Recording a treatment plan
A person will have 32 adult teeth, and when they are younger 20 baby teeth. During someone’s life the state of the teeth may change: all the way from a filling to an extraction.
The system should only record information only about a ‘treatment plan’ the work identified as needing to be carried out following an examination.
The dentist will fill out a visual representation on a pre-printed view of the teeth so that the patient is aware of what is going to be done. This visual representation is not recorded by the system instead the dentist makes professional medical notes. These medical notes will be short multi line text documents which are written in such as way that any trained dentist will understand.
Treatment plan consent and payments
Many NHS patients will pay a fixed free for the detail service which is split into three bands. Some patients are entitled to free treatment, depending on their individual circumstances. In both cases the patient signed a standard NHS form consent/treatment form, these are scanned and a copy is held on the system.
In the event of an emergency appointment this may be done immediately after the treatment is carried out.
The practice has suffered from many missed appointments, patients forget about appointments which are often set weeks or months in advance. In order to try and solve this problem SMS text message is sent to the patient five working days before the appointment, and another is send the day prior to the appointment.
It is also policy to phone parents who have long appointments. Some dental work may require 40 or more minutes to complete. Patients who have long appointments are contacted by phoned by a member of the reception team to double check that they will be attending. This normally takes place two working days before the appointment.
A third party service is used to contact patients via SMS text messages. The system should provide the following text document which will be sent to the service. The text document contains a list of the reminders to the sent that day; it has the mobile phone number and the day/time of the appointment. This should be in the form of a comer delimited file.
The system will also produce the list of phone numbers, names and appointment details for all those who have a long appointment in three working days time. This will be processed by the reception staff during quiet periods. Reception staff should be able to mark those who have been successfully contacted, those who have not been contacted by the end of the day will appear on the following day’s list. No further attempts will be made if they are not contacted on the second consecutive day.
The practice operates a policy deregistering anyone who has missed three appointments within a rolling five year period, this will only happen when their current treatment plan has ended. There are exceptions such as any patient who has a memory problem or if anyone has missed an appointment due to illness or bereavement, even events such as a traffic is seen as an acceptable reason for missing an appointment. A clarification for any missed appointment will be sort on the next interaction with the reception staff. Your system must prompt the staff to ask and then record if it allowable or not. In the event of a non-allowable reason the system must check if there has been two more within the past three years. If so, the patients’ record will be marked as one to deregister. If not them a record is made of the missed appointment.
Staff have the ability to request flexible working so it is possible that some staff may work less than five days a week. Or that they only work the hours between 10am and 2pm. The practice diary which contains all the staff and appointments is held six months in advance.
Staff can also request holiday. It is normal that there will be appointments which have already been made for the period of the holiday. In these cases reception staff will be able to identify and contact the patients so that they can rearrange the appointment.
Staff sickness. Staff may become ill and be unable to work for a period of time. If a member of staff becomes ill then it may be possible to move some of the appointments for a day to other dentists and also use half of the allocation of emergency appointments.
The system should be able to identify from the treatment plan and type of appointment which patients should be dealt with as soon as possible and which can be moved a new appointment in the future. Patients undergoing root canal work or crows are priorities and an attempt is made to fit them into current weeks work, checkups are seen as lest priority and are rescheduled last. Contact information is listed for all the affected patients. The receptionist calls each one in the list which has been prioritised. They explain the situation and work with the patient to choose an alternative day and time.