Reset. Reopen. Restore. A practical guide to help your business bou ceback safely
COVID - 19 WE’RE HERE TO HELP Henry Schein takes seriously its commitment to helping healthcare professionals manage the impact of the COVID-19 outbreak. We strive to be a valuable business partner that our customers can rely on to help operate efficiently and deliver quality patient care. We are always ready to stand by you during these challenging times. Please contact us or visit henryschein.co.uk for more information
Taking care of everything dental
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INDEX Preparing your Practice
Preparing your Staff
Reception
page 4
1. Staff Screening
page 28
Waiting Room
page 6
2. PPE - Masks, RPE and Fit Testing
page 31
Treatment Room
page 8
3. Staff Reinduction and Training
page 34
Decontamination Room
page 10
Training Requirements
page 34
Plant Room
page 12
Procedures Post Training
page 35
Washroom Facilities
page 14
RIDDOR Reporting
page 35
4. Staff Uniforms
page 36
5. Health and Wellbeing
page 38
6. Work Rotas and Staffing
page 39
NEW Equipment for Infection Control Air Filtration
page 18
Extra-Oral Suction
page 18
Intra-Oral High Volume Evacuation
page 18
Bounceback Loan Scheme
page 19
Diary Management and Appointment Planning for Reopening
Surface Stream Disinfection
page 19
Patient Triage
Going Digital
page 19
Mills
page 21
Preparing your Patients
3D Printing
page 21
Notification
page 44
Patient Screening
page 44
NEW Everyday Items The New Normal Protocols and SOPs
2
page 22
page 40
The New Patient Journey: Contactless Arrivals and Departures
page 45
Preparing your Practice Management Software
page 46
Further Information and Resources
page 47
Teledentistry
page 48
page 24 page 26
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Dear Customers, Now that further guidance and Standard Operating Procedure (SOP) has been released by the Office of the Chief Dental Officer (OCDO) for England, you will be preparing your staff, your practice, your equipment and your patients for the new normal. This document offers lots of ideas and information to help you do just that. There are playlists to help you recommission your equipment and prepare EXACT for the new messaging, shopping lists for you to select the new everyday items and equipment you will need to ensure safety, recommence treatment, how you can adapt your practice for the new experience, communicate with your patients, have a dry run with your team to make sure you are compliant, prepare your appointment book and give your patients the reassurance they need. This really is the time to reenergise your team and imagine a successful future by seeing beyond today and looking ahead to tomorrow. To help you with this we have been working hard on your behalf to collate the current and up to date advice, information, webinar content and recommissioning requirements to get you started. Ensuring that the correct procedures are followed could reduce the cost of potential repairs and further downtime for your practice. Our engineers are also on standby to take your calls. For more information on diary and appointment planning, marketing, AGPs, leadership, financial support and much, much more, click HERE to view our full and updated Business Bounceback document. Best wishes Jane MacRae Marketing Manager e: jane.macrae@henryschein.co.uk m: 07771 920949
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RECEPTION
4
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RECEPTION
CONSUMABLE ITEMS: • Hand Sanitiser • Hand Soap • Surface Cleaning Solution/Spray • Surface Cleaning Wipes • Clinical Floor Cleaning Solution • Over Shoe Covers • Disposable Apron • Face Masks • Face Shield Visor • Disposable Gloves • Pulse Oximeter • Infra-Red Thermometer • Plexiglass Partition Screen • Wipeclean keyboards • Contactless payment • Minimal paperwork and clear surfaces
EQUIPMENT ITEMS: • UV Air Sterilisation Unit • Steam Disinfection Surface Cleaning Unit
FIND THE COMPLETE LIST OF PRODUCTS AND EQUIPMENT STARTING FROM PAGE 18 WOULD YOU LIKE TO KNOW MORE? Choose how to contact us Call for technical service
Technical service
0800 028 4749
Call for consumables
Consumables
0800 023 2558
Call for equipment
Equipment
0800 028 4870
Contact our service desk via email equipment-servicedesk@henryschein.co.uk
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WAITING ROOM
6
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WAITING ROOM
CONSUMABLE ITEMS: • Hand Sanitiser • Hand Soap • Surface Cleaning Solution/Spray • Surface Cleaning Wipes • Over Shoe Covers • Disposable Apron • Face Masks • Face Shield Visor • Disposable Gloves • Contactless payment • Wipeclean keyboards • Minimal paperwork and clear surfaces • Remove chairs or use wipeclean fabrics • No magazines, drinking water, toys etc • Hygiene area for patient screening, decontamination and PPE
EQUIPMENT ITEMS: • UV Air Sterilisation Unit • Steam Disinfection Surface Cleaning Unit
FIND THE COMPLETE LIST OF PRODUCTS AND EQUIPMENT STARTING FROM PAGE 18 WOULD YOU LIKE TO KNOW MORE? Choose how to contact us Call for technical service
Technical service
0800 028 4749
Call for consumables
Consumables
0800 023 2558
Call for equipment
Equipment
0800 028 4870
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TREATMENT ROOM
Studio Dr Antonino Cacioppo, Palermo.
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TREATMENT ROOM
CONSUMABLE ITEMS: • Hand Sanitiser
• Face Masks FFP3
• Hand Soap
• Cap
• Daily Dental Unit Water Lines
• Face Shield Visor • Safety Glasses
Disinfectant Solutions • Dental Unit Water Lines Test Kit
• Disposable Gloves
• Suction System Non-Foaming
• Shoes/Clogs • Pulse Oximeter
Cleaning Solution • Surface Cleaning Solution/Spray
• Infra-Red Thermometer
• Surface Cleaning Wipes
• Rubber Dam Kit
• Clinical Floor Cleaning Solution
• Suction & Retraction Device (e.g. Isolite/Isovac)
• Dental Unit/Treatment Centre Barrier Protection Covers/Film • Over Shoe Covers • Disposable Apron
CLICK HERE
• Surgical Gown Sterile
for detailed guidance and videos for recommissioning your equipment
• Face Masks • Face Masks FFP2
EQUIPMENT ITEMS: • Treatment Centre With Automated Disinfection and Remote Monitoring & Diagnostics • UV Air Sterilisation Unit
CLICK HERE
• Extra Oral Vacuum Suction Unit (e.g. Optima EOS)
to view our range of dental chairs
• Steam Disinfection Surface Cleaning Unit
FIND THE COMPLETE LIST OF PRODUCTS AND EQUIPMENT STARTING FROM PAGE 18 WOULD YOU LIKE TO KNOW MORE? Choose how to contact us Call for technical service
Technical service
0800 028 4749
Call for consumables
Consumables
0800 023 2558
Call for equipment
Equipment
0800 028 4870
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DECONTAMINATION ROOM
10
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DECONTAMINATION ROOM
CONSUMABLE ITEMS: • Hand Sanitiser • Hand Soap • Surface Cleaning Solution/Spray • Surface Cleaning Wipes • Clinical Floor Cleaning Solution • Over Shoe Covers • Disposable Apron
CLICK HERE
• Surgical Gown Sterile
for detailed guidance and videos for recommissioning your equipment
• Face Masks • Cap • Face Shield Visor • Safety Glasses • Disposable Gloves • Shoes/Clogs • Heavy Duty Gloves for decon room • Helix Test kit
CLICK HERE
• Bowie Dick Test Kit
to view our range of autoclaves and decontamination equipment
EQUIPMENT ITEMS: • Washer Disinfector Unit • Vacuum Autoclave • Handpiece Lubrication Unit • Ultrasonic Bath • Reverse Osmosis Water Unit • Sealing Device • Magnifying Inspection Lamp • UV Air Sterilisation Unit • Steam Disinfection Surface Cleaning Unit
