The art of scrambling

March 21, 2012

You may not be a football fan, but hang in here for a minute with the analogy, because there are some important dental “plays” that you can implement when you have a change in your schedule.

You may not be a football fan, but hang in here for a minute with the analogy, because there are some important dental “plays” that you can implement when you have a change in your schedule.

It is standard operating protocol for football teams to spend time practicing before a game. The major league teams do this in an orchestrated, technical way. In addition to physical practice, they study films and diagram and plan out their offensive and defensive plays before every game. They plan out what they are going to do before the situation arises. They even have a plan for everything that can possibly go wrong. The plans don’t always work in the heat of the moment, but they have a much better likelihood of working because they have been thought out and planned out.

What happens when a planned play suddenly goes bad? The players scramble to quickly regroup and implement another plan. Good teams do this very well and go on to win more games.

Whether your dental team formally prepares for your next patient day with dedicated administrative time and a planned morning meeting or “huddle,” or if your team does what it must do for the next day when there’s time (ready to jump right into the morning), we trust that there is some preparation before you see patients.

Expect the unexpected

Even when patients have been confirmed, their charts have been reviewed, what is on the schedule matches the treatment plan, lab cases have been checked off, account balances have been reviewed, remaining dental benefits have been checked, etc.-in other words, even when you have done everything possible to prepare for the next day to ensure it will run smoothly and your patients will have the best experience possible-things can change in a heartbeat, and winning teams have back-up plans.

This is where scrambling comes in. Let’s say you are the Appointment Coordinator and in that case, most likely the “first responder.” You made sure the major treatment blocks for Monday were filled and confirmed when you left the office on Thursday. When you arrived on Monday morning and checked the messages, you find a patient has called and cancelled her crown prep appointment because of a family emergency. Now there is one and a half hours of prime time open in the schedule and there is only one minute before huddle. What do you do? It helps if it is not the first patient of the day, but regardless, the scramble starts now:

Report to the huddle on time and let that be the first thing that is shared with the doctor and team. Why? Because they may have a patient in mind who they want you to call, or they may have other important uses for that time that you are not yet aware of.

  • It is ideal to always have a back-up plan in case you get cancellations-be one step ahead if the “play” goes bad. Know the patients you can call beforehand so no time is wasted when you get an unexpected opening in the schedule. If there is no back-up plan at this time, read on.

  • See if another patient on the schedule can come in earlier-“We have a change in our schedule, and Dr. Jordan thought of you and thought you might like to come in earlier today-will that work for you?” You have just bought yourself some time to work on filling the later opening.

  • Is there another patient on the schedule who might like to save a trip back to your office and who may agree to more treatment today?

  • Access your ASAP list of patients and contact them if their procedure is a fit for the time slot that is open.

  • Are there patients scheduled in hygiene who could move over to the doctor’s operatory?

  • Is there an emergency patient on the schedule who can come in earlier-there may now be time that would allow for a procedure rather than just palliative treatment.

  • Are there lab cases ready and patients who could be called for an earlier delivery?

  • Can the time be used to provide treatment to a staff member?

  • Make sure to keep the clinical team informed of the status of the opening through instant messaging or by taking a note into the ops.

A variation on our scenario

What if the cancellation is in the dental hygiene schedule? It’s pretty much the same protocol except assistants will look for patients in the doctor’s schedule who are due or past-due for hygiene and offer to  save them a trip back to the office. Always make sure to first check with the front desk to ensure the open time is still available-things can change quickly! And, certainly check with the hygienist.

When the schedule changes, each team member needs to know what their part in the scramble is and what specific actions they should take. It takes excellent communication between front and back so team members aren’t running around like keystone cops. Remember this is a team effort, not just the Appointment Coordinator’s responsibility.

What about the person in charge?

The dentist’s role is very important, too. He or she needs to:

  • Set specific, clear guidelines and expectations based on vision and values for the protocol on how the team responds to openings in the schedule.

  • Put this protocol in writing and train the steps in a staff meeting.

  • Put this written protocol in your Systems Protocol Binder-it serves as a written reminder to the team as well as a training piece for any new hires.

If you have to scramble too much because of too many cancellations, you may need to work on building value for optimal oral health and the role it plays in total health.

We all know it’s impossible to have a zero cancellation rate, so protocol for scrambling must be in place. When the team gets good at it, you will be a Super Bowl caliber dental team! 

About the Author Callie Haynes has more than 30 years of experience in dental practice management and has been a consultant for Pride Institute since 1996. Callie’s extensive experience in this wide variety of roles in the dental office gives her instant credibility with dental teams and enables her to understand the challenges that a practice may face from different perspectives. Callie specializes in relationship building with patients and teams, customer service and systems implementation. To ask Callie about this article or for more information about Pride Institute, go to prideinstitute.com/subpages/ask/ask_pride.htm or call 800-925-2600.