Chapter 4. Clinic Operations

Introduction

I. Policies & Procedures Manual

a. What is a Policies and Procedures (P&P) manual?

b. What policies and procedures should be in place when the clinic opens?

c. What format should be used for policies and procedures?

d. What topics should be covered in the P&P manual?

e. What are practice guidelines or clinical protocols?

Section II. Personnel/Human Resources

a. Should we develop an employee/staff handbook?

b. What are professional standards of conduct?

c. What are position descriptions?

d. How do salaried employees differ from contractors and volunteers?

e. How can we recruit staff for the clinic?

f. What do we need to know about interviewing potential employees?

g. What do the terms "credentialing" and "privileging" mean?

h. What is the National Practitioner Data Bank (NPDB)?

i. How should we orient new staff?

j. What are some strategies for staff retention?

k. How can we offer training and continuing dental education (CDE)?

l. What laws relate to disciplining or terminating employees?


m. Where can we find information on state dental laws, rules and regulations, dental boards, and licensing requirements?

Section III. Malpractice, Risk Management, and Insurance

a. Why is malpractice insurance important to the clinic?

b. What is risk management?

c. What are incident reports and how are they used?

d. What kinds of insurance are needed for a dental clinic?

Section IV. Health Records

a. Why does a dental clinic need health records?

b. What clinic forms do we need?

c. What should the record contain and not contain?

d. Why is confidentiality of health records important?

e. What is HIPAA?

f. How do we handle health records in special circumstances?

g. Is there a web-based resource for dental charting abbreviations and terminology?

Section V. Purchasing and Inventory Management

a. Who should be responsible for purchasing supplies?

b. Do we need a system to purchase and stock supplies?

c. How can we track and manage inventory?

d. Where can we purchase dental supplies?

e. Should we stock and dispense medications?

Section VI. Patient Scheduling and Consent for Care

a. What is an appointment system?

b. How should appointments be scheduled?

c. How far in advance should we schedule appointments?

d. How can we handle broken appointments?

e. How can we manage dental emergencies using an appointment system?

f. What should we do to avoid wrongful termination or abandonment?

g. What is a preventive recall program?

h. How do we manage continuum of care?

i. What are patient rights and responsibilities?

j. What is informed consent?

k. What are policies and procedures around informed consent?

l. How do we obtain consent for minors?

m. Can patient consent be withdrawn?

n. What is informed refusal?

o. Do we need written follow-up instructions for patients?

p. How should the clinic handle interpretation services for patients who do not speak English?

Section VII. Billing and Collections

a. How do we set up a billing and collections system?

b. What is a superbill, charge slip or encounter form?

c. Who needs to be involved in the billing and collections process?

Section VIII. Infection Control, Environmental Health and Safety

a. What is infection control and how is it regulated?

b. What regulations govern hazardous materials used in dentistry?

c. How should the dental clinic handle mercury?

d. Are there standards for using nitrous oxide?

e. What standards cover radiation health and safety, including x-rays?

f. What guidelines are available for dental radiology (x-rays)?

g. How are work-related accident reports handled?

h. How should the clinic prepare for medical emergencies?

i. How should the clinic manage compliance with Life Safety Codes?

j. What should the clinic do for emergency preparedness?

k. How should clinic security be handled?

l. What are some other clinic safety issues and resources?

Section IX. Clinical and Prevention Information Resources

a. What are some good sources of dental, medical, and pharmaceutical information?

b. Where can we find information about treating patients with compromising medical conditions?

c. Where can we find information about clinical and community-based prevention strategies?

d. Where can we find information about clinical diagnosis and clinical technique?

e. What are some sources of information about behavior management of the fearful or apprehensive patient, including the use of restraints?

f. What is conscious sedation and when should it be used as a form of behavior management?

g. Where can information be found on the treatment of patients with disabilities or other special health care needs?

Section X. Dental Office Technology

a. What is Dental Office Technology?

b. What are information systems and information management?

c. What considerations are important in computer hardware and software selection?

d. What is technology integration?

e. Should our clinic consider using digital radiography?

f. Should the clinic consider purchasing a DIAGNOdent to diagnose dental decay?

g. Should we consider purchasing an intraoral camera?

h. What is air abrasion, and should we be using it in our clinic?

i. Is a dental laser needed to perform quality dentistry

Appendices