FIND THE COMPLETE LIST OF PRODUCTS AND EQUIPMENT STARTING FROM PAGE 18 WOULD YOU LIKE TO KNOW MORE? Choose how to contact us Call for technical service
Technical service
0800 028 4749
Call for consumables
Consumables
0800 023 2558
Call for equipment
Equipment
0800 028 4870
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PLANT ROOM
CLICK HERE
for detailed guidance and videos for recommissioning your equipment
CLICK HERE
to view our range of compressors and suction pumps
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PLANT ROOM Suction Pumps | Estimated Duration: 10 minutes • Ensure the electrical supply is switched OFF • Check the electrical supply cable for any sign of wear or damage • Check all connected tubing and hoses for any sign of wear or damage • Inspect in-line filters for any sign of wear or damage. Replace as necessary. • Switch the electrical supply ON • Switch your Treatment Centre ON • Start the Suction Pump by selecting a patient Suction Tube on the Treatment Centre or Suction Manifold • Check that the pump starts and runs smoothly, without excessive noise or vibration Compressors | Estimated duration: 20 minutes • • • • • • • •
•
•
Ensure the mains electrical supply is switched OFF Check the electrical supply cable to the compressor for any sign of wear or damage Check all connected tubing/hoses for any sign of wear or damage Ensure the Compressor drain valve(s) is closed For oil lubricated compressors, please check the oil level is above the indicated minimum level. Replenish as necessary. Switch the electrical supply ON Switch the compressor ON Allow the compressor to build-up pressure. Depending on the Compressor size and connecting pipework, it may take ≈10 minutes to achieve full pressure. If the Compressors continues to run after ≈10 minutes, this could indicate an air leak within the pressurised system. We advise checking any connected equipment for air leaks, this may include; Treatment Centre (pressurised water bottles), Milling equipment, Prophylaxis Air Polishers, DAC. When the Compressor reaches full pressure and switches OFF, a short escape of air will be heard for ≈10 seconds. For Compressors fitted with an air dryer, this escape of air may be as long as ≈20 seconds. Should the Compressor activate regularly when the connected equipment has not been in use, this may indicate an air leak somewhere within the pipework, or equipment.
If you are in any doubt WHATSOEVER as to the condition and/or safe operation of your plant equipment, you should switch OFF any power source and contact Henry Schein service for support.
FIND THE COMPLETE LIST OF PRODUCTS AND EQUIPMENT STARTING FROM PAGE 18 WOULD YOU LIKE TO KNOW MORE? Choose how to contact us Call for technical service
Technical service
0800 028 4749
Call for consumables
Consumables
0800 023 2558
Call for equipment
Equipment
0800 028 4870
Contact our service desk via email equipment-servicedesk@henryschein.co.uk
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WASHROOM FACILITIES
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WASHROOM FACILITIES
CONSUMABLE ITEMS: • Hand Sanitiser • Hand Soap • Surface Cleaning Solution/Spray • Surface Cleaning Wipes • Over Shoe Covers • Disposable Apron • Face Masks • Face Shield Visor • Disposable Gloves
EQUIPMENT ITEMS: • UV Air Sterilisation Unit • Steam Disinfection Surface Cleaning Unit
FIND THE COMPLETE LIST OF PRODUCTS AND EQUIPMENT STARTING FROM PAGE 18 WOULD YOU LIKE TO KNOW MORE? Choose how to contact us Call for technical service
Technical service
0800 028 4749
Call for consumables
Consumables
0800 023 2558
Call for equipment
Equipment
0800 028 4870
Contact our service desk via email equipment-servicedesk@henryschein.co.uk
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Description
Reception Desk
Waiting Room
Hand Sanitiser Hand Soap Daily Dental Unit Water Lines Disinfectant Solutions Dental Unit Water Lines Test Kit Suction System NonFoaming Cleaning Solution Surface Cleaning Solution Spray Surface Cleaning Wipes Clinical Floor Cleaning Solution Dental Unit/Treatment Centre Barrier Protection Covers/Film Over Shoe Covers Disposable Apron Surgical Gown Sterile Face Masks Face Masks FFP2 Face Masks FFP3 Cap Face Shield Visor Safety Glasses Disposable Gloves Shoes/Clogs Heavy Duty Gloves Pulse Oximeter
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Treatment Room
Decontamination Room
Locker Room
Toilet WC
Description
Reception Desk
Waiting Room
Treatment Room
Decontamination Room
Locker Room
Toilet WC
Infra-Red Thermometer Helix Test Kit Bowie Dick Test Kit Rubber Dam Kit Suction & Retraction Device Plexiglass Partition Device Ultra Violet Air Sterilisation Unit Extra Oral Vacuum Sterilisation Unit Steam Disinfection Surface Cleaning Unit Washer Disinfector Unit Vacuum Autoclave Handpiece Lubrication Unit Ultrasonic Bath Reverse Osmosis Water Unit Sealing Device Magnifying Inspection Lamp Treatment Centre with Automated Disinfection and Remote Monitoring & Diagnosis
Contact our service desk via email equipment-servicedesk@henryschein.co.uk
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NEW EQUIPMENT Air Filtration
VK 401
Extra-Oral Suction Click HERE to listen to a webinar presentation
VK 103
For the ultimate in staff and patient safety, consider air purifiers in your waiting room and surgery/ies. Leading the global fight against airborne and droplet viruses, and perfect for all areas of the dental practice, the Radic8 Viruskiller™ neutralises 99.9999%* of viruses in a single air pass. The patented core technology neutralises certain airborne pathogens and viruses through a combination of filters and air sterilisation. Even mercury vapour and other gases are neutralised. * Tested against Coronavirus DF2 (not SARS-CoV2), Adenovirus, Influenza virus
Optima EOS 350
With a medical grade filtration system and UVC sterilisation, B.A. International’s OPTIMA EOS 350 is a high power extra-oral suction system designed to effectively capture droplets and airborne aerosols produced from dental treatments while ensuring patient comfort.
Intra-oral High Volume Evacuation
Isovac®/Isolite® 90% of aerosols can be removed with proper high volume evacuation. Studies show that Isovac/Isolite is more effective in reducing aerosols and spatter than using a rubber dam + HVE, or an HVE alone. Not only that, but because Isovac/Isolite provides continuous isolation, retraction, and suction, you will not require an assistant to evacuate liquid and debris.
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Finance options available call 0800 028 5523
Bounceback Loan Scheme You can also make use of the government’s Bounceback Loan Scheme for new equipment. The scheme helps small and medium-sized businesses to borrow between £2,000 and up to 25% of their turnover. The maximum loan available is £50,000. The government guarantees 100% of the loan and there won’t be any fees or interest to pay for the first 12 months. After 12 months the interest rate will be 2.5% a year.
Finance options available Call 0800 028 5523
Henry Schein Financial services are also offering 3 months 0% deferred interest loans.
There’s never been a better time to go digital!
Surface Steam Disinfection
Polti Sani The Polti Sani range provides a rapid physical method of disinfection, for frequent use with zero drying time. It uses a nontoxic solution that can be used in the presence of staff and patients and requires no direct contact with potentially contaminated surfaces. With a 99.99% demonstrable efficacy to kill viruses, bacteria, germs, fungi and spores, this is the ultimate solution to surface disinfection. Plug and play and non-hazardous.
