If you received “OSHA” training, you only received five percent of the needed information to be compliant and reduce risk to yourself and patients. OSHA training is not,

• The Dental Practice Act
• Sterilization
• Patient Safety
• Dental Board Infection Control
• HIPAA
• Radiation Safety
• Environmental Heath Management
• Human Recourses

Dental Professionals must look beyond the “OSHA mentality” and take responsibility to find out what they need in order to be competent in their duties. They also need to change their mindset from doing only the minimum to adding value in everything they do.

Advertising Information

Attention Businesses – your advertisement helps charities.

Advertise your business on my blog, doing so you will receive an advertising banner that is placed on the sidebar of this blog. Also your advertisement will be included on all seminar handouts and visual presentation material. The exposure for your business, products or services is tremendous and you will be helping charities. The the fee is very affordable, just $250.00 to start and $50.00 per month, you may cancel at anytime.

100% of advertisements fees are donated to the following charities,

• Make-A-Wish Foundation
• American Diabetes Association
• St. Jude Children’s Research Hospital
• Humane Society of the United States of America

For more information or to get started send an email: tom@tomterryseminars.com

Thank you for supporting these charities,

Tom

All businesses that obtain and maintain healthcare information must provide the highest standards to protect the information from accidental or deliberate misuse or disclosure.

• New patient information is verified with a driver’s license or state issued ID.
• Insurance information is verified with a driver’s license or state issued ID
• Credit card transaction is verified with a driver’s license or state issued ID
• Third-Party Disclosure

Patient information is disclosed to third-party entities for the following purposes only,

• For treatment
• To obtain payment for treatment
• For healthcare operations

Control Accidental Disclosure - work practices that reasonably prevent accidental disclosure must be exercised at all times.  From a simple procedure of covering protected health information to locking-up unattended filing cabinets, to being aware of the surroundings when discussing patient information is vital.  In addition, patient’s protected health information should never be discussed out-side of work under any circumstances or for any reasons.

Restrict the use of Patient Information - the patient’s protected health information (PHI) must be used for healthcare related purposes only.

Apply the Minimum Necessary Rule – the concept of the “Minimum Necessary Rule” is that the very minimum of protected health information (PHI) be used, accessed or released for any purpose or task even if an exception is permitted.

No Marketing Activity – at no time protected health information may be sold or transferred to any third party for the purpose of marketing activity, whether for profit or not, or to introduce a person, business, product, or service.

Control Electronic Transmissions – prior to transmitting protected health information (PHI) on electronic devices such as computers, fax machines, voice mail, and telephones, it must be determined whether it is secured and if confidentially will be maintained and not compromised.

Control Discarding Protected Health Information – all documents that contain protected health information (PHI) when discarded must be shredded or destroyed, to prevent disclosure.  At no time documents containing protected health information are discarded if confidentiality will be compromised.

HIPAA and Patient Information Security is achieved only when employees are well trained, well informed and apply what they have learned.

Before using chemical products or any product for that matter, first read the label. If you do not understand the instructions ask management before using the product. Take the time and steps necessary to be safe!

The following is a basic checklist for waste management, be sure to check with your State, County and City agencies for specific requirements.

Amalgam/Mercury

• An Amalgam/Mercury management plan that includes the policies & procedures for handling and discarding Amalgam/Mercury is established and all staff members have reviewed.
• Amalgam Safes are located in each operatory where amalgam is placed.
• Trap filters are in use and maintained in each operatory. When amalgam is placed or removed traps are discarded in an Amalgam Waste Container which is removed by a waste management service.
• Empty amalgam capsules are discarded in the Amalgam Waste Container.
• An Amalgam/Mercury Separator is in use.  (either by regulation or by voluntary)
• If an Amalgam/Mercury Separator is not in use, the vacuum filter is discarded in the Amalgam Waste Container.
• Only Amalgam/Mercury Separator safe vacuum line cleaner is used.  (Read the label of the vacuum line cleaner before using and determine if safe with separators)
• Staff receives yearly training on Amalgam/Mercury management.

Hazardous Waste Materials

Most Cities and Counties have a “Zero Tolerance Policy” when it comes to discharging chemicals and hazardous materials into waste system.  The following common items, if used, must be removed by a waste management service,

• Lead
• Fixer
• Sharps
• Amalgam/Mercury (unused & scrap)

Note: Lead and Amalgam must be properly contained and the container clearly marked.  An Amalgam Safe is highly recommended.  Your Waste Management will advise you as to the proper storage containers to be used.

• Developer
• Vapor-Sterile
• Pharmaceuticals
• Cold Sterile (containing glutaraldehyde)

Universal Waste Rule

The State’s Universal Waste Rule prohibits specific items to be discarded into the standard trash system, therefore must be collected and discarded properly.  Check with your city (home & business) website for additional information.  The following are basic items,

• Used Batteries
• Fluorescent Tubes
• Electronic Devices
• Electronic Components
• Vapor Filled Light Bulbs
• Compressed propellant items
• Staff receives yearly training on Hazardous Waste management.

