Faculty Teaching Guide for Dental Office Management



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Module: Clinical and Financial Management

Faculty Teaching Guide for Dental Office Management


Module - Clinical and Financial Management

Faculty Teaching Guide for Dental Office Management



Module: Clinical and Financial Management

Module Overview

The dental office manager must properly manage both the human element and the money element in order to ensure that a practice thrives. The learner preparing to go into the field of dental office management must strive to master the people skills necessary to create and maintain a top-notch dental team. He or she also must have the ability to master the details of practice accounting. This module introduces learners to the basic building blocks of practice management and the ethical and legal considerations that must be considered.

The Big Picture





Resources

This module utilizes the following learner resources:



Textbook: Dental Office Management, by Ellen Dietz. Delmar Learning, 1999. ISBN 0-7668-0731-2.

Faculty CD-ROM: The faculty CD-ROM includes this Faculty Guide and PowerPoint Presentation for Dental Office Management.

The Internet: It is strongly recommended that faculty and learners alike have a working knowledge of the Internet.

Note to Instructor:

To make the best use of this module, it is recommended that the instructor make the following preparations:


  • Inform learners that they are to read Chapters ____, pgs. ____ in the textbook in preparation for the first class of the module.

  • The instructor will provide case histories for all activities that call for them.

  • The instructor may also write case histories based on real-life management situations arising in the dental office. However, instructors should be careful not to include identifying information including actual names and locations.

  • The instructor also will conduct polls of area dental practices to learn what the dental industry in the region expect of dental assistants and dental office managers. The instructor will use the poll results to focus and streamline class material.

  • Collect materials from area dental offices as needed for certain activities. These include mission statements, dental patient chart materials, and marketing materials,

  • In any simulations that occur in this course, the instructor will take the following steps: (1) Introduce the theory or concept; (2) Conduct a simulation; (3) Ask learners to evaluate what they have learned about the theory or concept through simulation; (4) Apply the principles learned to actual dental office case histories; (5) Compare learners’ action on the case histories to the actual outcomes; and (6) Have learners critique the simulation/case history experience as a learning tool.

Section 1: Managing Clinical Issues

Section Overview

The dental team is made up of highly trained professionals. Bringing them together into a cohesive unit is a challenge and, if ultimately successful, a joy. Everyone, including the patients, benefit from a well-managed staff. In addition, the office manager must master skills in records management, risk management, and must speak the dental language with proficiency. Last, but not least, the successful office manager realizes that an office travels at the speed of its telephone system, photocopier and fax machine. For this reason, the wise office manager always has a plan for managing office equipment.

Outline of Section 1

Part A: Managing the Dental Team
Part B: Managing the Dental Record

Learning Objectives and Competencies


These learning activities directly address the Learning Objectives and Competencies as stated.

Comprehension

1. Delineate the clinical roles of the dental team.

2. Detail eligibility pathways available to the dental assistant.

3. Summarize legal and ethical concepts in the dental office.

4. Discuss dental office personnel issues from a manager’s point of view.

5. Identify the basics of dental records management.



Application

6. Demonstrate risk management strategies and methods applicable to the dental office.

7. Use team-building techniques in classroom simulations.

8. Exhibit knowledge of dental terminology and anatomy.

9. Simulate charting of the oral cavity including coding.

Analysis

  1. Examine dental pharmacy procedures.

Synthesis and Evaluation:

  1. Create an office equipment specification sheet based on an operating budget.

  2. Contrast the policies and procedures of a local dental office with material presented in this module.


Learning Activities

These learning activities directly address the Learning Objectives and Competencies as stated.


