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
• 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 Management System.
• Empty plastic amalgam capsules must be disposed in the Amalgam Management System
• Chair-side traps must be disposed in the Amalgam 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.

Staff and patient safety must be blended into the daily activities and responsibilities. Safety isn’t something that is add-on when it is convenient or cost effective. The mindset of the Dental Profession towards safety in general must change otherwise staff and patient casualties will be astronomical.

After hours phone message must provide clear and complete instructions to the caller. The message should include the following,

1. The hours of operation
2. How to leave a message
3. In case of a medical emergency hang-up and call 911
4. How to contact the doctor in case of a dental related emergency
5. How to contact an on-call doctor when the doctor is not available.

Are you working on your business or are you working in your business?

When you are working on your business you are in the driver’s seat. You are in command of business growth, direction, and profitability. You have created a support team that sees to the day-to-day tasks, leaving you with plenty of time to spare or use in another ways, life is pretty good.

However when you work in your business you are trying to get things done by yourself with no end in sight. You are trying to get through the day which seams like an endless loop. Your staff is going in different directions; you have more problems than solutions. Yes you are busy and your practice is busy, but being “busy” isn’t much of a business indicator especially when it comes to profits, after all you can be “busy” reading the mail or digging a hole. First and foremost your dental practice is a business and if you are lacking the knowledge that will take you out of your business so that you can start to work on your business hire an expert, doing everything yourself to save a few bucks is Old School and it doesn’t work anymore!

Q: What is Universal Waste and does it concern dental offices?

A: Universal Waste refers to items like batteries, fluorescent light tubes, neon bulbs, electronic devices, devices containing mercury, and non-empty aerosol cans containing hazardous materials to name a few. The California Universal Waste Rule makes it mandatory for businesses which includes dental offices to collect Universal Waste and dispose of it properly meaning either having your waste management service remove it or deposit the items at a collection center. Many cities are adding specific items to the list so it is best to check with the city which your dental office is located to find out what additional items are regulated. By regulations you cannot throw Universal Waste in the trash.

Assuming that new hires both experience and inexperienced know what to do to maintain the standard of your office is risky business. Take the time and orientate all new hires to the policies and procedures of your office and constantly test their understanding of your standard. I suggest conducting a New Employee Orientation for the first ten days of employment and longer if needed, the areas of focus should be patient safety, patient information security, infection control, OSHA, Consumer Affairs and office policies & procedures. The key to successfully maintaining a standard is making sure everyone is on the same page. By the way, employee training should be conducted a minimum of once a year and for maximum results onsite!

Training is a process that improves knowledge and skills and information is the key ingredient for all training. Information must be current, specific to the job, presented by a qualified instructor and conducted yearly. Reducing employee training or looking to cut training costs by doing it yourself is ludicrous. Investing in employee training will payoff many times over and it is a critical element for a Patient Compliant office!

Five things you should do during inspections,

1. Ask questions
2. Take notes and photos
3. Don’t argue with the inspector
4. Walk around with the inspector
5. Ask the inspector for their suggestions

Q: I updated my compliance manual last year; do I need to update it this year?

A: YES – if your compliance manual is written correctly and contains policies & procedures based upon all regulations and not just OSHA, then all you need to do is revise it as new requirements are released or working conditions change, at the minimum your compliance manual along with employee training is updated once a year.. With all due respect doctor, I evaluate about 55 dental offices each month and haven’t found one office with a correct compliance manual, what I have found was a lot of time and hard work put into a binder with incorrect results. Why would anyone attempt to take on a project that even experts find intimidating at times? If you think you are saving money I suggest you think again.