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					Leeds Dental Institute

                          The World of Work as Dentistry Professional

                                       Resource Management

          Tutor notes

          In this session the participants will be asked to look at their own capacity for time
          management and then think about resources available for managing resources in a
          dental practice.


           Activity 1 (Slide 2)
           “What type of avoidance tactics do we use when we are avoiding doing tasks that
           we might want to do?”




           Activity 2 (slide 3)
           “Let‟s imagine some activities that might take place in a dental practice and see
           which boxes they might fit in. Please do this in pairs for 5 minutes.”
           Ask them for feedback




           Activity 3 (Slide 5)
           In Tray Exercise – handout the In-tray exercise (pages 2-10) . The participants
           have to imagine that all the documents need prioritising in order of importance.
           They could work in small groups to do this and before they give feedback ask them
           which criteria they used to organise the issues.




           Activity 4 (Slide 6-7)
           Give the participants Activity 4 handout - The Modern Digital Practice (page 11)
           They need to work in groups to look at this information and really begin to discuss
           how to manage resources in a dental practice.
           They need to address these issues:
               If you were setting up a practice how you would prioritise these activities?
               What criteria would you use to prioritise these activities? (Some as you can
                  imagine will cost more than others.)
               You also need to decide what methods you might use to set up these
                  systems.
               What staff training might you need to implement this?




                                                                                                  1
Leeds Dental Institute


                           The World of Work as Dentistry Professional

                                        Resource Management

          Activity 3 - The In-tray exercise
          Your task is to your prioritise elements in your in-tray and explore time management
          issues based on the letters, memos etc.

          The situation is that the Principal Dentist, Dr Eve Grey has been urgently called away
          and is to be away for an indefinite length of time. She has asked you to take care of
          things in her absence. It is a difficult family situation and you do not want to disturb
          her unless absolutely necessary.

          It is Monday morning, the locum dentist has arrived but you have cleared some
          space to go through the post in the in-tray. Working in pairs chat through what you
          might do with the items in the in-tray.




                                                                                                 2
          URGENT                           NON-URGENT
IMPORTANT DO NOW                           PLAN TO DO
                                           planning, preparation, scheduling
          emergencies, complaints and research, investigation, designing,
          crisis issues                    testing
          demands from superiors or        networking relationship building
          customers                        thinking, creating, modelling,
          planned tasks or project work designing
          now due                          systems and process development
          meetings and appointments        anticipation and prevention
          reports and other submissions developing change, direction,
          staff issues or needs            strategy
          problem resolution, fire-
          fighting, fixes                  Critical to success: planning,
                                           strategic thinking, deciding
          Subject to confirming the        direction and aims, etc. Plan time-
          importance and the urgency of slots and personal space for these
          these tasks, do these tasks      tasks.
          now. Prioritise according to
          their relative urgency.
NOT       3 - REJECT AND EXPLAIN           4 - RESIST AND CEASE
IMPORTANT trivial requests from others     'comfort' activities, computer
          apparent emergencies             games, net surfing, excessive
          ad-hoc interruptions and         cigarette breaks
          distractions                     chat, gossip, social
          misunderstandings appearing communications
          as complaints                    daydreaming, doodling, over-long
          pointless routines or activities breaks
          accumulated unresolved trivia reading nonsense or irrelevant
          boss's whims or tantrums         material
                                           unnecessary adjusting equipment
          Scrutinise and probe demands. etc.
          Help originators to re-assess. embellishment and over-
          Wherever possible reject and production
          avoid these tasks sensitively
          and immediately.                 Habitual 'comforters' not true
                                           tasks. Non-productive, de-
                                           motivational. Minimise or cease
                                           altogether. Plan to avoid them.




                                                                                 3
                                               14 Vine Street,
                                                         York
                                                    YO13 4FF


Dear Sir/Madam

I am writing to ask about the payment for the last dental
treatment for my wife, Mrs Evershed. When she made her
appointment it was for a filling, clean and polish.

She came home having paid for two fillings and a clean and
polish and says she felt pressured into having the second
filling done when she felt vulnerable during treatment.