[Insert In-Class Activity icon] Skills Mastery Assessment (Parts A-B, All Objectives)
[Insert In-Class Activity icon] Mission Possible (Part A, Objective 1)

[Insert In-Class Activity icon] Dental Team Match Game (Part A, Objective 1)

[Insert In-Class Activity icon] Who Brought the Donuts: Getting into the Morning Huddle (Part A, Objectives 4

and 7)
[Insert In-Class Activity icon] Personnel Problem-Solving (Part A, Objective 3-4, 6-7)
[Insert In-Class Activity icon] Panel of Experts (Part A, Objectives 1-5)
[Insert Homework Assignments icon] Textbook Assignment (Parts A-B, Objectives 1-12)
[Insert Homework Assignments icon] Oral Charting Flash Cards (Part A, Objective 8)

[Insert In-Class Activity icon] Reality Tooth Identification (Part B, Objective 8)


[Insert In-Class Activity icon] Reality Charting (Part B, Objective 9)
[Insert In-Class Activity icon] Reality versus the Classroom (Part B, Objective 12)
Part A: Teamwork in the Dental Office
Overview

Teamwork is never the accidental result of good intentions. It is the action of constant nurturing and support. The successful office manager understands the training and commitment that each member brings to the dental office. The office manager also is aware of the certification pathways available to the dental assistant and is in the position to encourage DAs to go as far as they can to realize their ambitions.



Initial Questions and Activities

1. If you were to write your own “practice philosophy” or “mission statement” for your dental career, how would it read?


Answers will vary. Encourage learners to brainstorm first, writing down whatever comes into their heads. Remind them that brainstorming means that anything they think of is fair game and is written down. Ask them to return to the brainstorming and to draw up at least three career paths that interest them. Have them locate the common denominator among the three. Help those who may have a harder time finding the common denominator. This consistent career interest will serve as the kernel of each learner’s practice philosophy or mission statement.


  1. Do you think there a difference between legal and ethical issues in dentistry? If so, how would you distinguish the two?

Ask learners to remember what they have learned in previous classes. Suggest that they begin by attempting to define each term and then contrast and compare the two terms. Encourage learners to use life and work experience to comment on a comparison of dental law and ethics.

  1. Have you ever had to maintain someone’s confidentiality? Was it difficult? Was it worth it in the short run? In the long run?

Have learners discuss this issue while maintaining that someone’s confidentiality. Urge them to remember how many times they almost slipped and what might have pulled them back. Ask them to gauge the difficulty factor in maintaining someone’s confidentiality. Was it easier with some topics than others or easier with some individuals than others? Have learners comment on the value of remaining confidential. One way of measuring this is to have learners relate what they’ve experienced when confidentiality was broken and the ramifications that occurred.

  1. Describe your worst experience with any piece of office equipment. Did the experience reveal any strategies

for managing this vital area of a practice?

Everyone who has ever worked in an office has horror stories of the copier going out or the fax machine failing just at the wrong time. Keep the discussion focused on what learners learned about managing equipment breakdown. What specific strategies did they adopt to either eliminate or lessen the impact of an equipment breakdown. If you wish, you can extend this conversation into the breakdown of clinical equipment.

Key Concepts

References and Activities

Slides

Introduction to Module

Slides 1-2

Introduction to Section


Slides 3-5

Key Terms




Chapters ____, pp. _____

[Insert InClass Activity icon] Skills Mastery Assessment

Slide 6

Introducing the Dental Team

Chapter ____, pp. ____

[Insert In-Class Activity icon] Mission Possible

[Insert Group Activity icon] Dental Team Match Game

[Insert Group Activity icon] Who Brought the Donuts: Getting into the Morning Huddle

Slides 7-15

Managing Risk

Chapter ____, pp. ____

[Insert InClass Activity icon] Personnel Problem-Solving

Slide 16

Managing Office Equipment

Chapter ____, pp. ____

[Insert InClass Activity icon] Panel of Experts

[Insert Home Ass icon] Textbook Assignment

[Insert Home Ass icon] Oral Charting Flashcards

Slide 17

[ ] Group Activities [ ] Homework [ ] Individual Activity [ ] Internet Activity [ ] In-Class Discussion [ ] In-Class Act [ ] Evaluation

[Insert In-Class Act icon] In-Class Activities


  • Skills Mastery Assessment (Parts A-B, All Objectives). Goal: To show learners how much they already know and to set the stage for further learning. Ask learners to take the Skills Mastery Assessment in Chapters _____of the textbook at the beginning of class. Reassure them that this is an ungraded activity, and that, in fact, only they will know their score. They are then to compare their answers to the answer key located at the back of the textbook. They are then to re-take the assessment at the conclusion of the section to check their progress.

