have, and then give them a hot refreshment towel to wipe their face off with. We then tell them what their next procedure will be, how much time it will take, and why it is important to get it taken care of before they have a problem with the tooth. Take the patient to the front desk. If another patient is at the front desk, ask the patient to take a seat and tell them the front desk person will be with them as soon as possible. Place the routing slip on the front desk, so the front desk person can check them out and make their next appointments. ASSISTANT DAILY DUTIES Arrive thirty minutes before the first patient arrives. All room should have the proper trays set up from the night before. Turn on the compressors for the hand pieces. Turn on all the computers and lights in the back treatment rooms. Open trays up, set up the rooms, and then cover the tray setups with a napkin. Make sure all hand pieces are set up. 50
Empty the sterilization unit, and get the instruments out of the cold sterile. Load the ultrasonic with solution and distilled water. Make sure all the operatory rooms have adequate water in the water bottles. Turn on the warm towel heater and make sure it has enough towels for the day. Turn on the diode laser and pull the tips for the patients having laser done. Open the chart in each operatory for the first four patients of the day. Be ready for the huddle patient – take the instruments and hand pieces and burrs to the back sterilization area. Wipe down the room and set up for the next patient. If the Doctor is doing a cleaning, ask him what the various levels of plaque, heme, stain and calculus. Typically you will write up the chart for prophy, perio recall patients. The Doctor will write up the charts for other procedures. We work as a team on this. The front desk person will go over these charts the next day to make sure that we did not make any errors. Those are always corrected before the end of the day. The assistant will take a 30 minute lunch break coordinated with what the schedule allows. END OF DAY DUTIES Make sure all treatment rooms are set up for the first four patients of the next day. Make sure the chairs are in an upright position, place a napkin under the foot petal on the chair. Make sure all units are turned off, the cavitron unit is turned off, and the computers are shut down for the night. Make sure the sterilizer is loaded if we have extra instruments to run. Make sure the ultrasonic machine is drained. 51
Place fresh towels out on the back counter. Make sure all the lights are turned off in the sterilization area. Make sure all operatory lights are turned off. If you are the last one to leave, make sure the office lights are off and the monitors on the front computers are turned off, the compressors are turned off and you lock the front door on leaving. Make sure you check out on the time clock on the computer. Hang your lab coat up in the back break room door or closet. If the phone rings please answer it and help the patient with their needs. WEEKLY ASSISTANT DUTIES 1. Make sure all drawers are neat and stocked. If we are low on a supply then place this on the supply list on the sheet above the sterilizer in the sterilization area. 2. Check and clean impression trays and sterilize them. They are under the sink in the lab. Change the solution in the canister as needed. 3. Run sterilization check on the sterilizer and mail it off to the sterilization monitoring company that we use. They will send a report to Dr. Lind and they will call us if there is a problem with a spore test result. 4. Check and clean the amalgam traps each week. You can change the traps if they start to get worn out. We have extras in the supply closet in the break room area. 5. Check plaster trap under the sink in the back. Let Dr. Lind know when it is full and we will change it and order a new one. 6. Check the Isolizer under the back sink, and when it is getting full, let Dr. Lind know so that we can order a new one and retire the old one. Dr. Lind will add the chemicals needed to solidify the solution that surrounds the needles, and then we dispose of the container once it is all solid. 52
7. Clean and run the hand pieces as per the instructions from mid west. We place the hand pieces in the beaker in the ultrasonic and let them run for five minutes. Then we relube them and run them through the sterilizer once they have been cleaned are relubricated. 8. Clean up the lab counters and change the plastic covers as needed 9. Check the supply list, and if any items are needed ASAP, please place the lab sheet on Dr. Lind’s desk, and he will place the order. 10. The last day of the week, please place the towels that need to be cleaned in the white bag in front of Dr. Lind’s office so he can get them laundered. ASSISTANT MONTHLY DUTIES 1. Clean out the sterilizer with the proper solutions. 2. Clean up back store room and make sure all the supplies are neat and orderly so that we can find the supplies we need. 3. Mike up the cold sterilization solution and change it and mark the cold sterilization box with the next date when it has to be changed. 4. Oil the slow speed hand pieces in the treatment rooms. Two drops of oil in the brass fitting. 5. Make sure all cabinets in the back operatory areas are neat and clean. Make sure everything is organized and easily found. Let Dr. Lind know if anything extra is needed such as trays, broken instruments, cavitron tips that need replacing. 6. Make sure any extra instruments are put back in the proper hygiene packs so that the packs are all complete. HYGIENE DUTIES Arrive fifteen minutes before your first patient. This is critical. This allows you time to review the routing slips of your patients. Do they have any special needs, do they need premed etc. Are they going to have LBR done? If you have time, pull your patients LBR tips Make sure you note which patients on your schedule need x-rays, periodontal probing. 53
