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    July 2018 Newsletter
                              developing clinical excellence
In This Newsletter
Can Your Office Pass An OSHA Inspection?
The Importance Of Running On Time
Fourth of July Celebration

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How Andrea can help:

· Sterilization review, design and implementation

·OSHA training, reviews and manuals

· Basic and advanced chairside duties

· Clinical training system and manual

· Indirect bonding

· Clinical coordinator

· Verbal skills to encourage compliance

· Reduction of emergency visits

· Personalized clinical manual

· Inventory control

· Instrument set ups and organization in the operatory

· Implementation of your treatment plans

· Reduction of patients beyond estimated completion date

On the web

Could your office pass an OSHA inspection

Got all the training bases covered? As you know, OSHA requires employees to be trained on certain topics annually, and others need to be repeated when a process change occurs. Whether you have one employee or hundreds ... as their employer, you are responsible for their safety.

The Occupational Health and Safety Act (OSHA) was established to ensure safe and healthful working conditions by enforcing standards and by providing training, education, and assistance.

Both acts have mandatory training requirements that can often be a source of confusion for dental practices. Are we required to train annually? Who does training apply too? How long should training be? What topics should be covered? If we do not hold training will we be subject to fines? 
1. Does OSHA training need to be conducted annually?  
Yes, annual OSHA training for all employees is mandatory, and training for new-hire employees must be completed within ten days of hire. 
2) Who does training apply too? Should the doctor also be trained?
OSHA training is mandatory for all employees, including the doctor, assistants, receptionists and part-time employees. 
3) How long should training be? 
OSHA doesn't specify a particular length for training.  What matters most is the content of the training and that the information is taught effectively.

4) What topics should be covered? 
Employers should refer to OSHA's web site ( for specific training requirements of OSHA standards. OSHA requirements include: 
  • Annual OSHA Employee Training
  • GHS: Global Harmonization System Proof of Training
  The following topics must be given to new employees, or if there is a change in the job procedures that introduces a new hazard:
  • General Office Safety - including injury and illness prevention program (IIPP), fire safety and emergency responses, eyewash stations, and washrooms.
  • Hazard Communication 
  • Ionizing Radiation 
  • Bloodborne Pathogens - including medical waste management information. 
5) Are we required to keep proof of training? If so, what documentation is required?
Yes, OSHA requires training be documented. Records provide evidence of the employer`s compliance with OSHA standards. Training records should include:
  • Dates of the training 
  • Content of the training 
  • Names and qualifications of trainers
  • Names and job titles of attendees
Other requirements: 
  • Employee training records must be maintained for three years.
  • Employee training records must be available to employees.
  • If the practice is sold, employee records will be transferred to the new owner.
6) Can we be fined if we don't conduct training, or fail to hold it annually?
Yes, OSHA failure to train citations can be issued if just one missed employee training. OSHA penalties can range from $0-$70,000, depending upon how serious the violation.

OSHA has adjusted the penalty amounts for inflation as of January 2, 2 018 to $12,934.00 per violation.  Hazard communication standard was listed as the #2 most frequently cited violation in 2017.

In addition to the Federal OSHA plans, twenty-six states, Puerto Rico, and the Virgin Islands have OSHA-approved State Plans.

Maintaining a safe workplace environment is more than just good business practice - it's the law.  Contact me to schedule your annual OSHA compliance walk thru and training.  I am also available for OSHA seminars for your referring offices.

  The Importance Of Running On Time

A recent car repair appointment gave me a great reminder of the importance of our offices running on time. This means not only getting our patients seated on time but getting their appointments completed on time.
I called to set an appointment time for my car to be repaired and was told it would take approximately one hour. I set up a time and adjusted the schedule for the rest of my day around this information. When I arrived for my appointment I confirmed the repair would take an hour, but was then told that they would not be able to get my car in and started for about an hour. This additional hour spent at the shop made a huge impact on the rest of my scheduled day and created a negative experience for me.
There are several components that contribute to your ability to run your clinic on time. First, we must have a schedule that is reflective of the doctors' delivery of patient care. How much time do they realistically need in each appointment and where is that time in each appointment.   I am often asked "how many patients should I be seeing per day?" There is no magic number. I have offices that see from 50 - 120 patients per day. Any of these can be successful if it is an accurate picture of what you and your team can do.
The next component is having a team that fully understands the schedule and how to make that perfect schedule work in a not so perfect world.   Seating your patient on time is the goal but before we can seat our next patient on time we must be able to finish our last patient on time. The best way to make sure the clinicians are able to achieve this is to be aware of the finish time of each appointment. The clinician can then work backwards from that point to prioritize the work in the procedure. If a patient is late for their appointment or has breakage the clinician can make the call chairside as to what can be accomplished while still meeting their out time. I encourage doctors with a strong clinical team to empower them to make clinical decisions as to what can be accomplished today and what may need to be rescheduled.
If an office is running a doctor time schedule the clinicians and TC's must also be aware of where that time is in their appointment and how many minutes they have. TC's can have a big impact on the clinic if they are not following the doctor time in the schedule. Clinicians and TC's should do what they can and still be calling for their doctor at the correct time, not the time they are ready for the doctor. If a patient is late for their appointment the doctor time and out time for the procedure does not change. The clinician will make the call on what can be accomplished and make decisions to meet these marks.   This may mean working at a faster pace or making adjustments in today's procedure.
One of the ways a patient is judging your office is if they are seen on time for their appointment.   With today's busy schedules (theirs and ours) we must be respectful of our patients' time. If we are respectful of their time they will learn to be respectful of your time by being on time for their appointments.
Empower your team and let them run your schedule.   Give them all the tools they need to be successful; organization, training, instruments, and your support. Their ownership of the schedule and the day will build a stronger team and enable them run your clinic on time.

Fourth of July
Independence Day is one of the best American holidays, both for what we celebrate and how we celebrate it.

Celebrating the independent skills and talents of each team member in your office can be a challenge at times. But the benefits of a diverse group will make a much stronger team.

"The strength of the team is each individual member. The strength of each member is the team." --Phil Jackson

Strong teams cannot exist in the absence of strong people. A strong team is one where each member knows the role they play. What's more, they know when to play it! A strong team expects each member to be fully present and ready to go when it is their time to shine.

For a team to be strong, they need to be about something larger than themselves. They must share a vision that isn't about the individual, but includes the individuals. A strong team exists when it is composed of strong people working towards a vision larger than a single person.

Help the entire team understand how individual people can contribute to the greater whole, and how their unique strength mix will move the mission forward.

So by all means, march in a parade, host a barbecue, have a few beers, head to the beach, light off some fireworks. I will be right there with you. But take a minute or two to reflect on the strong individuals who make up your team.
Thank you for your continued support of my clinical newsletter.  I hope you and your team find the information useful.  Please visit my website and feel free to email me with any comments or questions. 

Andrea Cook
Andrea Cook LLC