Looking for ways to systematize your dental office? In the book "The Checklist Manifesto" by Atul Gawande, MD, Dr. Gawande talks about the advantages of using discipline in our work day. Let’s face it, we’re human and prone to mistakes. Gawande shows how systems and checklists can reduce mistakes, increase efficiency and decrease stress.

Even the Journal of the American Dental Association (JADA) agrees. In an article published in August 2010, Harold M. Pinsky, DDS, a dentist who practices part time and also works as an airline pilot states “to enhance safety, practitioners must implement forward-thinking strategies. Because human error is inevitable, threat and error management techniques are needed to help identify and trap error before it develops into unexpected outcomes. Risk analysis increases situational awareness of potential dental error. Efficiency increases with early error detection.”

If you already have a good handle on discipline and have the time, energy and drive to develop your own systems and checklists for your practice, here are a few guidelines that make the process easier:
• Checklists are best broken into small pieces.
• Items that are frequently repeated in many procedures can be omitted or hidden. When I develop systems for StreamDent's online procedures manual, I hide the frequent lists so that a newer trainee can have access, and so an experienced user isn’t bogged down by unnecessary detail.

• While a trainee working to develop competency should follow a checklist the last detail, an experienced team member can set up for a procedure, then review the checklist as a fail-safe to avoid missing small details.
As I develop checklists for dental procedures, I like to include items to bring into the operatory, room setup (steps unique to the procedure), what to do when the patient is seated, what to say in order to review the consent form, postop instructions, and steps to be completed before the patient is dismissed.

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