Make sure the barriers are set up in your operatory and that you are ready to see the patient when they arrive. Please seat your patient on time. Make sure you have their routing slip in your operatory. You have one hour per patient. This includes taking x-rays, cleaning the patient’s teeth, probing as needed (we probe each patient once per year), and we spot probe any pockets greater than 4mm at each visit. If you notice pockets are deepening, anything over a 5mm pocket, let the patient know this is not good, and they will need extra attention in that area. Explain what root, plane, and curettage are and why they are helpful. Explain LBR as well as laser assisted periodontal root plane and curettage. Please use the hygiene templates to chart your patient’s treatment. If you need to do periodontal probing, please grab one of the assistants or the front desk person, if not busy, can help you with this. Make sure you finish your patient ten minutes before the hour so that Dr. Lind can come in and do an exam. We co diagnose in the office. Please let Dr. Lind know of any areas of concern, increase in pockets, broken fillings etc. The two of you will determine what needs to be the patient’s next appointment. The next appointment is placed on the routing slips. Give the patient a hot towel and take them to the front desk to schedule their next appointment. Then come back to the operatory and wipe you room down, take your instruments to the sterilization area, and get ready for your next patient. It is critical to run on time. Make sure you are done ten minutes early so that you and Dr. Lind can do his exam. Show the patient where they are missing with their brushing and flossing. Explain the value of Fl- to the patient and see if they need to purchase any more fluoride or bleaching gel. 54
EIGHT RULES FOR A SUCCESSFUL HYGIENE VISIT BEING ON TIME IS CRITICAL FOR PATIENTS. WE NEED TO SHOW THEM WE VALUE THEIR TIME. IF THEY NEED TO COME BACK FOR A FINE SCAE, EXPLAIN WHY AND REAPPOINT. 1. We ask the patient. “What’s new in your life” How is your mouth feeling? Any changes in your health history that we need to know about. 2. When the patient is late. We tell them we are sorry they are late, and we will do the best job we can in the time that is allotted. We explain to them that when they arrive on time, we are able to do our best job for them. 3. Then ask them how everything feels. If they have a complaint, we need to check that out. If an x-ray is needed, please take it. 4. Then go over their mouth with the explorer to see if anything is broken or cracked and bring it to their attention. If a photo is needed, please take an intraoral photo with our camera. 5. If their pockets are 5mm or greater – tell them about root planing, tell them about Perio Rx and how that will help them reduce their pocket depth. 6. As you clean their teeth, tell them where they are doing well and where they need improvement. Demonstrate proper flossing and brushing technique as needed. 7. Ask the patient if they are dry brushing using floss or using Fl-. Answer any questions they may have. 8. When Dr. Lind comes in to do his exam---he will ask you how the patient is doing. You will tell him about their perio pockets, any work that you see that needs to be done, and if you recommend perio RX or Fluoride rinse or gel. The key is for the Doctor and Hygienist to work in concert to help the patient. 55
PHONE SCRIPT FOR THE FRONT ANSWERING MACHINE Thank you for calling Dr. Lind’s Office. We are either helping another patient or out of the office. If this is a dental emergency, please call Dr. Lind’s cell at 619- 851-1578 and leave a detailed message about the problem you are having and the best number to reach you at. Dr. Lind will call you as soon as possible. If this is a scheduling question, please leave a message for us with the best number to reach you at, and we will call you as soon as we are able. Thank you and have a great day. MESSAGE WHEN DR. LIND IS GOING OUT OF TOWN AND ANOTHER DOCTOR WILL BE COVERING FOR HIM Thank you for calling Dr. Lind’s Office. Dr. Lind will be out of the office from ___________________________to_____________________________________ Dr. ___________________________will be covering Dr. Lind’s emergency call during this period. Please call _________________________(phone number) and Dr. ______________________office will be happy to assist you. If this is a scheduling question or you would like to make an appointment, please leave a message, and we will return your call as soon as possible. Thank you. 56
HEPATITIS B VACCINE I have completed the hepatitis B Vaccine in ________________year: I realize that every ten years I may need to have a backup vaccination. This would be determined by my physician and would require a blood test to check my titer of antiviral activity. I have not completed the Hepatitis Vaccine series, but I realize it is important to have it done to prevent Hepatitis B. Dr. Lind will pay for the vaccine for me. I know the Hepatitis Vaccine is important, but I choose not to have it at this time. I realize I may contract Hepatitis B if I do not have the vaccine. ________________________________________________ Date __________ Employee signature Employee name printed 57
EMPLOYEE ACKNOWLEDGEMENT FORM I acknowledge receipt of the General Office Policy Manual. I agree to familiarize myself with the information contained in the manual and to observe and comply with the policies and procedures described in it. I understand that I should consult the Office Manager or Dr. Lind regarding any questions I may have about the manual. I understand that my employment relationship with this Dental Office is not for a specified time and is “at will,” which means that either I or the Dental Office can end the relationship at any time, with or without cause or advance notice. I understand that the “at will” nature of my employment cannot be changed except in a writing signed by both me and Dr. Lind. Since the information, policies, and benefits described here are necessarily subject to change, I acknowledge that revisions to the manual may occur. Except for the nature of my at will employment, I understand that the Dental Office may change, rescind, terminate or add policies to this manual in its discretion. I acknowledge that the Dental Office will interpret the policies in this manual and may deviate from them when, in its discretion, it determines that doing so is appropriate under the circumstances. Furthermore, I acknowledge that this manual is neither a contract of employment nor a binding legal document, nor is it intended to alter the nature of my at will employment. EMPLOYEE’S NAME (printed): _______________________________________ EMPLOYEE’S SIGNATURE: _______________________________________ DATE: _________________________________ 58
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