  • Mission Possible (Part A, Objective 1). Goal: To show learners how actual dental practices express their mission. Hand out examples of area practices’ mission statements. Ask learners to compare what they contain with what they have read in the textbooks. Conduct a group discussion to assess the mission statements and to explore how learners might approach developing a practice philosophy and writing a mission statement.
  • Dental Team Match Game (Part A, Objective 1). Goal: To quickly familiarize learners with the variety of disciplines that make up the dental team. This is a timed exercise. Divide learners into teams. The instructor will read the job definition drawn from the textbooks for each of the following: dentist, dental hygienist, dental office manager, chairside dental assistant, dental lab technician, denturist, infection control coordinator, dental supply representative, and dental service representative. One member from each team will go to the board, write the name of the job position, and return to his or her seat. When the faster team member is seated, the instructor will read the next definition and the next person on that team will go to the board and so on. The group with the most correct dental team job positions on the board when time is called wins.


  • Who Brought the Donuts: Getting into the Morning Huddle (Part A, Objectives 4 and 7). Goal: To have learners get the feel of a widely used dental management technique. Randomly assign team member roles to learners. If there are more learners than there are roles, divide the group into as many teams as will accommodate the size of the group. Present the teams with a list of possible concerns for the day’s clinic, and ask them to simulate problem solving in the morning huddle. Examples of last-minute glitches might include: (1) An established patient calls with a dental emergency. (2) A patient is being seen today for an extensive procedure but the ball has been dropped on obtaining precertification from the insurance company. (3) A new patient expects to be seen today, but they do not appear on the schedule. (4) A patient scheduled today for required surgical follow-up has called this morning to cancel. Ask learners to contribute boo-boo scenarios from their own experiences. After everyone has had a chance to participate, re-group to discuss what has been learned.

  • Personnel Problem-Solving (Part A, Objective 3-4, 6-7). Goal: To give learners a chance to try some of the management techniques being introduced. Give learners scenarios detailing actual personnel problems experienced in area dental practices. (Do not use real names or addresses.) Ask learners to assess the case histories and to develop a response plan based on the information contained in Chapter ____ of the textbook. Learners may work individually or in groups. At the conclusion of the activity, learners will re-group to discuss application of the principles and to learn what steps the actual practice manager took to solve the problem.
  • Panel of Experts (Part A, Objectives 1-5). Goal: To frame learners’ classroom experience with insights provided by dental office managers working in the area and to give learners the chance to network). The instructor will arrange for at least five dental office managers currently working in the field to talk about the most current challenges and opportunities they are grappling with. Learners are to have at least one question prepared ahead of time to ask the panelists. If possible, before or after the panel discussion, the instructor will arrange to introduce learners to the panel members in a social setting (perhaps with simple refreshments) and will encourage them to practice their networking skills. Learners will follow up the event with a thank you note to each panel participant.


[Insert In-Class Dis Ques icon] In-Class Discussion

  1. What are an office manager’s typical duties in a small office? In a larger practice?.

The dental office manager handles all business activities involved in running a practice. In a small office, the office manager may wear all the hats: receptionist, appointment secretary, and billing clerk. In a larger practice, the office manager supervises employees who work in the front office and at chairside.

  1. What is the purpose of the morning huddle?

The morning huddle is an opportunity to efficiently share information. It is a chance for members of the dental team to be on the same page as they approach a clinic day. Before clinic starts, the team gathers to set the tone, strategize procedures, discuss specific patient needs, and communicate any last minute changes. Some of the information communicated includes any problems from the previous day, identification of new or special patients, the flexibility of the day’s schedule, important financial information about the day’s patients, and a check on possible marketing opportunities in the day’s schedule.

  1. Who on the dental team can be held liable in a malpractice suit?

Vicarious or second-hand liability means that the dentist may be held liable for the action or deed of an employee or independent contractor. In fact, a dentist or dental practice owner may be held liable without having ever met the complaining patient. However, although the dentist is the primary defendant in a malpractice suit or complaint, each member of the dental team has the potential of being held liable.
  1. What is the importance of the telephone to a dental practice?


