Disaster Preparedness for Your Dental Practice

By Julie Brightwell, JD, RN, Director, Healthcare System Patient Safety, The Doctors Company

Recently, hurricanes, floods and fires nationwide have highlighted the importance of planning for disasters. Hurricane and flood damage in Texas and Florida left practices without power for days or even weeks. Wildfires in California forced several dentists to quickly relocate their practices ― some permanently ― and to move scheduled procedures to different facilities. Is your practice prepared for this type of situation?

A disaster can overwhelm a dental practice, with damage that can include shattered windows, flood debris, power outages, disrupted telephone systems, computer and system outages, unsafe drinking water, destroyed dental records, medication exposure to temperature and humidity extremes, contaminated instruments and building structure failure.

Disaster preparedness requires a continuous cycle of planning, organizing, training, equipping, rehearsing and evaluating. Dentists are critical participants in disaster preparedness, ensuring that patient care and critical services are not interrupted.

Plan Ahead Now
Before the next disaster strikes, make sure your practice has a plan in place. A checklist, ordered by priority and customized to specific types of disasters, can provide the framework for a comprehensive plan. The checklist should include these elements:

  • A full-circle call tree that outlines who contacts whom.
  • Instructions for setting up instant messaging technology that enables staff to communicate without a wireless network or cellular data connection.
  • A Certificate of Insurance for your dental malpractice coverage, or instructions for contacting your agent or insurer directly to obtain proof of coverage. This document will be necessary if you are forced to temporarily relocate your practice or procedures.
  • Steps to follow upon returning from evacuation.

When Disaster Strikes
Planning today makes accomplishing the following tasks more feasible during a disaster:

Communication

  • Contact staff immediately to determine realistic time frames to return to work.
  • Notify external vendors and business associates of your practice interruption and targeted resumption of operation.
  • Implement staff briefings at the beginning and end of each day.
  • Create temporary phone, fax and answering services.
  • Establish patient telephone triage.
  • Implement temporary controls to ensure HIPAA compliance.

Computers and systems

  • Contact computer service vendors to ensure integrity and recovery.
  • Verify insurance coverage for repair or replacement costs and losses.
  • Evaluate applicable warranties and consider an information technology restoration service contract.
  • Inventory and document hardware and software.
  • Document the type and extent of both lost electronic and paper data.
  • Ensure data backup and periodically test compliance.
  • Re-establish filing systems and internal programs.

Dental records

  • Determine the extent of damage to, or loss of, patient records and filing systems.
  • Attempt to restore all damaged charts and document inventory findings.
  • Notify the state dental board for specific guidance pertaining to lost or damaged records.
  • Document all efforts to restore and protect existing records.
  • Reconstruct lost charts at the next patient encounter.
  • Contact your insurance carrier for restorative services and/or claim procedures.
  • Re-establish a filing system and temporary storage if necessary.
  • Obtain legal guidance for patient notification during recovery efforts.
  • Contemporaneously date and initial all late entries and duplicate information in context of recovery efforts.

In addition, create an inventory of all equipment and medications that may have been exposed to water or extremes in temperature. Repair, replace or discard damaged items appropriately.

Once your plan is in place, regularly re-evaluate its steps and update all contact information. Practice and rehearse the plan’s protocols. An effective disaster preparedness plan will help keep your practice focused on delivering care during an emergency.

The guidelines suggested here are not rules, do not constitute legal advice and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

Reprinted with permission. ©2017 The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors.com/patientsafety.

What is “Plan B?” The New Normal in a Post-Irma World

By a Fellow FDA Member

Call it intuition, but I had the feeling we —and the entire east coast of Florida — dodged a bullet last year with Hurricane Matthew. It just seemed like a matter of time before our 13-year dry spell was going to end.

I desperately wanted to be wrong, as I watched CNN every evening for the latest update on Hurricane Irma, and the National Hurricane Center for the more elaborate interpretation.

The memories of spending another post-Labor Day weekend away from home (Hurricane Frances, 2004) sadly is still too vivid in our memories. I worked as a dentist a total of four days that month, and two of those were without air conditioning — which is a testament to the determination of my staff and my patients to create a sense of “normalcy” in the aftermath, despite the obvious disruption to our personal lives.

Doctors, it is time for “Plan B.”

Depending on where you are in your practice career, it may not make economic sense to “build over” before or after your insurance adjuster has given you the final assessment. For dentists with more than 25 years of practice, the return on investment may not be in your favor at such a late period, as the current tax laws for business owners after 50 provide decent “catch-up” provisions in a defined benefit (like a government pension) and defined contribution (401K-type) plans that would be more beneficial.

For a mid-career solo practitioner, you have been faced with rising overhead costs since 2007, and along with diminished income (ADA Health Policy Institute has the data), the time is ripe for a multi-doctor practice formation, which should always be created with expert legal and financial advice.

Look “around the neighborhood” and reach out to other dentists who may share the same dilemma you do. If you have damage to your office, and someone nearby does not, now would be the time to construct a well-defined contract that outlines the term and time limit for this new arrangement. And if the relationship works on a limited basis, you may find the new arrangement something you want to solidify.

Likewise, if your office came out unscathed, reach out to your colleagues in this period and strategize. This is not a DIY project, so retain the professional advice you need to make this happen. Involve your bankers and financial advisors for expert advice.

In closing, I want you to know that I understand what you have gone through, and I look at 2004 as a defining year in my professional career. The decisions I made after these disasters guided me to where I am today, and my family is better for it.

Make the right choice for your loved ones and your staff members, and don’t be afraid to execute “Plan B!”

 

 

Post-Irma Disaster Recovery Resources

Last week, the Florida Dental Association Foundation teamed up with the American Dental Association Foundation to prepare and assist FDA member dentists in need. Below is information we provided members last week, but want to share with you again, as we know that those who might be in need may forget these resources. If you know of fellow members who need assistance, please share this information.

The ADA Foundation offers support that may be helpful to dentists affected by the storm. This includes:

  • ADA Foundation emergency grants
    • Emergency Disaster Grants — Any dentist who is a victim of a disaster may apply to the ADA Foundation for a grant up to $2,000 to help cover the costs of their personal emergency needs, such as food, clothing and shelter. (ADA membership is not required.)
    • Emergency Disaster Grants for 501(c)(3) organizations providing dental care following a disaster — Grants of up to $10,000 are available for this purpose.

More information can be found at ADA and ADAF Disaster Support.

Please click here to access the ADA/FDA relief application. ADA Foundation grants are up to $2,000 and FDA Foundation grants are up to $1,500. This information also can be found on the FDA website at floridadental.org.

Additional information/resources from Volunteer Florida Emergency Management can be found here.

Please know the FDA, its officers and trustees are here for you, and haven’t stopped working to make sure members’ needs are first.