POLTI SANI SYSTEM BUSINESS
POLTI SANI SYSTEM PRO
POLTI SANI SYSTEM BUSINESS
Intra-oral scanners
Trios Move There is no better time than now to consider going digital. It will save you chair time, be far more comfortable for your patients, and reduce the risk of infection dramatically with no more impressions (or storage). Hygiene options include autoclavable and single use disposable sleeve options. Plus of course the extra benefits of increased accuracy, consistency of fit, less remakes, less chair time and increased patient engagement and treatment uptake alongside easy patient monitoring.
3 years FREE subscription worth £2595+VAT
Check out our helpful scanning ebook for everything you ever wanted to know about the subject.
Finance options available - including 3 month 0% deferred payments - 0800 028 5523
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CEREC PRIMESCAN Intraoral Scanner It enables all kinds of dental treatment, from single tooth to full impression of the entire jaw in just 2 to 3 minutes, offering a much faster and more accurate experience for the patient.
Check out our helpful scanning ebook for everything you ever wanted to know about the subject.
Benefits at a glance:
✓ Speed – more than 50,000 images per second and data transfer to laboratories instantly. ✓ Accuracy – with an innovative smart pixel sensor processing more than 1,000,000 3D points per second and up to 20mm measuring depth with perfect sharpness.
✓ Usability – enjoy the increased field of view to visualise larger areas with less sweeps and immediate precision. ✓ Connectivity – it is now faster than even to connect to labs with open data transfer options.
✓ Hygiene – choose from three different sleeves – stainless steel, sapphire glass or as an autoclavable option. ✓ The NEW acquisition centre – a slicker, more modern feel with touchscreen and touchpad for perfect ergonomics.
Are you ready to future-proof your practice with an intraoral scanner which is more accurate, faster and easier to use?
Click on any of the products to book a demo or speak to one of our team.
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Disposable sleeves for Primescan available
NEW EQUIPMENT Mills
3 months 0% deferred payment available
CEREC Primemill And for the ultimate in same-day digital dentistry, consider the full chairside option of a milling machine which not only offers swift turnaround and minimises infection risk, but speeds up treatment time, gives you maximum control and optimises your cashflow.
3D Printer
Formlabs 3B Consider purchasing a 3D printer. Not only can you use it for printing temporaries, splints, mouth guards, surgical guides etc, but you can also print your own PPE. Check out our 3D printing ebook to find out more.
Useful Links There are some great resources to help you research the options online, including many videos and websites with information and ROI calculators including:
Finance options available - including 3 month 0% deferred payments - 0800 028 5523
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NEW EVERYDAY ITEMS Rubber Dams Rubber dams should be incorporated for use within all AGPs. For routine hygiene procedures, a split dam technique may be an option.
Visors
Mouthwash The use of a 60 second pre-procedural mouth rinse along with the use of high volume suction apparatus significantly reduces the aerosol contamination and hence chances of cross-infection. A mouthrinse containing oxidative agents such as 1% hydrogen peroxide or 0.2% povidone is recommended.
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Masks For AGPs: Tight fitting FFP2 or FFP3 masks (respiratory protective equipment) which will need to be fit tested (see page 32 for more details). For non AGPs: Fluid-resistant surgical masks (Type IIR).
Reception Shield Cough screens and sneeze guards by Shop Shields offer an ideal solution for receptions and waiting areas in dental surgeries. Creating a protective barrier and helping prevent the spread of viruses by blocking infectious airborne particles. ShopShield’s range of Reception Desk Shields have been designed and made to meet the specific needs of dental practices and health clinics. Offering protection, whilst allowing for clear viewing and communication between staff and patients, with a small opening for transactions. Standard and bespoke options are available.
Plug ‘n’ Play Handpiece Motor If you lack an inbuilt chair motor, B.A. International offer a simple solution: the Ultimate EM420 is a cost efficient, plug and play electric micromotor that connects directly to your chair’s existing air supply.
Order from henryschein.co.uk or phone Customer Services on 0800 023 255
Electric Handpieces Electric contra-angle handpieces generate fewer aerosols and also generally benefit from internal anti-retraction systems. Apart from being a safer, more hygienic option, electric contra-angles feature various other benefits:
• Consistent torque provides smoother and more precise cutting edge.
To download your full shopping list, click HERE
Contactless Thermometer
• More efficient at cutting harder materials. • Smaller head diameter results in a better sight of the preparation area. • Quieter and produce less vibratory sensation.
• Most models are equipped with an LED light.
Single Use Instruments Switching to single-use devices and instruments reduces the risk of patient-to-patient crosscontamination as well as saving the time and cost involved in reprocessing.
Gowns The NHS and Public Health England recommend the use of long-sleeved disposable fluid repellent gowns (covering the arms and body), or disposable fluid repellent long-sleeved coveralls/apron for AGPs or when working in higher risk areas. Staff need to be trained in the safe removal of coveralls. If non-fluid resistant gowns are used, a disposable plastic apron should be worn underneath.
For daily availability of PPE items, please check our website
Order from henryschein.co.uk or phone Customer Services on 0800 023 255
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THE NEW NORMAL As lockdown eases and dentists begin to resume their work, what will the new ‘normal’ look like for your dental practice? What’s changing? Here is a collection of all the things you will need to consider before finally opening your doors. See also our useful information, links and resources on page 47 Staff changing room
•• Provide an area for your team to don and doff their PPE •• Airtight laundry basket with bag for easy and safe removal •• Instructions for donning and doffing PPE clearly displayed on wall
•• Air purification system such as Radic8 Hextio for small spaces •• Hand gel and PPE dispenser for the team
•• Disinfectant solution to apply before they leave the clinic •• Tissue dispensers
Radic8 Hextio
Reception area
•• Clear screen to protect receptionist •• PPE for receptionist
•• Individual phone headsets for each staff member
•• All forms pre-filled in for fully contactless registration •• Contactless payments or provide branded pens for patients to keep •• Wipe clean keyboards •• Tissue dispensers
•• Minimal paperwork and clear surfaces Front door
•• Screen patients before they come for their appointment. Download sample screening form.