I would like to know how your system operates with regard to
selling more treatment during a pre-booked treatment as I feel
that this is unethical.

Regards,



Simon Evershed




                                                             4
Email from: Sarah Greenhall
Association of UK Dentists

To : Dr Eve Grey

Date : 9/1/08


Thank you for your conference submission to the Annual Conference of UK
Dentists: in Glasgow at the Adelphi Hotel, 12th-15th March. We have included
your abstract in the Conference Programme and would ask that you email
your slides to us by the 12th February so that we can organise printing the
handouts.

Please could you also let us know what equipment other than PC and
projection equipment you will need.

Thank you.


Sarah Greenhall,
Events Co-ordinator
Association of UK Dentists




                                                                               5
                                                   Smith Dental




Memo
       To:          Dr Grey
       From:`       Liz Cooke - Practice Manager
       CC:          All dentists
       Date:        09/01/08
       Re:          Staff Lateness


Lateness of Staff


       I feel I must bring to your attention that Susan Mitchell and Lesley Mills
       are persistently late for work. It happened a few times before the holidays
       which I overlooked due to the festivities but now as we all return to work I
       feel that it is setting a bad example. I have spoken to them but nothing
       has changed.

       Although I have only been working here for two months, I feel that they
       have no respect for my authority and must therefore pass the
       responsibility on to you.



       Liz




                                                                                 6
York Place Dental Practice

9/1/08

Dear Dr Gray:

          You recently requested pricing information from our company. Here is our quote:

                    Service                                             Estimated cost
Quote for refurbishment of windows
to replace wooden frame windows at
York Place Dental Practice
6 secure windows @ £880                                                                  5280



                                                      Total                           5280
                                                       Tax                              792
                                               Grand total                            6072
                                              Delivery date                         28/2/08

Because we haven’t had the pleasure of doing business with you before, we have a special
offer to express how much we’d like to: If you confirm this estimate within five days of
the date on this letter, we’ll give you a discount of 10% on the job.

Thank you for giving us the opportunity to bid for your business. We have been in
business since 1998 and have established a reputation for quality. We look forward to
showing you that it is well deserved.

Yours sincerely,




Dean Windows Ltd, 79 Hale Road, Manchester


P.S.     If you would like to discuss items in this quote, or if you need any additional
         information, please call me personally at 0161 294 5007.




                                                                                          7
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                                                                                                8
Survey Of Dentists' Attitudes To The New NHS Dental
Contract, Introduced In April 2006, Shows That One In
Four Intends To Quit The NHS, UK
Main Category: Dentistry
Article Date: 01 Aug 2008 - 0:00 PDT




A survey of dentists carried out by the Dental Practitioners' Association in May
2008 has confirmed anecdotal evidence of high levels of dissatisfaction with
the new NHS dental contract introduced in England on 1st April 2006

- 30 per cent of dentists said that they did not meet treatment targets last year.
- 65 per cent are having money clawed back.
- Only 4 per cent have received funding to accept new patients.
- 95 per cent said that compulsory registration of nurses will increase staffing
costs.
- 95 per cent said that access to NHS treatment has not improved.
- 85 per cent said that the system of paying by 'units' is unworkable.
- 26 per cent said that they do not intend to stay on the NHS after April 2009.

CEO of the DPA Derek Watson said "These figures are very worrying as they
show that the drift of dentists away from the NHS is likely to accelerate in April
2009. This is exactly the reverse of what was promised by the Department of
Health. It confirms what we are hearing from our members, which is that they
are using the three-year period during which their earnings are guaranteed to
plan an exit strategy from the NHS.

"Unlike the old system where funding followed the dentist and provision could
be expanded, at the moment dental funding is based on historical spending.
From April 2009 all bets are off and PCTs will have absolute freedom to tell
dentists where to work and who to see while taking none of the business risk.
Dentists are continuing to drift into the private sector due to the large disparity
in terms and conditions between the NHS and private sectors. This transfer of
risk will cause many dentists to reconsider working in the NHS.