Waste Management Recordkeeping

• When waste products are removed from the office, a record in the form of a manifest or receipt must be obtained.  (Self-contained systems are exempt)
• Manifest must indicates each item that is removed from the business. Manifest that “group” items is not acceptable.
• Manifests are stored in a binder or folder in an organized manner.

It is amazing how often I am asked “What’s new with OSHA?  When the question should be “What’s new with Dental Compliance?”

Why?  its simple; Dental Offices are regulated by more than OSHA, depending on the county and city your practice is located in; it can be as many as seven agencies!

However, if you look beyond your OSHA training and gain an understanding of the compliance makeup you will also gain an appreciation that compliance regulation is an essential part of your business operations, both in growing your practice and maintaining your practice, not to mention reducing financial risk. Today compliance has taken on a whole new meaning, it is no longer a back office issue; it is a “total” practice philosophy.  Compliance is good – good for the staff, good for the patient and good for the practice.  So think “Dental Compliance” and not just OSHA.

Legal services for Dentists,

Ali Oromchian, J.D., LL.M.

Counsel, P.C.

Bishop Ranch 3 - 2603 Camino Ramon, Suite 200, San Ramon, CA 94583

Phone: 925-242-2511 - Direct Dial/After-Hours: 925-999-8200

Fax: 925-884-1725

Email:  ao@dentalcounsel.com

Website: www.dentalcounsel.com

Employee turnover is hitting the dental profession hard and will continue for many more years, but turnover is no reason for not staying compliant with regulations, especially when it comes to hiring and training.  So let’s focus on being proactive, here are some suggestions,

Hiring - The candidate should complete an Employment Application and should submit a current resume along with a list of personal and business references. Asking the following questions in a face-to-face interview should provide an overview of the candidate’s qualifications and experiences.

• Education & Training
• Work Experience
• Expectations (relating to employment)
• Career Goals

Background & Reference Check - Because of the increasing issues surrounding employment verification and background checks I highly recommended engaging the service of a firm that specializes in background checks, however if you conduct the background yourself verify the following,

• Date of hire
• Date of departure
• Positions & Titles
• Rehire Status

Don’t be surprised that the previous employer declines to answer your questions over the phone, but instead request a letter for employment verifications be sent, this is becoming a standard.

Personnel File (or Employee File) - There should be a Personnel File setup for every employee on your staff.  The following is the “basic” documents that should be maintained in the Personnel File,

• Employment Application (Original)
• Employment Eligibility Verification form (I-9)
• Copy of Driver’s License (or State ID)
• Copy of Social Security Card (not just the number)
• Completed “Hepatitis B Vaccination” form
• Copy of current professional license issued by licensing board  (if licensed)
• Copy of current CPR card (if applicable)
• Copy of license support documents (i.e. radiation safety certificates)

The Personnel File must be kept in a locked filing cabinet.

Employee Training - All employees including managers and supervisors should receive training on general and job-specific safety practices.  Training and instructions should be provided,

• When policies are established or changed.
• New staff members should receive compliance orientation training within the first 10 days of employment.
• Staff members who are given new assignments for which training has not been previously provided.
• When new substances, processes, procedures or equipment are introduced to the workplace.
• When new or previously unrecognized hazards are discovered.
• To supervisors to familiarize them with safety and health hazards to which staff members under their immediate direction and control may be exposed.
• All staff members with respect to hazards specific to there job assignment.
• A “refresher” training session for all staff members of the primary training topics are conducted a minimum of twice a year.

Core Training Topics - Core training topics should be the key sections of your Compliance Manual,

• Prevention Program
• Hazard Communications
• Infection Management
• Exposure Management
• Emergency Protocols
• Safety Protocols

Never over look the importance of training and meetings, both will keep employees advancing forward while promoting a safe and injury-free work environment. Make Compliance work for you!

No doubt, with the advancement of dentistry and the introduction of new composite materials, amalgam days are numbered.  In fact, the phrase “Mercury Free Dentistry” has grown a good momentum among dental offices, however amalgam is still here, still being removed from patients and still needs to be disposed of properly.  Here are some suggestions,

• Install an Amalgam Separator.
• Obtain an Amalgam Waste Management System (dental supply)
• Establish a written policies & procedures for handling and disposing of amalgam
• Amalgam traps and amalgam waste, no matter how small of amount must be captured and disposed in the Amalgam Waste Management System
• Empty plastic amalgam capsules must be disposed in the Amalgam Waste Management System
• Chair-side traps must be disposed in the Amalgam Waste Management System
• Unused amalgam capsules must be stored in a secure container and properly labeled
• Do not store amalgam waste for more than six months