•• Write to them and ensure they know what to expect when they arrive and to come alone where possible •• Advise patients to wait in car or outside the practice until they are called
•• Electric doors for minimal contact, leave front door open (will also assist with ventilation ) or escort each patient into the practice •• Poster in window to show how are you are addressing COVID-19 to maximise patient confidence:
•• Advertise that you are a clean air practice with Radic8 virus killer certification •• Specify that you are now a fully contactless practice •• Display certificates for water treatments, COVID-19 decontamination treatments etc
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Waiting room
•• No magazines, drinking water unit
•• Chairs 2m apart and seamless wip
•• Social distancing stickers on the f
•• Air purification system such as Ra
•• 3-D printer for printing your own P •• Tissue dispensers
•• Shoe disinfection mat or provide
•• Add patient toilet facilities out of s
Surgery one (non-AGPS) •• Correct PPE
•• Infection control SOPs
•• Air purification system such as Radic8 VK401 Window open for ventilation •• No air-conditioning
Radic8 VK401
•• Chair with continuous sanitisation •• Disposable covers on headrest
•• Rubber dam – use for appropriate procedures to reduce aerosol •• High-volume evacuation such as Isolite/ Isovac to reduce aerosol
Zyris Isolite
•• Chemo mechanical caries removal (reduced drilling)
Surgery two (AGPS)
Surgery one (non-AGPS)
•• Extraoral evacuation e.g. VacStation •• Rubber dam
•• Single use items or disposable
3Shape Trios Move
•• Extraoral radiography where appropriate
•• Electric handpieces (generate less aerosol) •• Special water line cleaning
•• Consider digital solutions to reduce infection transmission •• Tissue dispensers
•• Minimal paperwork and clear surfaces Surgery two (AGPs)
•• If possible, undertake all aerosol generating procedures in a single surgery •• Air purification system such as Radic8 VK401 Window open for ventilation
•• Thorough cleaning process required in between patients including chairs, keyboards, curing lights, handpieces etc. •• Door sign to show where the surgery requires decontamination or is ready for use •• Tissue dispensers
•• Minimal paperwork and clear surfaces Hygiene area for patients
•• New PPE dispenser including shoe covers
•• Sink for patients to wash their hands with automatic tap and soap dispenser •• Hand sanitising gel for patients
•• Table for patients to bag their belongings next to PPE dispenser
ts, toys etc
•• Contactless thermometer for temperature screening
pe down material or cover them
floor
adic8 VK102
•• COVID-19 test with instantaneous results (when available) Radic8 VK102
PPE in addition to your usual dental products. protective shoe covers
service
•• Preprocedural mouth rinse with 1% hydrogen peroxide or 0.2% povidone •• Patient to don disposable masks and disposable gloves and advised not to touch anything •• Tissue dispensers
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PROTOCOLS AND SOPS Protocols and SOPs The Office of the Chief Dental Officer (OCDO) for England has provided a Standard Operating Procedure (SOP) for the transition towards the resumption of the full range of dental provision.
For Wales, click HERE
The FGDP has produced its guidelines: Implications of COVID-19 for the safe management of general dental practice: a practical guide The DDU have also made their position clearer, click HERE.
Association of Independent Dental Surgeons (UK & Eire) 31st May 2020
PANDORA Group: An Independent Think Tank Dear Colleague:
Pandora Dental represents many of the UK & Eire’s leading independent dental practices and was founded in recognition of the need for evidence-based best practice and guidance during the Covid-19 pandemic. They provide information and feedback from highly experienced primary care dental clinicians to support the key policy and decision makers in UK dentistry.
In conjunction with the IndepenDent Owners Group, they have recently launched their new Back to Work Protocol.
In anticipation of the reopening of private/independent dental practices closed since late March we offer here some templates for the required additional documentation following Covid-19 to supplement practice manuals in accordance with the requirements of the CQC and GDC. As the evidence base is in flux this can only be viewed as a living document. Consequent to the changing requirements adoption of this document must be the subject to continued and frequent review. Although every effort has been made to check the accuracy of the materials presented here within the context of the current evidence base it is an absolute requirement that ultimate ownership of the final template must by necessity rest with the individual practitioner. It is not a perfect document however we trust that it will prove of considerable help to you as you face the challenges of the post covid-19 era. We have endeavoured very hard indeed to produce this set of working documents and they represent many hundreds if not some thousands of hours of work by our dedicated team. My particular thanks are due to the following individuals who worked tirelessly to help colleagues such as yourself return safely to practice: • • • • • • • •
Dr Tasleem Ahmed Dr Nicola Gore Dr Ashish Deved Dr Michelle Wyngaard Dr Petros Mapanda Dr Nadia Raitchev Dr Ivo Raitchev Dr Genevieve Edwards
Yours sincerely
• • • • • • •
Dr Mario Correia Dr Mark Becker Dr Maheshi De Silva Dr Jeremy Bliss Dr Cohan Rajan Dr Robin Horton Dr Raj Wadwhani
Dr Mark Cronshaw, BSc BDS LDSRCS (Eng) MSc Dental Surgeon President, Pandora Dental: Association of Independent Dental Surgeons (UK & Eire) Email: Drmarkcronshaw@outlook.com Web: Pandoradental.org.uk
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For Scotland, click HERE
For Northern Ireland, click HERE
For Ireland, click HERE
See how other countries are preparing to reopen
Documents from Pandora PANDORA CHECKLISTS • Personal protective checklist • Chairside checklist • Consent to dental treatment during COVID-19 • CSDG COVID-19 daily screening log • Face fit test certificate • Fit testing questionnaire and log • Tips on what your staff should say during COVID-19 • RPE policy with posters DENTAL UNIT WATERLINES • Background on dental waterlines with links • Legionella policy • Legionella risk assessment template • Waterline management
OTHER GUIDANCE DOCS • FGDP guidance on record keeping PATIENT CONSENT FORM • Patient consent form for COVID-19 RISK ASSESSMENTS • COVID-19 risk assessment for the surgery • COVID-19 risk assessment cleaning • COVID-19 risk assessment hand washing • COVID-19 risk assessment social distancing • COVID-19 risk assessment checklist
SOPS AND BACK TO WORK PROTOCOL • Pandora dental and the independent practice owners UK - Protocol to get back to work • SOP version 5 • Appendix to the SOP EMOTIONAL AND HEALTH SUPPORT FOR STAFF • Front office protocols • What are we doing to keep you and our team safe? • CDO England Scotland Wales Ireland • Contact list for wellbeing support guidance letters • 10 tips to help manage anxiety - every mind matters • Glossary of terms MARKETING TO PATIENTS • PPE training and marketing for patients (customisable) • Welcome back letter for Campaign+ • Welcome back letter
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PREPARING YOUR STAFF
1. Staff Screening It’s important to think about preparing your team for their return to the practice, both for the practical changes they’ll experience, and also the reassurances, additional training and education they may need. Consider screening staff for symptoms of COVID-19 on their initial return to work, and then on a daily basis thereafter. A staff screening log should be maintained.
An initial risk assessment should explore risk factors arising from each team member’s time out of the practice (e.g. were they/a member of their household self-isolating for symptoms of COVID-19 at any point? Did they volunteer to work in another area of healthcare or for a charity during lockdown? Have they had a test for COVID-19, and what was the result?). The daily screening process below could then be followed, in order to identify staff as:
• Possible/confirmed COVID-19 cases, directly or through their household, who should self-isolate.
• Staff who are at increased risk of harm from COVID-19 infection and should be shielded or may need to take other precautions in line with the UDC SOP.
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• Other staff who are considered at lower risk of harm from COVID-19 who should follow the updated PPE guidelines and ICPs.
Until reliable, low cost, instant antigen and antibody screening tests for COVID-19 are available, the daily screening process could be to take each team member’s temperature with a contactless forehead thermometer, then ask questions in line with the COVID-19 case definition, in particular:
• Do you have a fever?
• Do you or does anyone in your household have a new, continuous cough? • Have you lost/noticed a change to your sense of smell or taste?
• If you or anyone in your household has tested positive for COVID-19, are you still in the self/ household isolation period?
If a team member answers yes to any of the questions, or has a temperature of 38°C or above, they should be considered at high risk of having COVID-19 infection and sent home. Note that temperature checks should not be used in isolation to determine risk, as they are not considered a reliable measure of infectivity.
