AADOM QUICKcast: Hygiene Harmony – 3 Keys to Clinical Consistency

Video Description:

Hygiene Harmony: 3 Keys to Clinical Consistency for Leaders- While establishing a written clinical hygiene standard of care is vital for patient safety and continuity of care, it’s often a hard conversation for practice leaders to have with the hygiene team. This quickcast will provide 3 key elements that practice leaders can employ to begin the process of developing a written hygiene clinical standard of care and gaining commitment from the hygienists for implementation.

Learning Objectives:

• Understand the critical importance of having a written Hygiene Standard of Care
• Recognize the legal and ethical responsibilities involved
• Source evidence-based resources to back up recommended diagnostic and treatment standards for ideal patient outcomes and team calibration
• Gain tools for ongoing assessment and refinement of care standards

Hygiene Harmony: 3 Keys to Clinical Consistency for Leaders

By Rachel Wall, RDH, BS, CEO, Inspired Hygiene

Running a busy dental practice requires utilizing so many different skill sets at the same time. From being the team cheerleader to giving tough feedback and everything in between – all in one day. Practice managers wear a lot of hats.

One thing we hear that’s often challenging for practice managers is maintaining harmony in the dental hygiene department. As a clinical hygienist for 30 years and hygiene coach for over 20, I’m very familiar with the wide range of culture dynamics of a hygiene team. I’m also very familiar with the varying levels of care delivered within the same hygiene team.

It is very frequent that I speak with a dentist and/or practice manager who share they’ve had multiple conversations with their hygienists about clinical standards such as when to perform and chart a complete periodontal evaluation, the frequency they’d like the hygienists to take blood pressure or the threshold at which they expect patients to move from preventive care to periodontal care. It’s incredibly frustrating when the clinical leader communicates their expectations, and they are not followed.

Their frustration is apparent and my next question to them is often, ’Do you have a written Standard of Care outlining those clinical expectations?’. Nine times out of ten the answer is ‘No’.

Delivering consistent high-quality care involves lots of systems and processes. Some of these processes make the practice run smoother and others are critical to fulfilling the clinical and ethical responsibilities your team has to your patients.

The Hygiene Standard of Care is one such system.

It’s a document, a declaration of sorts, that states what diagnostic screenings will be performed and how often along with setting guidelines for when a patient is determined to need a different treatment than what was previously delivered.

On a recent Inspired Hygiene virtual growth forum, we conducted a poll of the attendees asking them the question ‘Do you have a written hygiene standard of care that is followed by all hygienists in the practice?’

67% answered no. 67%! And this audience was a group of proactive practice leaders.

In my experience, one of the very first, most impactful steps to create hygiene harmony is establishing a clear, written Hygiene Standard of Care.

Here are 3 keys to creating a written Hygiene Standard of Care in your practice.

1 – Clinical Evidence

Dental clinicians are taught to seek clinical evidence to validate the effectiveness of a treatment or to make any change to their internal standards of care.

It’s not enough to tell your hygiene team they need to take blood pressure on each patient. Even if you believe they should know the ‘why’ behind this screening, it’s much more effective to approach this with clinical evidence in hand that confirms the value of the service.

Find a valuable resource that speaks to the risks of giving anesthetic to an individual with undiagnosed or uncontrolled high blood pressure. Share a resource showing the percentage of Americans with undiagnosed high blood pressure and the associated risks.

PubMed is a good resource, as are associations like American Heart Association and the American Academy of Periodontology.

2 – Collaboration

Most hygienists take great pride in the quality of their work, and they appreciate the respect of their dental colleagues.

The clinical leader in a dental practice is typically the practice owner(s) dentist or the Chief Dental Officer in a dental group. While the dentist makes the final decision on diagnostics and the clinical standards of their practice, hygienists

should absolutely be involved and have a voice in the creation of a Hygiene Standard of Care.

Set aside time for a collaborative session to go through each section of the document, use relevant evidence and come to an agreement on what the standard will be.

3 – Commitment

Very often practice leaders recognize the need for a clear Standard of Care in response to discord or disagreements between the dentists and hygienists or within the hygiene team. For this reason, it’s likely that the new standards will be set at a higher level than what is currently being performed in the practice.

For example, a dentist recognizes that complete periodontal charting is not being done annually and communicates that this must be part of the Hygiene Standard of Care. The rationale and clinical evidence are provided, and an agreement must be made by all clinical team members to uphold this standard. This might require more time spent on this screening during the hygiene appointment, additional equipment needed to fulfill this as well as new communication tools may be needed.

Once you’ve created this agreement, communicate how you will hold each other accountable if you see the team or clinical leaders not providing care that is meeting the standards.

This should not be a document that is created and then never reviewed again.

It is reasonable to expect the standards to be followed and implemented daily in the practice. Over 20 years of experience facilitating this process with teams, we consistently see them achieve improved clinical consistency, less stress and upset around clinical disagreements and better patient outcomes.

If you’re struggling to implement this or would like to have an outside expert support you to facilitate, coach and see the results of creating a Hygiene Standard of Care, please reach out to us. We’d love to work with you. clients@inspiredhygiene.com

Sponsored by: Inspired Hygiene

Rachel Wall, RDH, BS is CEO and Founder of Inspired Hygiene, a coaching firm focused on elevating hygiene services, systems, and profits. Inspired Hygiene strives to help dental teams achieve a triple win with healthier patients, empowered, engaged hygienists, and a profitable practice.

She is an award-winning educator, author of the book “Return on Hygiene”, and has spent over 30 years serving the industry as a clinical hygienist and hygiene productivity coach. To learn more about how Inspired Hygiene can help your team achieve their goals, visit InspiredHygiene.com.