Early Childhood Caries Management Holding the Gains Wednesday, June - - PowerPoint PPT Presentation

Early Childhood Caries Management

Holding the Gains

Wednesday, June 22, 2016 1:00-1:45pm ET

Agenda

Man anaging aging th the Sc e Schedu hedule le

Poll:

Within the last month, how many of your scheduled patients returned for on-time recare?

• A. Recare? I am lucky if I get patients to keep their initial

appointment.

• B. Like…about 5?
• C. About half of our scheduled patients.
• D. Almost all our patients – we’ve got on-time recare down!

Questions to Consider

• How do we create schedules that accommodate more

frequent recare for high risk patients?

• Have you made any changes that have improved patient

scheduling and show rates? If so, what were they?

• How do you engage patients and families in between visits?

Has this had any effect on no shows?

• How is the front desk engaged in the process?
• What obstacles do you still face with managing the schedule?

ECC Patient Recall Tips

Amy Nagai, DDS University Pediatric Dentistry ECC Coaching Mentor

ECC Disease Management Recalls

Where do they fit?!

• Phase II:
• DM visits initially booked in hygiene schedule
• DM visits booked in private room with hygienist
• Visits booked every 10 minutes on designated half days
• Phase III:
• DM visits booked in side column/follow up
• DM visits booked at specific times throughout the day

(8am, 1pm, :50, etc)

• Presently:
• DM visits booked in separate column on the half hour
• Hygienist specifically assigned to DMV column

ECC Disease Management Recalls

How do we get them back?! Make them feel valuable! Praise and thanks! Make it a personalized visit! Keep them motivated!

• Disease Management “Schedule of Visits”: Let them know what to expect!
• Return Visit 1: Caries Process Education, Personalized OHI instruction,

Review of current SM goals

• Return Visit 2: Review of SM goals, set new SM goals,

timer toothbrush gift, fluoride varnish

• Return Visit 3: Review of SM goals, possible ITR, topical fluoride regimen
• Return Visit 4: Review of SM goals, certificate of accomplishment!

ECC Disease Management Recalls

PDSA Ideas Dummy Code: FDM: Disease Management Visit Failure Rescheduling: Train your staff! HOW you reschedule is important! Who is making the phone call? Is it personal? Personalized DM postcards

Strategic Scheduling

Carolyn Brown, DDS ECC Coaching Mentor

Knowing the Client- the 0-5 Year Old

• Need to nap.
• Lots of baggage.
• Urinate often.
• Squirmy.
• Spook easily.
• Why a dentist?
• Mouth is confusing.
• Minimize mid-day appts.
• Bigger rooms, + Transit time.
• DDS enters room once.
• Short appts are best.
• Playroom-like settings.
• ENGAGE whole family.
• Changes (new teeth, hormonal)

are standard.

What we know: What to Do for them:

Important to note:

Scheduling Design should strive to be:

• UNIQUE to your program, site,

provider, day.

• Actively managed.
• Clearly defined roles for staff.
• In line with demand.
• Reflecting productivity and

access goals.

• Increased access for Priority

Patients (preg women, 0-5)

STRATEGIC SCHEDULING

Steps to Achieve Strategic Scheduling-

Define or Assess the following resources:

• Priority patients
• Patient Demand- unique to 0-5 aged patients
• Number of existing appointment types, times
• Open or advanced access- how to balance
• Staffing for each day
• Vacation requests or school holidays- calendar
• Data such as broken appointment data for each site,

provider, pedo vs. adult

• Operational goals
• Scheduling policy and related job descriptions
• Workflows and scripts for each dept. and position

Creating a Scheduling Policy

• Query staff, management, and PATIENTS
• Create a formal scheduling policy
• Create a communication plan and tools
• Include scheduling templates as attachments
• Review the policy with entire staff
• Make sure staff responsible for scheduling know how to use the templates
• Maximize EDR/EMR software to automate
• Strongly consider designated template slots that release 24hours in advance

if not filled.

• Monitor the process closely, provide immediate feedback when staff deviate

from the process and tweak the templates

• Use this same process with the No Show Policy

Adult dental access is limited to mid- day, 1st am or late day access for some

• r all providers

0-5 y.o. dental access is a priority in the am bw 9-11/11:30 a School-aged children are given priority 3-5p

Operational goal: 55% Pediatric/45% adult as scheduled (total 22 appts) Broken Appt rate: 20% (17-18 patients as production goal) Preventative/Restorative ratio: 70%/30% Staffing: 1 DDS:1 RDA: 1 DA

Biggest Threats to Success

• Scheduling policy must be followed faithfully.
• Key staff must review this often.
• Someone must be empowered to tweak it.
• Templates only work when clinics are 100% staffed.
• Scheduling only works when we know our no-show rates.
• When a specific appointment type is filled for a particular

day, scheduler needs to look for the next available appointment.

• Designated slots only get filled in with other appointment

types if unfilled 24 hours prior to day.

• Constant vigilance is required!

Success is not static, it is a state of mind and a constant quest.

Schedule Busters

• Parents who cancel at the last minute
• Families who don’t show up
• Families who show up late
• Double- or triple-booked patients who all show up

unexpectedly= CHAOS

• Too many emergencies/walk-ins worked into the daily

schedule without open access blocks.

• Logjams at check-in or out.
• Providers run late = practice falls behind.
• Patients have the wrong appointment slots.

Ho How w do yo you u man anage age yo your ur sc schedu hedule? le?

Poll:

Did this call give you some ideas/strategies to get patients back on time?

• A. Yeah! I can’t wait to discuss with my team and

try our next PDSA.

• B. It definitely helped but I’m still not sure what to

do next.

• C. Good information, but we’re overwhelmed with

too many other things right now.

• D. This information isn’t relevant to me.

Important to Know

Adam Richman Project Manager, Quality Improvement

Introducing Chenelle Norman

• E-mail:

Chenelle.Norman@dentaquestinstitute.org

• Phone: (508) 329-2330

Announcements

• Data Submission

– Keep your data coming! We’ll continue to review and provide feedback each month

• How To Guide

– Undergoing revisions this summer, more information to be shared soon!

IHI Open School

• IHI Open School courses are

free for faculty, residents, and students so we encourage those of you that work in academic settings to take advantage of this

• Check out the Improvement

Capability Courses www.ihi.org/openschool

Join us on Facebook!

https://www.facebook.com/groups/eccdiseasemanagement/

Next Holding the Gains Call: Wednesday, September 28 from 1:00-1:45pm ET