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COVID-19 Safe ways of working
A visual guide to safe PPE Aerosol Generating Procedures or High Risk Areas
Eye protection to be worn on risk assessment
Eye protection eye shield, goggles or visor
Fluid resistant surgical mask
Filtering facepiece respirator
Disposable apron
Long sleeved fluid repellent gown
Gloves
Gloves
Clean your hands before and after patient contact and after removing some or all of your PPE Clean all the equipment that you are using according to local policies Use the appropriate PPE for the situation you are working in (General / AGPs or High Risk Areas) Take off your PPE safely Take breaks and hydrate yourself regularly
For more information on infection prevention and control of COVID-19 please visit: www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control
Š Crown copyright 2020. Public Health England Gateway Number 2019296. Version 1 April 2 2020
General contact with confirmed or possible COVID-19 cases
Check out our PPE website which shows daily availability of essential items
2. PPE - Masks, RPE and Fit Testing Some of the most critical changes for patient-facing team members will be the new PPE requirements. GOWNS The NHS and Public Health England recommend the use of long-sleeved disposable fluid repellent gowns (covering the arms and body) or disposable fluid repellent long-sleeved coveralls/ apron for aerosol generating procedures or when working in higher risk areas. Staff need to be trained in the safe removal of coveralls. If non-fluid resistant gowns are used, a disposable plastic apron should be worn underneath. Where an AGP is a single procedure, PPE is subject to single use with disposal after each patient contact or procedure as appropriate.
If wearing an apron rather than a gown (bare below the elbows), and it is known or possible that forearms have been exposed to respiratory secretions (for example cough droplets) or other body fluids, hand washing should be extended to include both forearms. Wash the forearms first and then wash the hands.
See article on What is the most appropriate gown/apron for preventing Covid-19 contaminated fluids transfer in dental practice?
You may consider purchasing an industrial washing machine so that staff are not taking infected garments out of the practice. For instructions on laundering re-usable gowns from the Health and Safety Executive click HERE.
The US Centers for Disease Control and Prevention also recommend that procedures are established to routinely inspect, maintain (eg mend a small hole in a gown, replace missing fastening ties), and replace reusable gowns when needed (eg when they are thin or ripped). Donning and doffing procedures are vital and your team should refresh their knowledge on these. You will need a designated donning and doffing area within the practice.
COVID-19
Quick guide – gown version
Putting on (donning) personal protective equipment (PPE) for aerosol generating procedures (AGPs)
Removal of (doffing) personal protective equipment (PPE) for aerosol generating procedures (AGPs)
This is undertaken outside the patient’s room. Pre-donning instructions • ensure healthcare worker hydrated • tie hair back • remove jewellery • check PPE in the correct size is available
1
COVID-19
Quick guide – gown version
Put on the long-sleeved fluid repellent disposable gown
Perform hand hygiene before putting on PPE
2
PPE should be removed in an order that minimises the potential for cross contamination.
1
Eye protection
4
Gloves – the outsides of the gloves are contaminated
Respirator Perform a fit check.
Clean hands with alcohol gel
2
3
The order of removal of PPE is as follows:
Gloves
3
Gown – the front of the gown and sleeves will be contaminated
Eye protection the outside will be contaminated
4
Respirator
Clean hands with alcohol hand rub. Do not touch the front of the respirator as it will be contaminated
5
Wash hands with soap and water
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2. PPE - Masks, RPE and Fit Testing OTHER FACTORS
• At the dentist’s discretion, respirator masks may be considered for single sessional use rather than single patient use. Respirators should be worn for no longer than 8 hours, with the caveat that they should be replaced if damaged, soiled, compromised or uncomfortable.
• Current UK advice is that respirator masks should not be reprocessed (decontaminated) then reused. Reusable respirators (marked with an “R”) should not be purchased or used in the practice.
• NHS England in their SOP recommend that if wearing an FFP2/3 mask that is not fluidresistant, a full-face visor must be worn.
• We advise against buying any type of mask from consumer ecommerce websites – they may not meet current regulations, may be poor quality and may not offer the level of protection that is promised.
• Team members who cannot wear an FFP2/FFP3 mask due to failure of fit • Look for FFP2 or FFP3 masks that are testing have the option CE marked and meet European standard of wearing a powered EN149:2001+A1:2009. However KN95 masks air purifying respirator ARE safe, compliant and approved for use in (PAPR) hood. A PAPR UK dental practices iif they meet the below hood functions at requirements: the level of an FFP3 1) Masks must be CE marked. mask but is reusable 2) Suppliers must be able to demonstrate how and does not require they know the documentation and CE marking fit testing. is genuine, supported by Notified Body documentation showing compliance with the essential health and safety requirements as required by the Personal Protective Equipment Regulations (EU) 2016/425.
Back to Practice and Respiratory Protective Equipment Click here for this excellent webinar from Dentinal Tubules
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Click here for
Detailed Fit Testing Information
from the Health and Safety Executive
YOUR BUSINESS IS OUR PRIORITY Infection Control for your Practice: A 360° Perspective A showcase for infection control and aerosol generating procedures
This new publication designed to showcase many of the key products associated with infection control and aerosol generating procedures in various environments within the dental practice, and how you can incorporate safer measures into your practice and day to day workflows. We thank you for the trust you have placed in us and hope you will find the content provided within this publication useful, as you Click here look to restart your practice.
to view online
Essentials for Practice Reopening Your essential guide to the products you will need when reopening your practice
As you return to practice and the start of the ‘new normal’, there is a range of products that you will find yourself needing more frequently, as well as lots of new ones that you didn’t need before. So we’ve tried to make the selection easier for you by filling this brochure with all the topline essential practice reopening products that you will need, to help take some of the strain. Everything is split into the relevant product categories for ease of reference, including PPE, cleaning and infection control products and Click here aerosol reducing equipment. Each category is set up as a mini online shopping list for you to view online to simply add the quantity you want.
Essentials
for Practice Reopening
COVID - 19
WE’RE HER E TO
HELP
Henry Schei n takes seriou commitmen sly its t to helpin g healthcare professional s manage the impact of the COVID -19 outbreak. We strive to be a valuab le business that our custo partner mers can rely on to help opera te efficiently and delive quality patien r t care. We are always ready to stand by you during challenging these times. Please contac t us for more informa or visit henryschein.co .uk tion
Taking car e of everyt
hing dental
0800 023
2558
henrysche in.co.uk
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3. Staff Reinduction and Training With all these new processes, your team will need to be trained when they return to work. All staff should read the UK government COVID-19: infection prevention and control (IPC) guidance, updated Resuscitation guidelines, and updated PPE requirements.
