Health Center Best Practices & Frequently Asked Questions Janet Bozzone, DMD, MPH Marty Lieberman, DDS Jay Anderson, DMD, MHSA Bob Russell, DDS Monday, November 2, 2009

OBJECTIVES Discuss Best Practice concepts Share some Best Practices resources Share answers for FAQs Open discussion for additional questions Discover missing resources & links Introduce the developing Best Practices Chapter in the Health Center Operations manual

What is a “Best Practice? Management practices and work processes that lead to world-class, superior performance.”* *Fletcher Challenge Ltd

What is a “Best Practice? Aligns with strategy Reduces costs Improves productivity Promotes timely execution Enables better decision making Leverages/exploits existing/emerging technologies Ensures acceptable levels of control and risk management Optimizes the skills and capabilities of the organization Promotes collaboration across the extended enterprise -Hackett Benchmarking

A Best Practice is NOT… A cookie cutter solution! but is a starting recipe that requires adaptation to your facility.

Decide what you can measure and if it is an improvement! Rapid PDSA Cycles Decide what you can measure and if it is an improvement! *From the Institute for Healthcare Improvement

Some Best Practices Online Resources NNOHA! http://www.nnoha.org/resources.html ASTDD http://www.astdd.org/index.php?template=bestpractices.html DMC http://www.dmcnet.org/DMCConferenceLinks.html CDN http://www.cdnetwork.org/NewCDN/LibrarySearch.aspx CDA http://www.cdafoundation.org/

Additional Online Resources Oral Health Care during Pregnancy and Early Childhood - Practice Guidelines http://www.health.state.ny.us/publications/0824.pdf Improving Women and Children’s Oral Health: http://www.idph.state.il.us/HealthWellness/oralhlth/ "First 5" web-based training for dental providers: http://www.first5oralhealth.org CAMBRA Risk Assessment: Journal of the CDA http://www.cda.org/page/Library/cda_member/pubs/journal/jour1007/index.html

http://www.cdafoundation.org/library/docs/jour1007/ramos.pdf

Common Frequently Asked Questions You are not alone!

Who should the Dental Director report to? NNOHA recommends the dental director have the same reporting structure as the medical director usually the CEO… but advocate for whoever will be your better champion!

How much administrative time should I have as a Dental Director? Dan’s Formula but… Realize you will never have enough scheduled time.

How much of the 330 funding should be allocated to the dental department? At least some! Advocate for percentage of overall budget based on: departmental budget, # patients seen, or some other logical method.

How do I build a relationship with my administration? First, get a good boss If that fails Make your boss a better boss Speak the language they understand! $$$$$

Fees! How do I set up a sliding fee scale? What is the difference between a nominal fee, a co-pay, and sliding fee scale? Does every procedure (e.g. crown & bridge, veneers, bleaching etc.) get 'slid', or just required services?

No-Shows, DNKAs, and Broken Appointments! How do I deal with no-shows? Can we bill patients for no-show appointments? Can I bill Medicaid for no-shows?

Should I still treat a patient if they refuse radiographs? It depends! but… Remember…a patient cannot consent to negligent care. Do not perform invasive treatment in the absence of diagnostic x-rays

How do I balance my current panel with emergency cases? No easy answers here! Look at the needs of your community. Work to get patients into comprehensive care who can finish treatment plans

Questions, Comments, or Suggestions?

NNOHA - www.nnoha.org - 303-957-0635 THANK YOU NNOHA - www.nnoha.org - 303-957-0635 Janet Bozzone, DMD, MPH Director of Dental Services Open Door Family Medical Centers jbozzone@ood.org Marty Lieberman, DDS Dental Director Neighborcare Health martinl@neighborcare.org Jay R. Anderson, DMD, MHSA Chief Dental Officer janderson@hrsa.gov Bob Russell, DDS Dental Director Iowa Department of Public Health brussell@idph.state.ia.us