"We do not expect all 26 per cent of dentists to quit the NHS, but even a loss of
10 per cent of the dental workforce will cause a severe supply-side shock. The
job of commissioning has been delegated to Primary Care Trusts and Health
Boards; but responsibility lies fairly and squarely with the Department of
Health which dictates the system in which dentists and PCTs must work."


http://www.medicalnewstoday.com/articles/116794.php


see below……




                                                                                     9
10
Activity 4 - The Modern Digital Dental Practice



   •   Financial management for the patient – accurate billing but also accurate and
       professional estimates for future work. Information sent directly from chair side
       discussion to admin staff – it is created monitored and tracked to ensure consistency
       and lack of confusion

   •   Financial management for the practice - Link directly to financial software to enable
       real time income expenditure, cash flow management and financial planning.

   •   Office Management - Can link billing directly to patient records and funding body
       (where necessary) – again keeping consistency required for good relationship
       management.

   •   Digital appointment systems –keeping full control and allowing best time
       management practice- prompting automated email reminders. Tie patient data to
       marketing function – newsletters – practice information.

   •   Stock Control - Monitor stock control and usage – automated prompting and re-
       ordering of stock.

   •   Practice website – increasingly important – enable patients to book their own
       appointment, pride general information, health education, additional services etc.

   •   Clinical Governance Allowance - easy implementation of changes to clinical
       governance

   •   Audits – A key requirement in any practice to improve quality of care. important part
       of improving the service are also made much easier than paper based systems.
       Collecting/comparing analysing data.

Ref: I.-V. Wagner, R. S. Ireland and K. A. Eaton - BRITISH DENTAL JOURNAL VOLUME
204 NO. 7 APR 12 2008



   Tasks:

           If you were setting up a practice how you would prioritise these activities?
           What criteria would you use to prioritise these activities? (Some as you can
            imagine will cost more than others.)
           You also need to decide what methods you might use to set up these
            systems.
           What staff training might you need to implement this?




                                                                                            11
Leeds Dental Institute

                          The World of Work as Dentistry Professional

                                       Resource Management



          Personal time management skills are essential skills for effective people.
          People who use these techniques routinely are the highest achievers in all
          walks of life, from business to sport to public service. If you use these skills
          well, then you will be able to function exceptionally well, even under intense
          pressure.

          What's more, as you master these skills, you'll find that you take control of
          your workload, and say goodbye to the often intense stress of work overload.

          At the heart of time management is an important shift in focus:

          Concentrate on results, not on being busy

          Many people spend their days in a frenzy of activity, but achieve very little,
          because they're not concentrating their effort on the things that matter the
          most. www.mindtools.com


                                       URGENT                                     NON-URGENT
           IMPORTANT                   DO NOW                                      PLAN TO DO
                                                                        planning, preparation, scheduling
                           emergencies, complaints and crisis     research, investigation, designing, testing
                                              issues                     networking relationship building
                         demands from superiors or customers thinking, creating, modelling, designing
                        planned tasks or project work now due          systems and process development
                               meetings and appointments                   anticipation and prevention
                             reports and other submissions           developing change, direction, strategy
                                     staff issues or needs
                         problem resolution, fire-fighting, fixes    Critical to success: planning, strategic
                                                                  thinking, deciding direction and aims, etc.
                          Subject to confirming the importance       Plan time-slots and personal space for
                           and the urgency of these tasks, do                       these tasks.
                        these tasks now. Prioritise according to
                                    their relative urgency.
              NOT              3 - REJECT AND EXPLAIN                       4 - RESIST AND CEASE
           IMPORTANT            trivial requests from others       'comfort' activities, computer games, net
                                   apparent emergencies                surfing, excessive cigarette breaks
                          ad-hoc interruptions and distractions       chat, gossip, social communications
                            misunderstandings appearing as        daydreaming, doodling, over-long breaks
                                           complaints               reading nonsense or irrelevant material
                              pointless routines or activities       unnecessary adjusting equipment etc.
                              accumulated unresolved trivia           embellishment and over-production
                                 boss's whims or tantrums
                                                                  Habitual 'comforters' not true tasks. Non-
                          Scrutinise and probe demands. Help       productive, de-motivational. Minimise or
                           originators to re-assess. Wherever        cease altogether. Plan to avoid them.
                         possible reject and avoid these tasks
                               sensitively and immediately.