Disposable Plastic Apron
Context
Acute hospital inpatient and emergency departments, mental health, learning disability, autism, dental and maternity settings
Performing a single aerosol generating procedure2,9 on a possible or confirmed case3 in any setting outside a higher risk acute care area4
single use5
Working in a higher risk acute care area4 with possible or confirmed case(s)3
single use5
single use5
Working in an inpatient, maternity, radiology area with possible or confirmed case(s)3 – direct patient care (within 2 metres)
single use5
single use5
Working in an emergency department/acute assessment area with possible or confirmed case(s)3 – direct patient care (within 2 metres)
Disposable fluid-repellent coverall/gown
Fluid-resistant (Type IIR) surgical mask
Surgical mask
Filtering face piece respirator
single use5
single use5
single use5
single use5
Operating theatre with possible or confirmed case(s)3 – no AGPs2
single use
5
single use
5
Labour ward/area – 2nd/3rd stage labour vaginal delivery (no AGPs2) – possible or confirmed case3
single use
5
single use
5
Inpatient care to any individuals in the extremely vulnerable group undergoing shielding8
single use
5
single use
5
Eye/face protection1
single use5
single use5
single use5
sessional use6
sessional use6
sessional use6
sessional use6
sessional use6
All individuals transferring possible or confirmed case(s)3 (within 2 metres)
sessional use6
risk assess single use5,7 single use
2
single use
sessional use6 risk assess sessional use6,7 sessional use6
single or sessional use5,6
risk assess single or sessional use5,6,7
single or sessional use5,6
single or sessional use5,6
single or sessional use5,6
single or sessional use5,6
5
Table 1
1. This may be single or reusable face/eye protection/full face visor or goggles. 2. The list of aerosol generating procedures (AGPs) is included in section 8.1 at: www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/covid-19-personal-protective-equipment-ppe. (Note APGs are undergoing a further review at present). 3. A case is any individual meeting case definition for a possible or confirmed case: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-initial-investigation-of-possible-cases/investigation-and-initial-clinical-management-of-possible-cases-of-wuhan-novelcoronavirus-wn-cov-infection 4. Higher risk acute areas include: ICU/HDUs; ED resuscitation areas; wards with non-invasive ventilation; operating theatres; endoscopy units for upper Respiratory, ENT or upper GI endoscopy; and other clinical areas where AGPs are regularly performed. 5. Single use refers to disposal of PPE or decontamination of reusable items e.g. eye protection or respirator, after each patient and/or following completion of a procedure, task, or session; dispose or decontaminate reusable items after each patient contact as per Standard Infection Control Precautions (SICPs). 6. A session refers to a period of time where a healthcare worker is undertaking duties in a specific care setting/exposure environment e.g. on a ward round; providing ongoing care for inpatients. A session ends when the healthcare worker leaves the care setting/exposure environment. Sessional use should always be risk assessed and considered where there are high rates of hospital cases. PPE should be disposed of after each session or earlier if damaged, soiled, or uncomfortable. 7. Risk assessed use refers to utilising PPE when there is an anticipated/likely risk of contamination with splashes, droplets of blood or body fluids. 8. For explanation of shielding and definition of extremely vulnerable groups see guidance: https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/ guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19 9. Ambulance staff conveying patients are not required to change or upgrade PPE for the purposes of patient handover. Patient use of PPE: In cohort wards, communal waiting areas and during transportation, it is recommended that suspected or confirmed cases wear a surgical face mask if this can be tolerated. The aim of this is to minimise the dispersal of respiratory secretions, reduce both direct transmission risk and environmental contamination. A surgical face mask should not be worn by patients if there is potential for their clinical care to be compromised (e.g. when receiving oxygen therapy).
POTENTIAL TRAINING REQUIREMENTS
• COVID-19 facts and dentistry specific information • Triage procedures
• Designated surgeries for AGPs and non AGPs
• Appointment scheduling
• Information for patients prior to attending • Information obtained from patients prior to attending • The new contactless patient journey and walkthrough
• Signs present within the practice
• Minimising ‘touch points’ for patients and use of hand sanitiser for patients (and staff) • Procedures for gaining consent, receiving payments, signing of any forms
• Cleaning and disinfection of communal areas • Cleaning and disinfection of surgeries and surgery equipment • Instructions for use of any new equipment • Waste disposal protocols
• PPE, what is to be used, when it is to be used and the correct ‘donning’ and ‘doffing’ of PPE
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Disposable Gloves
Setting
Working in an inpatient area with possible or confirmed case(s)3 (not within 2 metres)
© Crown copyright 2020. Public Health England Gateway number: 2019302. V1. 14-05-2020
This Visual guide to safe PPE for AGP and non-AGP dental treatments should be printed and displayed in the staff room or office. This chart provides further detail.
Recommended PPE for healthcare workers by secondary care inpatient clinical setting, NHS and independent sector
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• Fit testing requirements
• Uniform/clinical clothing, when and how to change into and out of and how to transport and launder • Reusable and single use items
• Travelling to and from the practice
• Staff rotation and designated working environment
• Personal items, how to store, when and how to clean and disinfect • Social distance measures • External deliveries
• Procedures for engineers
• Decontaminating water lines • Clinical procedures
• Chaperones for vulnerable patients
• Sickness reporting and what to do if you show signs/symptoms of COVID-19
• Procedures for if members of your household are confirmed to have or are suspected of having COVID-19
• Hand hygiene techniques and when to perform
PROCEDURES FOLLOWING TRAINING
• Ensure all staff members understand the information given
• Encourage feedback and questions
• Advise where to locate any information provided • Advise what to do if procedures have not been followed
• Advise who to ask should any questions arise • Reassure all staff
• Evidence all staff who have attended and obtain signatures to evidence attendance and understanding • Conduct regular sessions to refresh knowledge, confirm understanding and to inform of any updates
RIDDOR REPORTING
A report under RIDDOR (the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013) will apply when: • An unintended incident at work has led to someone’s possible or actual exposure to coronavirus. This must be reported as a dangerous occurrence.
• A worker has been diagnosed as having COVID 19 and there is reasonable evidence that it was caused by exposure at work. This must be reported as a case of disease. • A worker dies as a result of occupational exposure to coronavirus. Further guidance is available HERE.
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4. Staff Uniforms • Staff should not travel to and from the practice in clinical clothing/uniform – including reception/ admin staff. • Assign a designated changing area where possible. • When arriving at the practice, ‘home clothes’ should be placed into a separate bag or pillowcase.
• No jewellery should be worn, bare to the elbow is required to enable hand washing (long sleeved gowns will cover this area when required), and hair should be tied back.
• At the end of the day, clinical clothing including shoes should be removed. Clothes should be placed straight into a plastic bag or washable bag/pillowcase. Footwear should be made of a wipe clean material and cleaned at the end of each day and should remain on site. Wear ‘home shoes’ and ‘home clothes’ to go home.
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• Appropriate hand washing should be carried out following the removal of clinical clothing.
• Upon arriving home, the clinical clothing should be placed straight into the washing machine and the bag disposed of or the washable bag placed into the washing machine with the clothing. Do not mix with other household laundry. Launder at the highest possible temperature. The washing machine should be half of a full load allowance. Hands should be washed following completion of this.
• Showering and washing of hair as soon as possible is recommended. • Wiping down the washing machine after the load is complete and removed is recommended.
For more information from Public Health England, Scotland, Wales and the HSC, click HERE
Check out our PPE website which shows daily availability of essential items
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5. Health and Wellbeing Consider the impact of lockdown and the pandemic on your team members, particularly their mental health: guidance is available from NHS Employers, WHO, Mind UK and the RCN. Ensure your sick leave policy is non-punitive for staff who are self-isolating with symptoms of COVID-19 infection. Make sure your team are fully briefed on the updated PPE and ICP guidelines, and are confident in answering questions from patients around any changes to the patient experience.
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6. Work Rotas and Staffing Ensuring you manage your practice staffing levels against your appointment book will be one of the key challenges facing practices after lockdown. With salaries to pay and income streams diminished, making the right decisions at the right time will be crucial. It’s important to note that despite a wide range of interventions put in place by the Government, the principles of employment law have remained the same and therefore any decisions must be made with this in mind. Outside of any further Government support being available, some of the options that you could consider are:
• Use annual leave or agreed unpaid leave
• Agree a mutual contractual variation e.g. reduced hours, longer hours and zero hours. • LOST (Lay-off Or Short-Time working) • Redundancy (voluntary, compulsory)
• You may wish to introduce a shift pattern and split your dental team, particularly if you extend work hours. This will reduce the whole team’s risk exposure. • Consider fallback scenarios should any of your team need to self-isolate. • Consider staff with care responsibilities (childcare or vulnerable adults).