Most of the time, the telephone is the patient’s primary means of contact with the dental practice. More often that not, a patient’s first impressions are formed through phone contact, which means that professionalism and etiquette are important. A practice should have a telephone system that makes it easy for patients’ calls to get through, and the office manager must choose a phone system that efficiently handles call volume. While front desk personnel must have strategies for managing incoming calls, the office manager can take advantage of the brief time that callers are placed on hold by running pre-recorded messages that market the practice and/or provide helpful information. Communication with emergency patients also is important and the office manager must make sure that the equipment and services that support this communication are reliable.

Textbook Assignment. Read pgs. ____ in the textbook.

Oral Charting Flash Cards. Learners are to make flashcards with abbreviations and charting symbols covered in Chapter ____ of the textbook on one side and the answers on the other. They are to use these to prepare for class and to study as needed. Suggest that learners choose flashcard buddies for more effective practice.

Presentation Tools


Note: If you change Objectives or Assignments, don’t forget to change the slides accordingly.


Slide 1

[Insert DOM-1-1]

DOM – Stands for Dental Office Management. The 1st number represents the Module called Clinical and Financial Management. The 2nd number represents the slide number.


Power Point Presentation for Dental Office Management

Module: Clinical and Financial Management

Introduce the module.

Start by asking learners what they expect from this module.


Slide 2

[Insert DOM 1-2]

Module: Clinical and Financial Management

Introduce the sections and each part.



Slide 3

[Insert DOM 1-3]

Section 1: Managing Clinical Issues

Discuss each objective in detail. Learners need to know what they will be learning and why. Try to relate it back to their careers in the health care field.



Slide 4

[Insert DOM 1-4]

Section 1: Managing Clinical Issues (cont.)

Continue to discuss each objective in detail.



Slide 5

[Insert DOM 1-5]

Section 1: Managing Clinical Issues (cont.)

Continue to discuss each objective in detail.



Slide 6

[Insert DOM 1-6]


Key Terms

Review each key term and discuss.



Note to Instructor: If available as a resource, for legal terms and law and ethics discussion in this Part, refer to Chapter ____ in Dental Assisting, A Comprehensive Approach, 2nd edition, by Phinney and Halstead, a Delmar Learning textbook.

In-Class Activity: Stop here for the Skills Mastery Assessment activity.

Slide 7

[Insert DOM 1-7]

Part A: Managing the Dental Team

Address the difference between a dental practice philosophy, mission and goal.

Discuss the idea of the mission statement as a reflection of the entire dental team.

Examine what it can and cannot express about a dental practice.

Stress that the overriding mission of any dental office is to make the patient the first priority.

In-Class Activity: Stop here for the Mission Possible activity.


Slide 8

[Insert DOM 1-8]

Members of the Dental Team

Go over each member of the dental team and present their scope of practice and credentialing requirements.

Discuss the eight dental specialties recognized in the U.S.

Consider how different specialties may make different demands on the DA and the dental office manager.

Explain the dentist’s supervisory role with all members of the dental team.

Examine the education/certification requirements of the eight disciplines listed in the textbook.

Present the dental office manager’s role in coordinating these disciplines into a functioning team.


In-Class Activity: Stop here for the Dental Team Match Game activity.


Slide 9

[Insert DOM 1-9]

DA Qualifications and Credentials

Explain the difference between licensure/registration and certification and identify the corresponding organizations.

Point out that each state issues its own license and registration provisions and that these may differ from state to state.

Define DANB and ADA.



Short Activity: Stop here so that learners can go on line to locate their state’s board of dental examiners’ website. Ask learners to examine the details of licensure, registration, and license renewal and to discuss these as a group.

Slide 10

[Insert DOM 1-10]

DA Eligibility Pathways

Detail the requirements for each pathway to certification.

Point out the options that exist for many of the steps.

Emphasize the importance of learners staying current on their CPR health care provider level certification.

Discuss what is involved in the infection control exam (ICE) and the dental radiation health and safety exam (RHS) and note that the ICE and RHS exams make up two-thirds of the CDA exam.


Slide 11



Continuing CDA Education

Go over the nine CDA re-certification guidelines.

Explain the process of earning 12 hours of accredited CDE courses every year.

Discuss what re-certification resources are available in the learners’ community.


Question: Ask learners which method or mix of methods they think they would prefer to use and have them explain why.

Review the multiple certification renewal CDE requirements.

Describe the annual random CDE audit.