                                                                                                     12
2007 survey by the Proudfoot Consulting (Guardian 22 Oct 07) covering 2,500
businesses over four years and 38 countries, indicated that wasted time costs
UK businesses £80bn per year, equivalent to 7% of GDP.

The causes of wasted time - labour inefficiency in other words - were:
   •   inadequate workforce supervision (31%)
   •   poor management planning (30%)
   •   poor communication (18%)
   •   IT problems, low morale, and lack or mismatch of skills (21%)



The Modern Digital Practice

   •   Financial management for the patient – accurate billing but also
       accurate an professional estimates for future work. Information sent
       directly from chair side discussion to admin staff – it is created
       monitored and tracked to ensure consistency and lack of confusion
   •   Financial management for the practice - Link directly to financial
       software to enable real time income expenditure, cash flow
       management and financial planning.
   •   Office Management - Can link billing directly to patient records and
       funding body (where necessary) – again keeping consistency required
       for good relationship management.
   •   Digital appointment systems –keeping full control and allowing best
       time management practice- prompting automated email reminders. Tie
       patient data to marketing function – newsletters – practice information.
   •   Stock Control - Monitor stock control and usage – automated
       prompting and re-ordering of stock.
   •   Practice website – increasingly important – enable patients to book
       their own appointment, pride general information, health education,
       additional services etc.
   •   Clinical Governance Allow - easy implementation of changes to
       clinical governance
   •   Audits – A key requirement in any practice to improve quality of care.
       important part of improving the service are also made much easier than
       paper based systems. Collecting/comparing analysing data.

Notes on - Clinical governance--- is defined by the Department of Health as
„A framework through which National Health Service (NHS) organisations are
accountable for continuously improving the quality of their services and
safeguarding high standards by creating an environment in which excellence
in clinical care will fl ourish‟.18

This definition is not confined to care provided within the NHS but can be
extended to apply to treatment provided under any payment system. In trying
to implement continuous quality improvement it is necessary to establish
minimal standards for both clinical and administrative care which are


                                                                             13
nationally or locally accepted. The advantage of utilising ICT solutions is that
the defined and accepted standards can be incorporated into the ICT system
such that the system is programmed to prevent the clinician or any member of
the dental team from accepting data input which falls short of the prescribed
standards. For example, many hand-written clinical patient records are
deficient on important registration data such as telephone numbers,
post codes etc. An electronic data entry form can be programmed to
prevent the user from progressing until this important data is registered
correctly. To further improve the quality of the data recording, the dental
record can benefit from being made interactive, ie the administrator can be
prompted to record all the appropriate data.



What are the disadvantages of automated ICT systems:
• The initial expense of installing appropriate software and hardware and the
ongoing costs of updating and maintenance
• The lack of versatility in the software package in meeting the specific needs
of an individual operator or practice
• The need for frequent electronic backup to avoid potential data loss
• The need for additional staff training, the problems of staff adaptation to
change and the problems of adjusting to, understanding and managing new
and complex technology
• The fragility in the software market possibly resulting in a need to change to
a new system and the potential problems of compatibility in transferring data
onto a new software package
• The difficulty in transferring patient data between different software systems
when patients join or leave a practice
• The pressure on the software developers to adapt to changes in the
requirements of third party payers.

All information from:

Ref - http://0-
www.nature.com.wam.leeds.ac.uk/bdj/journal/v204/n7/pdf/sj.bdj.2008.243.pdf


Resource Management is a key part of any SME, including a dental practice.
It is important to remember that in order to be able to operate as a
professional dentist, the whole operation must be professional.

The BDA offer Continuing Professional Development Courses to enable you
to build these skills.

http://www.bda.org/




                                                                               14

				
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