Whichever option you are looking at, each will come with its own set of risks and procedures. Petaurum can support and advise you, so that any decisions you make about your workforce will not only be the right ones but also legally compliant.
For information on the Coronavirus Job Retention Scheme and bringing workers back to practice, click here.
If you have an HR question that is keeping you up at night and want some free advice, or you are looking for longerterm HR support, then CLICK HERE for more info. Watch Petaurum’s video for their top 5 tips to help your business come out of lockdown. With all of your other worries about bringing your practice up to speed after lockdown, let Petaurum take HR off your hands. Henry Schein customers get a discounted rate.
Contact our service desk via email equipment-servicedesk@henryschein.co.uk
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DIARY MANAGEMENT AND A Think about your diary zoning plans and sessions. Which patients do you want to come first thing, last thing and in between? Will you be using two surgeries? Can you limit one surgery (even for part of each day) to AGPs? Manage your appointment planning for reopening by calling and prioritising your patients. Don’t simply rebook patients that have missed appointments during lockdown because your days will be very different. You are likely to see far fewer patients and each will take a much longer time to include prescreening and hygiene measures. So leave a realistic amount of time for each appointment and also for deep cleaning the surgery in between.
Patient Triage Your aim should be to retain your existing patients and to reopen in a structured way by prioritising existing patients in need of restorative work and using short notice lists to fill gaps with check-ups. If you end up with general appointments booked up when someone has an emergency, they may go somewhere else if they cannot be seen by you. So formulate your priority list as follows: 1. Existing patients who need urgent restorative work focusing on the most highly productive procedures first to start to rebuild your revenue stream. Don’t forget to train your team on this. 2. Patients who had contacted the COVID-19 UDC system and already been triaged for urgent dental care, or require follow up care. 3. New patients. 4. Priority patients for check-ups. 5. Set aside clinics for vulnerable and shielded patients (those more likely to develop serious illness: older people, people with underlying medical problems, e.g. high blood pressure, heart problems, diabetes) at the beginning of the day.
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OTHER FACTORS
• Stagger appointments to minimise the number of patients in the practice at the same time.
• Block sessions for patients requiring AGPs and for patients requiring non AGPs.
• Plan your AGP sessions at the end of the day. • Allow longer time for hygiene appointments with hand scaling. • Covid-19 positive patient emergency slots can be limited to the end of the day only or they may be referred to your local UDC. It’s likely that hot sites or urgent dental care centres will continue to operate and treat patients who need urgent treatment but have the symptoms of COVID-19.
• Manage your time very carefully and make sure nobody runs over.
• When are you going to start implementing recalls? Your low risk patients could be moved onto annual checkups. If they’re on a patient plan, explain your decision and offer them a double appointment when they next come in so they still have the same amount of time allocated. Most patients should be happy with that if you’re explaining it well.
APPOINTMENT PLANNING
Don’t forget to book your complimentary Bounceback Review with Software of Excellence for more help on planning appointments for your return to practice.
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NEW PATIENT
JOURNEY VIDEO With these changing times ahead, how are you telling your patients about the new patient journey? Your patients will need to get used to the ‘new normal’ in your practice and one of the best ways of communicating this is via an animated video.
Buy Now
£97 inc V AT
JSP Media Group have created 3 different colour variations of the same video, which contains a voice-over and accompanying music. The video itself is divided into 4 parts: • • • •
Before Your Arrival – this section explains to patients what to expect before they set foot into the practice On Appointment Day – this tells patients to arrive on time wearing a mask and the logistics once they come in
Inside The Practice – this informs them about their temperature being taken and that they will be required to sanitise their hands
Before Visiting Us – this advises patients not attend if they have any symptoms of COVID-19
The video is customised with your practice logo and can be featured on your social media channels, your website or even sent out as an e-mailed link to inform your patients of the changes you are making in practice.
3 different versions are available for you to choose from:
Multi-coloured version
Dark version
Light version
You can purchase by clicking here Once you have made the purchase, just email your logo to JSP Media Group at info@jspmediagroup.com and specify which version you want.
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Positioning your Business for Success in the Post-COVID World
After a long lockdown, face-to-face dentistry is returning. But the world has changed. Our teams, patients and the public continue to live through a situation that is unprecedented in our lifetime. And the expectations of business from our staff, patients and the public have come more sharply into focus. Even before lockdown, almost 90% of people said they expected us to ‘be responsible’: keeping our teams safe, well informed and cared for, looking after and communicating with our patients and doing what was possible to help our communities. The businesses that did this well have avoided many of the problems that those that didn’t are facing right now - departing patients, staff reluctant to return from furlough, or causing disruption with negative attitudes.
The key to post-Covid recovery The businesses that are doing the best coming out of lockdown are those who have continued to act responsibly and do the right things. There’s a reason for this. The future of successful business is holistic. And our communities are looking to us to show them we are doing the right thing. They are looking for Corporate Social Responsibility (CSR). The CSR Coach helps businesses to grow with purpose. We make sure their business covers all their social and environmental responsibilities effectively and builds a reputation as the kind of business that people want to work for and buy from.
What can CSR do for me? • Help you to attract and retain a more engaged team - increase productivity, reduce staff turnover • Fulfil your environmental responsibilities - allay your staff and patients’ concerns • Engage with and impact your community and good causes - make a difference and boost team morale • Demonstrate simply and clearly that you’re a responsible business - build your reputation and increase trust
If you’re like the many practices we talk to, you’re more and more aware of the need to think about how responsible your practice is. Demonstrating that you’re environmentally and socially responsible are now imperative if you want to reassure patients and staff that you’re a ‘good’ business to deal with - that you have a conscience, and that you care about your community.
CSR Coaching We understand that you’re busy and might need some help putting a plan in place. Perhaps you want an expert to handle everything for you, or some additional input to guide your team. Whatever stage you are at, we have a coaching solution to help you - from group webinars to face-to-face consultancy, and bespoke planning and supported implementation. We can take the thinking off your desk and get a simple and effective CSR plan in place that matches your business and team. Download our free 60 Minute CSR Plan at TheCSRCoach.uk
A business should never be considered complete until it has its own CSR, however big or small. Our CSR projects make us appreciate our current surroundings and have brought us together as a team, which is invaluable and something that money simply can’t buy. Prof Joe Bhat - Director - Moor Park Specialist Dental Centre
Schedule a complimentary call to discuss how certification can help you stand out AND build your business. Or email mark@marktopley.co.uk to find out more quoting code HSD-02021.
10% discount for Henry Schein customers
Contact our service desk via email equipment-servicedesk@henryschein.co.uk
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PREPARING YOUR PATIENTS As you plan to reopen, clear and open communication with patients is key. Consider some of these helpful tips and tools for communication and marketing messages. Inform patients about protective protocols and the updates they can expect during this time.
Notification you are open
Patient Screening
At this critical time, it’s important not to reduce your marketing. In fact the very opposite. You need to communicate all your practice information, virtual consultations, reopening and infection control processes you are adopting. Let your patients know that you care and that you are here for them.
Pre-appointment screening is vital. Call your patients 24 hours before their appointment and ask some screening questions. Making a risk assessment, you may be able to offer a remote appointment rather than face-to-face. The risk assessment will also guide the patient’s experience in the practice. Other information is gathered from the patient at this point to help reduce their time spent in the practice: medical history updates, information on payment, and forms that would normally be completed at the practice such as FP17 and consent.
