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Section 1: Partnerships and Planning
Telling Your Story
Community Oral Health Needs Assessment
Gathering the Facts
Building Collaborative Relationships
Defining Potential Partners
Engaging Partners
Clinic Planning
Level of Service
Organizing for Action
Section 2: Key Principles
Characteristics of an Efficient and Effective Dental Program
Key Practice Parameters for Sustainability
Tracking Productivity and Performance
Determining Dental Clinic Capacity
Strategic Planning
Best Practices
Section 1. Facility Design and Construction
Capacity and Cost Estimates
Location, Size, and Floor Space Considerations
Location
Size
Floor Space
Design Principles
Design Options and Floor Plans
Open or Enclosed Operatories
Operatory Layout
Compliance Requirements for Facility Design
Construction Options
Ergonomic Design
Section 2. Equipment and Supplies
Delivery Systems
Over-the-Patient Delivery
Rear Delivery
Side Delivery
Major Equipment
Patient Chairs
Dental Units
Dental Handpieces
Operator and Assistant Stools
X-Ray Units
Conventional vs. Dental X-Rays
Dental Operating Lights
Computers
Communications Systems
Pre-Owned Equipment
Electronic Dental Systems
Challenges
What Can Be Integrated
Implications for Facility Design
Key Features of Electronic Dental Systems
Wireless Technology
Supplies and Small Equipment
Maintenance and Repair
General Maintenance
Preventive Maintenance
Equipment Repair
Service Life
Section 3. Staffing
Staffing Configurations
Staffing Decisions
Dental Assistants
Dental Hygienists in Alternative Practice
Expanded Function Dental Auxiliaries
Section 1. Financial Viability
Balancing Access and Sustainability
Interactive Budget-Planning Workbook
Revenue
Patient Care Revenue
Public Programs
Commercial Insurance
Self-Pay Patients
Estimating Patient-Care Revenue
Number of Patient Visits or Encounters
Average Reimbursement per Visit or Encounter
Factors That Affect Patient-Care Revenue
Determining Appropriate Clinic Fees
Relative Value Units
Developing a Relative Value Units Conversion Factor
Sliding Fee Schedule
Implement a Sliding Fee Schedule
Contracts
Other Sources of Revenue
Expenses
Compensation Packages
Typical Fringe Benefits
Volunteers
Dental Equipment and Supply Costs
Other Expenses
Bad Debt
Equipment Depreciation
Lab Fees
Administrative Expenses
Fundraising
Section 2. Clinic Finances
Managing Clinic Finances
Assistance with Financial Management
Developing a Budget
Financial Reporting for Program Planning and Management
Assessing Financial Performance and Sustainability
Business Plans
Business Plan Success Factors
Safety Net Dental Clinic Business Plan Model
Independent Audits
Section 3. Grants and Fundraising
Grants
Grantwriting
Grants Management
Sources of Grants
Government Funding
Foundation Funding
Corporate Funding
Fundraising
Section 1: Policies and Procedures
Policies and Procedures Manual
Format and Topics
Evidence-Based Clinical Care Guidelines
Time-Out Policy
Oral Surgical Procedures Policy
Section 2: Human Resources
Employee Handbook
Professional Standards of Conduct
Position Descriptions
Salaried Employees, Contractors, And Volunteers
Recruiting
Interviewing
Credentialing and Privileging
Sample Dental Provider Privileging Procedures
Credentialing and Privileging Details
Additional Considerations
National Practitioner Data Bank
Orientation
Retention
Training and Continuing Dental Education
Disciplining or Terminating Employees
Section 3: Liability Protection
Malpractice Insurance
Risk Management
Common Risk Management Issues
Incident Reports
Required Insurance
Federal Tort Claims Act (FTCA)
Section 4: Scheduling
Appointment System
Strategies for Scheduling Appointments
Scheduling in Advance
Broken Appointments
Preventing Broken Appointments
Compensating for Broken Appointments
Emergency Appointments
Considerations for Dental Emergency Patients
Wrongful Termination or Abandonment
Recall/Re-care Appointments
Continuum of Care
Tips for Managing Referrals
Patient Rights and Responsibilities
Informed Consent
Withdrawal of Consent
Informed Consent Policies and Procedures
Consent for Minors
Minors Under Age 14
Adolescents Age 14-18
Informed Refusal
Written Follow-Up Instructions
Interpretation Services
Section 5: Billing and Collections
Establishing a Billing and Collections System
Electronic Dental Record
Superbills, Charge Slips, And Encounter Forms
