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    How to create a culture of safety at your practice

    Reinforcing safety at your office doesn't have to be difficult, but it does require diligence and teamwork.

    The safest offices, naturally, are mindful of practical, day-to-day issues like hand hygiene, personal protective equipment and keeping up with infection control news. But beyond the nuts-and-bolts matters, they must also engender a spirit and culture of safety throughout the practice. It’s not necessarily a difficult task, but it’s one that does require elements of diligence, effort and teamwork.

    Where to begin

    “It’s a multifaceted approach,” says Joyce Moore, RDH, an infection control consultant and clinical instructor at Bristol Community College in Fall River, Massachusetts. “When you go into a practice, it’s different than going into a federally qualified health center or a healthcare system. Each office, even if they’re part of a group practice, tends to have their own ways of doing things. But I think that you have to start at the top. If you’re going to provide safe care, it depends on all of your highly trained individuals with different roles and responsibilities acting together in the best interests of the patient.”

    Creating a culture of safety must start with the leadership, Moore says.

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    “The safety culture has to begin with the senior leadership because it’s based on their actions and their beliefs,” she explains. “The leadership needs to model safe behavior and enforce safety guidelines so that the employees are likely to rise to those standards. They have to provide clearly defined expectations. They should have set policies and procedures that follow the regulatory mandates, the guidelines, the recommendations. So, we’re looking at evidence-based practices. And those leaders also need to allocate resources to patient safety activities, annual safety training. They should have regular staff training. There should be attendance at continuing education, not just for the staff but for the leaders as well. Leadership is a huge portion of having a safety culture because if they’re not on board, then the others aren’t going to be on board.”

    Guiding philosophy

    Often, creating a safe practice begins with simply embracing a mindset of safety.

    Andrea Putt, patient safety coordinator at North Ridgeville Family Dentistry in North Ridgeville, Ohio, says that her practice embraced that spirit thanks to the guidance of an infection control consultant.

    “What really kick started this culture of safety in our office was our consultant,” Putt says. “She did an amazing presentation with our office. She went over all the changes we can make that would increase our safety measures. There are always ways you can improve, in any office, no matter how careful you are. I still believe we have some work to do, but I feel like we are definitely more safety conscious than we were a couple of years ago when I started.

    Safety“One way that we encompassed that change was just an overhaul of our procedures and protocols,” she continues. “In-depth procedures for sterilization, room turnover and our own staff safety. It’s just having those things in mind. How you would want to be treated when you enter an office is kind of my philosophy. If I’m afraid to sit in one of our chairs to get a cleaning or have work done because I’m not sure if it has been cleaned properly, then I’m not going to want any patient coming to that same room.”

    That culture of safety represents many facets both big and small.

    “You think about little things,” Putt says. “For instance, stocking – you don’t want to touch anything with bare hands that will potentially be going into the mouth of anybody. So that’s where I started, with the mind shift.”

    Those guidelines don’t occur in a vacuum, however. There’s plenty of official direction to get the practice started. From there, the practice can take its own initiative.

    “Policies and procedures are basically a set of guidelines for people to follow,” Moore says. “They will evolve based on what’s happening in your practice. So, if you have a new piece of equipment, if you have a new technology, those will change and evolve over time. To be more specific and to give a solid set of guidelines, some policies and procedures are very basic. What you really need to focus on is the details because there’s a specific set of steps to make sure you’re doing things properly and safely.”

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    For the best outcomes, practices should be willing to embrace change.

    “A lot of times you do what you do because that’s what the person before you did,” Moore says. “Without clear guidelines, we really run the risk of not knowing what to do in a situation and we want to know what to do, whether it be an acute situation in the operatory or what we need to do if there’s a chemical spill. These guidelines need to be there because you don’t want to do the wrong thing in the time that you can do the research on what the right thing is.

    “But I do think it’s very common that practices have not set the time to establish it,” she adds. “It might get lost in the shuffle. Larger healthcare facilities have someone that is specifically performing these services. All dental offices should have a dedicated infection prevention coordinator. That’s something that they could be doing, creating these policies and procedures or reviewing their current policies and procedures. And they need the time to actually sit down and be able to do that, especially with the changing technology and updated information that we have.”

    Up next: Power to the people...

    Robert Elsenpeter
    Robert Elsenpeter is a freelance writer and frequent contributor to Dental Products Report and Digital Esthetics. He is also the author ...

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