It’s essential that you have a clear message on your website homepage, that includes:
• Your updated opening hours - or if closed a statement to that effect
• Contact information for emergency cases • Your Covid-19 protocols, hygiene routine and new patient journey
A nice way to make sure that everyone sees your message is to add a popup. When you are ready to reopen, you can send a link to this information in your recalls and reminders. You can also send a letter or email to your patients to let them know what to expect. Pandora have developed a Welcome Back Reassurance letter. It is equally important to inform your patients of new protocols and efforts you are making to ensure their safety. Consider sending out and printing posters with a message about how your protocols are changing. Many practices are also preparing videos to demonstrate the new patient journey (see page 45). Ensure that patients are comforted knowing these changes are due to concern for their health, as well as that of the other patients, the dentist, the staff and anyone else with whom they might come in contact.
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In-practice patient screening also takes place when the patient arrives. Here is a useful screening form for you to use on both occasions.
• Measure the temperature of the patient using a contactless forehead thermometer. • If the patient replies yes to any of the screening questions, and his or her body temperature is below 37.3°C, postpone the treatment until 14 days after the exposure event.
EXACT’s Patient Portal will have a COVID-19 questionnai which patients can complete (along with al the other forms needed at home, spending less time in the practice.
• If the patient replies yes to any of the screening questions, and his or her body temperature is 37.3°C or higher, postpone treatment and follow advice on the current guidelines for isolation. • However, if the patient replies no to all the screening questions, and his or her body temperature is below 37.3°C, treatment should be permitted.
• Finally, if the patient replies no to all the screening questions, but his or her body temperature is 37.3°C or higher, the patient should be directed for further medical care (Peng et al, 2020).
S
ire
ll d) s
The New Patient Journey: Contactless Arrivals and Departures Prepare for contactless arrivals and departures – the fewer physical touchpoints there are in your practice the less risk there is of transmission. Sending forms direct to patients’ mobile devices prior to the appointment and encouraging self check-in via a QR code and kiosk in reception, combined with contactless payment options on departure, all help to minimise risk. Treatment plans can be emailed in advance having discussed them with the patient so by the time they come in you know exactly what they’re coming in for. Access to these services is free of charge from Software of Excellence until the 1st September. Register your interest HERE. Book a complimentary Bounceback review with SOE: during the call, we will consider both risk and fear and how you can navigate them. We will look into the increasing demand for a fully contactless service and the steps you can take to ensure you can provide this contactless experience. In this way, you, your patients and your team will be comfortable returning to work when you reopen your practice. The call will take a maximum of an hour, at a time of your choice. And during this time we will create a bespoke action plan around the following:
Here are some helpful videos for planning your new protocols and patient journeys.
Portman Dental Care
HEE Yorkshire & Humber Urgent Dental Care Centre
• Financial impact
• Patient communications
• Team engagement
This plan will aim to get you and your practice team recuperating lost earnings and get you returning to a full diary in the safest way possible.
Dental Beauty Swanley
To book your consultation simply complete the form and we’ll be in touch to confirm your appointment. It’s going to be essential that you are adaptable, flexible, lean and creative for your practice to survive what becomes the new ‘normal’. Dr Rafi Romano in Israel
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45
PREPARING YOUR PRACTICE MANAGEMENT SOFTWARE As you prepare to return to work, there are some essential tasks you must complete within EXACT before re-opening. To guide you through these tasks we have compiled a collection of ‘how-to’ videos that are now available on SOE's YouTube channel.
TOPICS COVERED INCLUDE:
• Patient Communication (use bullet points)
• Enable appointment reminders and editing SMS and email templates with new protocols • Enable automatic recall reminders
• Create lists of patients to send mass communications to (email or SMS) about reopening and new protocols • Patient Management
• Import Covid-19 custom screens
• Consider contactless arrivals and departure
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DIARY MANAGEMENT
• Prioritise patients with ongoing treatment using Care Manager • Use the Short Notice List to increase diary utilisation
• NHS practices – tidy open UDA courses of treatment and rollover your NHS contract
• Creating a wait list for those patients waiting to book specific treatments.
The Health & Safety Executive and the Health Protection Surveillance Centre’s ‘Guidance on Managing Infection Related Risks in Dental Services’.
The Kois Center ‘COVID-19 Resources’.
Click here
The FGDP’s ‘Implications of COVID-19 for the safe management of general dental practice: a practical guide’.
Click here
Click here
Click here
Denplan ‘Considerations for Re-Opening Denplan practices’
Click here
Pandora’s ‘Back to work protocol.’
The FGDP has a very useful resource library here.
Click here
Alpha Omega on ‘Returning to dental practice: realistic considerations, practical solutions’
Dentinal Tubules on ‘Back to practice and respiratory protection equipment’.
Click here
Click here
NHS England COVID-19 guidance and SOP for urgent dental care systems.
Click here
Dentinal Tubules ‘Risk assessment and protocol for going back to practice’.
Click here
Click here
Julian Perry on ‘How could I reopen my dental practice after COVID-19?’.
Click here
European Association of Periodontology ‘Suggestions for the management of a dental clinic during the Covid-19 pandemic’.
British Association of Private Dentists ‘Return to practice position paper’.
Click here
Click here
BSDHT’s ‘New dental protocol advocated to allow dental practices to reopen sooner’
American Dental Association ‘Return to work interim guidance toolkit’.
Click here
California Department of Public Health ‘Guidance for resuming deferred and preventive dental care’.
Dr. Markus Troeltzsch webinar on ‘Dealing with space infections’.
Click here
Click here Click here
American Dental Association ‘COVID-19 Safety and clinical resources and guidance’.
New Zealand Dental Council ‘Guidelines for oral health services at COVID-19 Alert Level 3’.
Click here
Nissit Patel on ‘How to protect ourselves and our patients post lockdown’.
Click here
COVID-19 Dental Services Evidence Review (CoDER) Working Group ‘Recommendations for the re-opening of dental services: a rapid review of international sources.
Click here
FURTHER INFORMATION AND RESOURCES
Contact our service desk via email equipment-servicedesk@henryschein.co.uk
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NEW MEDPOD is a new teledentistry solution launched by Henry Schein to allow you to stay personally connected, 24/7, with your patients and to triage dental emergencies and perform post-procedure checks using video consultations. This simple video consultation tool can be used with any smartphone, tablet, or computer. It’s an on-demand, cloud-based, software that requires no downloads or installations.
Click here for more information and to book a demo.
PRICING
Pay-per-use: set up fee of £50 + £4 per visit
Monthly unlimited subscription: £150 per user monthly Discounted rates available for 10+ users
Key features include:
• AES 256 Bit Encryption, double the standard 128k encryption.
• Custom URL and branded virtual waiting room facility. • Patient can register or enter as a guest. • DHCP can view all patients in the waiting room and reason for visit.
• 2 setups available to handle incoming patient calls.
• Patient can select a specific dentist or wait for the next available. • Patient can view DCHP availability • Chargeable to the patient via Worldpay (or using your own practice management system).
Click HERE to listen to a webinar presentation
t 0800 028 4749 e info@henryschein.co.uk w henryschein.co.uk HenryScheinUK
Please visit http://www.henryschein.co.uk/gb-en/Dental-GB/LegalTerms.aspx for full terms and conditions. E & OE.
HSD178-06-20
Henry Schein Dental, Medcare House, Centurion Close, Gillingham, Kent, ME8 0SB.