Responsibilities for Billing and Collections Process
Section 6: Inventory Management
Purchasing and Stocking Supplies
Tracking and Managing Inventory
Dental Suppliers
Stocking a Formulary
Section 1. The Vision for Quality
Health Care Quality
Quality Assurance
Quality Improvement
Quality Improvement Process
Quality Control
Adopting an Approach
Developing Your Quality Vision
Quality Vision Statement
Prioritizing the Quality Vision
Health Resources and Services Administration Requirements for Federally Qualified Health Centers
Oral Health Quality Improvement Committee vs. Health Center Quality Improvement Committee
Standards of Care and Guidelines
Section 2. Setting the Stage for Quality
Accreditation
Credentialing
Privileging
Section 3. Measuring to Improve Quality
Applying Quality Assurance/Quality Improvement Principles in the Dental Clinic
Clinic Administration
Patient Registration
Billing and Collections
Purchasing/Inventory Management
Referrals and the Continuum of Care
Appointment System, Including Broken Appointments
Incident Reporting. Processing Patient Complaints, Treatment Issues, and Safety Events
Access and Its Effect on Quality
Retention of Staff
Compliance
Onboarding of Staff
Electronic Dental Record and Chart Notes
Consent
Patient-Satisfaction Surveys
Staff-Satisfaction Surveys
Clinical Services
Methods of Measuring Clinical Quality
Quality Metrics
Quality-Based Reimbursement
Incident-Driven Peer Review
Initiating Peer Review
Peer Review Through Existing Components of Local Dental Societies
Peer Review Within the Dental Office
The Review Process
Clinical Quality Control
Curing-Light Intensity
Emergency Kit Expiration Dates
Emergency Oxygen Canisters
Post-Operative Calls
Preventive Maintenance
X-Ray Developer
Monitor Logs
Acting on Findings
Section 4. Data Collection and Analysis
Collecting Data
Analyzing Data
Flow Chart
Cause-and-Effect Diagram
Pareto Diagram
Scatter Diagram
Histogram
Run Chart
Control Chart
Sharing Results of Quality-Assurance/Quality-Improvement Activities
Developing a Patient-Satisfaction Survey
Administering Patient-Satisfaction Surveys
Analyzing Patient-Satisfaction Surveys
Section 1: Health Records
Health Record
Electronic Templates and Clinic Forms
Inactivation
Elements of the Health Record
Guidelines for Records Maintenance
Confidentiality
Health Insurance Portability and Accountability Act
Section 2: Infection Control, Environmental Health, and Safety
Infection Control and Regulation
Organizations That Support Infection Control and Safety
Centers for Disease Control and Prevention
Occupational Safety and Health Administration
Dental Evaluation and Consultation Service
Organization for Safety, Asepsis and Prevention
American Dental Assocation
Bloodborne Pathogens and Needlestick Prevention
Post-Exposure Management
Products and Devices for Infection Prevention and Control
Waterline Maintenance
Monitoring and Evaluating Compliance
Regulation of Hazardous Materials
Mercury
Radiation
Nitrous Oxide
Medical Emergencies
Life Safety Code
Work-Related Accident Documentation
Emergency Preparedness
Clinic Security
Other Clinic Safety Issues
Eye Protection
Emergency Treatment of Eye Injuries
Noise Control
Ventilation
Section 3: Clinical Topics
Clinical and Prevention Issues
Treating Medically Complex Patients
Clinical and Community-Based Prevention Strategies
Clinical Diagnosis and Clinical Technique
Treating Patients with Special Health Care Needs
Behavior Management
Conscious Sedation
Section 4: Dental Office Technology
Information and Clinical Technology
Information Systems and Information Management
Computer Hardware and Software Selection
Technology Integration
Digital Radiography
Other Technical Equipment
DIAGNOdent
Intraoral Camera
Air Abrasion
Dental Lasers
Apex Locators and Rotary Endodontics
CAD/CAM Milling System
3D Printers
DentaQuest Partnership for Oral Health Advancement’s Safety Net Solutions and the National Maternal and Child Oral Health Resource Center have created this revised edition, in collaboration with several author/reviewers. The original manual was produced by the Ohio Department of Health’s Bureau of Oral Health Services in collaboration with the Association of State and Territorial Dental Directors and Indian Health Services. We gratefully acknowledge the expertise and effort of all collaborators over the span of the manual's lifetime.