Assisted Hygiene Model of Efficiency, Productivity and FUN A Continuing Education Course for Dental Professionals Presented by Dianne Glasscoe Watterson, RDH, BS, MBA 2825 Roderick Road, Frederick, MD 21704 (301) 874-5240 fax and office Email diannemba@gmail.com Web 2013. All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transcribed in any form without the prior written permission of Dianne Glasscoe Watterson.
1) Assisted Hygiene What it is NOT: hygiene Hygiene on Prophys every doing prophys What it IS: Better use of when needed Better Less fighting the Essential Elements of a Dental Hygiene Visit Assistant time Hygienist Time Set up operatory 5 Review patient record 1 Seat patient and greet patient 2 4 Take blood pressure 1 Review medical history 3 Oral cancer screening and head and neck exam 2 3 Expose any necessary radiographs 5 Inquire about dental concerns 1 Plaque control and oral hygiene instructions 5 Discuss dental needs 5 Periodontal charting 5 Prophylaxis 20 30 Signal and wait for doctor 10??? Dispense oral hygiene aids 1 Record areas of caries or other pathology 2 Relate concerns to doctor 2 Make patient s next appointment 3 Document in patient chart (computer) 5 Dismiss patient 2 Operatory turnover 5 Sterilization 5
2) Disadvantages of solo hygiene is often delayed or not done at all. Hygienists spend copious amounts of time in activities. Productivity is due to limited scheduling. Other staff members are when another set of hands are needed. Hygienists are forced to waiting for the doctor to perform the exam. 3) Pre-requisites for the assisted model Two mirrored hygiene operatories that are fully equipped and stocked A dedicated hygiene assistant An understanding of how to engineer an assisted hygiene schedule 10-minute increment scheduling A commitment to implementation and patience during the adjustment period. 4) Comparison of productivity between solo and assisted hygiene Hygienist without an assistant Assume one patient/hour and a 32-hour week, three cancellations, hourly pay at $35/hour Average cost of dental hygiene appointment - $150 (including doctor exam) 32 patients X $150 = $4800 Subtract 3 cancellations (450) TOTAL 4350 Subtract salary (1120) Subtract benefits (6%) (67) GROSS PROFIT $3163 Hygienist with an assistant Assume one patient per 40 minutes, 32-hour week, four cancellations. Assistant salary @$12/hour 48 patients X $150= $7200 subtract 4 cancellations (600) TOTAL 6600 Subtract hygienist salary (1120) Subtract assistant salary (384) Subtract benefits (6%) (90) GROSS PROFIT $5006 Productivity $5006 (assisted) -3163 (solo) $1843/week X50 weeks worked in a year $92,150 extra potential profit with assisted hygiene
Sample Assisted Hygiene Schedule Using Two Operatories Room 1 Personnel Hyg,Pro Dr.Pro Room 2 Personnel Hyg.Pro Dr.Pro 8:00 Recall 1 - seat, greet, update A 8:10 1110 H 93 8:20 274 H 70 Perio Patient, seat, update A 8:30 120 H 45 OHI review, disclose,anest A 8:40 OHI, Dr. exam A Perio scaling H 8:50 Reappoint, dismiss A 4341 H 220 9:00 H 9:10 H 9:20 Recall 3 - seat, update A H 9:30 1110 H 93 Dismiss, reschedule A 9:40 120 H 45 A 9:50 H 10:00 H Recall 4, seat, update, x-rays A 10:10 Reappoint, dismiss A 1110 H 93 10:20 274 H 70 10:30 120 H 45 10:40 Perio or recall 5 A H 10:50 4910 H 125 Dismiss, reschedule A 11:00 180 H 65 11:10 H Sealant or child prophy, seat A 11:20 Dr. exam, dismiss, reappoint A 1351 X 4 H 160 11:30 room set-up H 11:40 H 11:50 Dismiss, reschedule A 12:00 LUNCH 12:10 12:20 12:30 12:40 12:50 1:00 Recall 7 A 1:10 1110 H 93 1:20 274 H 70 1:30 120 H 45 Recall 8 A 1:40 Dismiss, reappoint A 1110 H 93 1:50 274 H 70 2:00 Recall 9 A 120 H 45 2:10 1110 H 93 Dismiss, reschedule A 2:20 274 H 70 2:30 120 H 45 2:40 H Recall 10 A 2:50 Dismiss, reappoint A 1110 H 93 3:00 120 H 45 3:10 Recall 11 A H 3:20 1110 H 93 Dismiss, reschedule A 3:30 120 H 45 3:40 H Recall 12 A 3:50 Dismiss, reappoint A 1110 H 93 4:00 272 H 50 4:10 Recall 13 A 120 H 45 4:20 1120 H 72 Dismiss, reschedule A 4:30 1203 H 30 4:40 272 120 H 50 45 4:50 Dismiss, reappoint H/A 5:00 Total prod. this column 952 335 Total prod. this column 942 180 Total Production $2,409
5) Advantages of assisted hygiene Hygienist always had someone to assist with. Hygienist has assistance with. Hygienist never has to for the doctor. Hygienist does not spend productive time performing operatory. Productivity can increase from 7-9 patients/day to patients/day. Hygienist will see more patients and be tired at day s end. The work is far more with an assistant than without. 6) How to sabotage the assisted model Not having that are fully stocked and equipped. Hiring an and not dedicating her to hygiene. the hygiene schedule. Not being committed to. Katherine 3 month stats D1110 D1120 D1203 D1206 D1351 D4341 D4342 D4355 D4381 D4910 D0210 D0274 D0330 D0020 D0021 TOTAL PRO Month 1 76 14 14 0 4 0 0 1 0 0 7 42 5 24 24 10,990 Month 2 73 12 12 0 0 0 0 1 0 0 2 32 7 20 22 8,973 Month 3 79 12 12 0 0 2 0 0 3 0 2 43 15 20 20 11,022 30,985 Gross pay 14,592 Salary/production ratio 14592/30985 = 47% Christy D1110 D1120 D1203 D1206 D1351 D4341 D4342 D4355 D4381 D4910 D0210 D0274 D0330 D0020 D0021 TOTAL PRO Month 1 79 16 16 4 4 5 13 0 6 6 6 40 8 35 79 15,324 Month 2 79 14 14 6 4 8 15 2 5 10 6 38 4 40 79 15,782 Month 3 74 13 13 4 0 9 12 1 6 5 8 42 6 32 74 14,459 45,565 Gross pay 12,288 Salary/production ratio 12288/45565 = 27%
7) Things that decrease productivity in general Improper Too much Unbalanced. No adjunctive being offered Failure to perform comprehensive 8) Positive ways to increase productivity Improve Decrease with effective communication skills and recall system Improve the mix Offer such as power brushes and intrapocket therapies Full & recording on every adult patient once/year Implement