Point out that proof of CDE should be retained by the CDE for the two previous years.



Slide 12

[Insert DOM 1-12]

Working Together as a Dental Team

Examine the different ways team members can solve problems in the dental office.

Compare routine opportunities to address issues to ad hoc approaches that take place as problems crop up.

Review steps the office manager can take to organize effective staff meetings.

Underline the importance of keeping the routine meeting focused and only as long as is necessary to accomplish office business.

Stress that the office manager may facilitate the meeting but that the dentist is always the final decision maker.

Provide learners with ideas on how to effectively interact with the dentist on addressing practice issues in the context of a regular staff meeting.

Give examples of how to build consensus among the various members of the dental team during regular staff meetings.

Discuss how to hold a regular morning huddle and detail the benefits of this technique.

In-Class Activity: Stop here for the Who Brought the Donuts: The Dental Team Morning Huddle activity.


Slide 13

[Insert DOM 1-13]

Law, Ethics, and the Dental Team

Ask learners to compare jurisprudence with ethics, how they differ and when they come into play.

Contrast and compare the ADA code of ethics with the ADAA code of ethics.

Address the difference between civil, criminal, and contract law.

Explain what the purpose and function of the State Board of Dental Examiners.

Examine the State Dental Practice Act and the status of expanded DA functions in your state.

Discuss the Doctrine of Respondeat Superior and how it relates to the function that the dental assistant performs.

Define what a contract is and discuss the differences between an expressed vs. an implied contract.

Point out how a contact can be terminated and when this is appropriate.

Explain the role that each member of the dental team plays in the ethical treatment of patients and in reducing or eliminating the risk of malpractice.

Address the purpose of the Good Samaritan Law.

Discuss the purpose of the AwDA.

Explain the difference between an informed consent vs. an implied consent.

Point out the purpose for the HIPAA and the privacy policies and standards that must be followed by a dental practice.

Review the code of professional conduct that each member of the American Dental Assistant Association must pledge to comply with.


Slide 14

[Insert DOM 1-14]

Dental Team Management

Point out the dentist’s role as ultimate supervisor of the team.

Discuss the dentist’s responsibility in general and direct supervision and give examples of direct supervision of delegatable duties as opposed to duties that staff can perform without having the dentist present.

Question: What potential impact would there be on the dentist should errors occur under his/her general or direct supervision?

In-Class Activity: Stop here for the Personnel Problem-Solving activity.


Slide 15

[Insert DOM 1-15]

The Law and Dental Team Supervision

Explain the importance of communicating effectively with the members of the dental team.

Review the legal requirements for hiring, employing, and firing employees.

Point out the value of the office manual for establishing policies and procedures and educating employees on office expectations.

Examine the purpose of the office manual as containing the right information for preventing and solving routine problems and for bringing new employees up to speed.

Discuss ways to make the office manual user friendly and easy to update.

Review personnel policies and underline the importance of making positive use of performance reviews.

Look at the five provisions of the AwDA and point out the implications for the dental office including office renovations.


Slide 16


[Insert DOM 1-16]

Risk Management

Emphasize the role that the office manager as well as the entire team plays in reducing exposure to malpractice actions.

Define negligence and give examples drawn from actual practices to illustrate the consequence of adverse actions.

Discuss the National Practitioner Data Bank and explain how to access this information.

Examine the concepts of standard of care, abandonment, and burden of proof in relation to the dental office.

Review the elements of malpractice, the circumstances that can lead to malpractice suits, and the steps to preventing malpractice.

Emphasize the deleterious effect of a patient’s unrealistic expectations and link this to the upcoming section on patient relations.


Slide 17

[Insert DOM 1-15]

Managing Office Equipment

Explain why the successful office manager never takes office equipment for granted.

Ask learners to consider all the reasons that a properly working phone system is essential.

Discuss the importance to the dental practice of a properly working fax machine and photocopier and how these machines support excellent patient care.

Provide learners with insight into the ins and outs of working with equipment vendors and what to look for when negotiating equipment leases.

Talk about establishing a reliable maintenance system for equipment and building a good relationship with equipment repair personnel.



In-Class Activity: Stop here for the Panel of Experts activity.

Homework Assignment: Stop here to assign and discuss the homework.


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