Communicating in a Chartless Office
This article is intended for offices that are paperless/chartless. I prefer the term “chartless” since dental practices purchase many reams of paper each year and are never truly paperless. For dental offices that are still using paper charts for patients, I would highly encourage you to take the leap to become chartless. If, at best, 5 minutes/chart is spent each day retrieving and filing each chart, multiplied by the number of patients that are seen each year, it adds up to quite a bit of time that could be better spent calling your past due recall patients, unscheduled treatment or overdue accounts.
Who is communicating? Have you, the dentist, given any thought to what and how much information must be communicated in your office – between you and your team members, among team members, between team members and patients, and amongst team members and other dental community people such as labs, referring dentists, insurance companies, software support, etc.?
How is it communicated? How is all of this information presented to the proper person in a timely and accurate method? When you had charts, much of the information to referring dentists, labs, and information about the patients’ treatment was written in the chart. Then, all of sudden, there were no more charts to depend on for much of the information. My guess is that everyone felt helpless for a while, having to depend on reading the notes in the digital chart or trying to find the scanned documents that now replace the referral letters, lab slips, and other necessary information that needs to be available.
Much information is transferred verbally between the team members to the patient and from the doctor to the team members. In many cases, the breakdown happens with information between the clinical team and business team. Directions are given and forgotten and information needs to be conveyed, but the business team members are either on the phones or assisting patients. Who does the hygienist or assistant now talk to about Mrs. Brown’s next appointment? The computer should be used for indicating a patient’s arrival to the clinical team. A light system can also be used, as well as wireless walkie-talkies and most importantly, routing slips/forms.
What is a Routing Slip? When I visit an office that is not using routing slips, I know immediately there is a breakdown in communication between the clinical and business team. On behalf of the team, most offices are either not familiar with routing slips, have used them in the past and felt that they were a waste of time, or used them in other offices but did not attempt to implement them in their current office.
The routing slip acts as the sticky note, the clinical notes and the verbalized words on one single piece of paper for each patient, along with the patient’s medical alerts, demographics, insurance and account balance information. In addition, other family members and their recall dates are also listed, along with planned treatment that is not completed and the MOST important piece of information, what needs to be scheduled next and how much time is needed.
Regarding insurance information, wouldn’t it be nice to know in November if your patient still has remaining benefits for the year so you can encourage the patient to schedule for their much-needed crown or root canal? This is considered internal marketing as well as providing a service for your patient, as they will lose those benefit dollars if not used before the end of the year, in most cases. For account balances, it’s important to know if the business team is doing a great job of collecting the money for your hard work. And regarding other family members, you want to know if the entire family is up-to-date on their recall appointments so that if not, a team member can inquire.
Best of all, routing slips allow you to have morning meeting discussions about patients who have planned treatment that has not yet been performed. All your team needs to do is review the routing slips. No recommended treatment is lost in the paperwork or in the chart notes or simply missed due to time.
How to Implement the Routing Slips. Each clinical team member has a routing slip for their patient. The routing slip should already have the treatment that is scheduled for the day indicated. Once the treatment is completed, the doctor/assistant/hygienist simply makes a check next to the treatment indicated, edits the information as necessary and then either circles the next visit from the planned treatment list or writes NV: MOD comp #15 – 6 units.
If the Scheduling Coordinator is free to greet the patient, the clinical team member will reiterate the treatment completed and repeat the treatment that is needed verbally so the patient hears it a third time (from the doctor first and the assistant or hygienist second) to improve case acceptance. If the routing slip is brought to the Scheduling Coordinator and he or she is on the phone with another patient, the clinical member simply slides the routing slip in view of the Scheduling Coordinator so she/he knows exactly what was performed today with any modifications, and what needs to be scheduled next with the appropriate time units.
Incorporate routing slips into your practice and it will improve communications!
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