In a dental practice, few things can send stress levels soaring for all the team as rapidly as poorly booked emergency appointments. Picture this scenario: a jam-packed schedule, then suddenly, ping, a 15-minute appointment is double booked for an emergency appointment , with no information about why the patient needs to be seen It’s a recipe for chaos, and it’s a situation that many dentists and practice managers are all too familiar with. Yet, this situation is preventable reducing the stress to your team and patients.
Today we are going to delve into the heart of this challenge, exploring why emergency appointments, when booked haphazardly, can turn a smoothly running practice into a stress-filled battleground. We’ll dissect the various aspects that contribute to this stress and, more importantly, offer practical solutions to ensure that emergency cases are handled with efficiency, effectively and with empathy. this is a win- win for everyone.
What is Your Emergency Policy?
Do you have an emergency policy for the practice that is clear and everyone understands?
Establishing a clear and comprehensive emergency policy is the first step in managing emergency patients effectively.
Your policy needs to cover,
- What constitutes and emergency that is seen the same day.
- What is urgent and should be seen within 48 hours.
- What is a priority and needs to be seen within 7 days.
For each situation emergency, urgent and priority you may find it useful to think about what are the signs, symptoms and the treatment that needs to be provided to get your patient out of pain or distress.
As part of your policy include, how patients contact your practice, and what are your fees for during the working hours and out of hours.
How Much Time Do I Need for Emergencies?
For your reception team to schedule appointments without double booking, the appointment book must contain spaces that are pre allocated for your emergencies, and only booked on that day. How much time that you need to pre allocate will vary from practice to practice, differing with your patient cohorts, style of dentistry you offer and quality of your clinical work.
The first place to start is to count the number of calls that come in on a daily basis over a month.
Next step is to identify what the optimal treatment is for each situation.
Step 3 to calculate how much time each patient optimally needs to be allocated for diagnosis, consent, and treatment.
Finally, you will be able to calculate how much time on average that each clinician needs to have set aside each day for emergency, urgent and priority care.
How do I plan my diary?
Allocate dedicated time slots in your appointment book to accommodate emergency patients. These appointments are best scheduled immediately before lunch or at the end of the day, avoiding double booking, or running late for patients which usually happens if emergencies are booked in mid clinic. If you have several clinicians at the practice, you can offer different times with different clinicians if that works for you. Emergency slots should not be opened until the same day. if there is too much pressure on your emergency slots and they are being booked up days ahead, it indicates, failure in your triaging, insufficient emergency time or that there is a problem with the quality of your work. Having these slots readily available will help reduce stress, ensure patients are managed correctly.
How Do I Keep Self-Employed Clinicians Involved?
Your associates are probably self-employed, as such they have ultimate control over their appointment book. If the practice enforces appointment book rules, it could be deemed as exerting control creating an employed status. engage your clinicians in the discussions and planning of the appointment book, find out how much time they want to treat irreversible pulpitis, lancing and draining an abscess, recementing a lost crown, fractured tooth etc.
Your associates need to appreciate that you are making changes to the appointment book to reduce their stress, improve treatment protocols, so reducing the risk of complaints. Encourage open communication, listen to what your associates and their nurses need to manage your patients well. Collaborative involvement helps maintain a cohesive team and ensures all clinicians can contribute to handling emergencies effectively.
What Does My Reception Team Need to Know?
Your reception team plays a critical role in managing emergency patients. In many practices the reception team don’t have any surgery experience and are in the dark when it comes to what is involved in diagnosis, consenting and treating an emergency. When a receptionist books 15-minutes they are doing the best they know how to do with the information and training they have. Spend time with your reception team creating a triage sheet, so that they are better able to schedule the correct time and provide the surgery with the information they need in advance. Your receptionist cannot diagnose and with a good triage flow chart they can schedule patients well.
your patients will always ask your reception team “how much will it be?” they obviously cannot answer this question accurately. It is useful to have fee for Diagnosis, discussion, and consent (DDC) and the necessary treatment fees are additional to the DDC. You can give your receptionist a range of indicative costs that is based on a good triage.
Training your reception team to handle emergencies with accuracy, professionalism and empathy is often overlooked yet essential if you are going to reduce the stress at work.
How Do I Arrange My Appointment Book?
Organise your appointment book with flexibility in mind. Allocate specific time slots for emergency cases, ideally before lunch and at the end of the day. Avoid scheduling emergencies mid clinic and where possible maintain some buffer time between regular appointments to accommodate unexpected time critical emergencies such as an avulsed tooth without causing delays. Open the emergency slots on the same day.
Won’t I lose money?
Many people panic about leaving open slots for emergencies, losing money. You don’t need to worry, you can relax. double booked appointments, appointments too short, cause a lot of stress to all the team and patients. If you have done your audit and keep track of what is happening, you can be flexible in your emergency scheduling. If you don’t have an emergency patient, you have time to do some of all other things that you have to do, letter writing, checking radiographs, reviewing, and filing your photographs etc.
When you are charging for the DDC and treatment on top, provided that you have correctly set your fees, you have no need to worry.
What Are the emergency No No’s?
There are some common pitfalls that antagonise patients, stress out your team, potentially put you in breach of your contract and GDC standards, putting you at risk of complaints. Common pitfalls in managing emergency patients should be avoided and include,
- Not having any time available to offer patients timely appointments. I am often contacted by patient who attend their practice with irreversible pulpitis or a fat face only to be offered and appointment in several weeks.
- Not offering your patients an appointment and telling them to call 111.
- 15-minute appointment for diagnosis, discussion, consent, opening and access cavity, pulp extirpation and dressing. This is not enough time to do the treatment well. etc
- Private practices expecting 111 to do their out of hours cover.
By following these guidelines, you can create a more streamlined and stress-free approach to managing emergency patients in your dental practice. I acknowledge that as an NHS practice you cannot charge for DDC, your fees are fixed, yet you can still apply the principals. Preparation, communication, and a well-defined emergency policy are key to reducing stress for both your team and your patients.
