Dental Practices have a choice in who they use for accreditation. Two agencies now provide accreditation for Dental Practice. QIP will be familiar to ADA members but now HDAA offer accreditation with an alternative pricing structure.
Non-ADA members should really look seriously at HDAA.
How do agencies qualify to provide accreditation?
Accreditation is regulated by the Australian Commission on Safety and Quality in Healthcare. This is the organisation that set the healthcare standards against which practices are accredited. There are about 8 different agencies that can accredit against the National standards. To my knowledge only 2 have chosen to dental practice accreditation.
Is one accreditation more highly regarded than the other?
No! Same standards used.
QIP provides ADA templates. QIP has a set list of requirements to pass accreditation. These are available to any ADA member. The relationship between the ADA and QIP is, I think unique in accreditation and probably will not remain the same now accreditation has become more common place. For practices doing QIP accreditation and using the ADA templated policies they will find them full of statement that “we will do ‘xyz'”. While the dental practice agrees to do many things, it is unlikely that anyone will ever require you to provide any evidence that you have done any of them. HDAA accreditation is assessed in a manner that is more akin to that required by other healthcare organisations. HDAA requires more documented evidence that you are conforming to the National Standards (e.g. doing the things you say you are doing within the ADA template policies). The level of evidence required by HDAA still takes into account the fact that we are dental practices and not major hospitals.
How does Smartdentist work with either accreditation agency?
Smartdentist has been designed help you comply with both accreditation agencies and manage the requirements into the future. I am always happy to walk you through the accreditation requirements (or ‘nag’ you through them). There is no extra cost for this service. QIP enrolled: If the ADA/QIP supplied an excel spread sheet for it…then we set up a simpler solution for storage of data online. Smartdentist is a content management system so we load your ADA template policies in web friendly format into SmartDentist (QIP paid up practices only).
As far as passing accreditation, Smartdentist system collects your evidence in the one evidence page so you or we can quickly see where you are up to. HDAA: HDAA gives a list of requirements and Smartdentist has many executive reports and systems in place so you can actually do what you say you are doing! Smartdentist has templated policies covering the accreditation requirements so practices can use these or if you have previously used the ADA templates they will be a start to your HDAA accreditation.
Can you swap accreditation agencies?
Yes, once your accreditation comes up for renewal you can move to either agency.
Are Accreditation Standards and Requirements going to change?
“The Commission is developing a set of national safety and quality standards specifically for primary health care services. It is expected that these standards will be available for implementation from 2020. Public dental services and private dental practices will transition to the primary care standards once they are implemented..” From the Commission website.
It will be interesting to see what these standards look like. Every other healthcare organisation has moved to another set of healthcare standards (ed 2) except for private dental practices. The new standards for healthcare are more complex to pass. The Commission is also going to introduce ‘short notice’ assessments for other healthcare organisations. [that would be fun].
When the accreditation requirements change Smartdentist can automate to any new requirements.
Will accreditation become mandatory? Best guess – no. Accreditation started in 2013 so non-accredited dental surgeries have saved themselves quite a bit so far.
Medibank Private preferred providers now need to be accredited so there is a possibility that the process will be driven by health funds in the future.
What is Smartdentist recommendation about accreditation? There is no evidence at all that accreditation will be easier because the ADA has involved dentists in the process. There is no evidence that accreditation will be cheaper if you do it now instead of in the future.
Accreditation is great for change management for the average dentist who owns a practice. e.g. “we have to do .xyz.. because of accreditation…”
Workplace performance reviews can be seen as particularly important in 3 contexts:
As a requirement of QIP Dental Practice accreditation ( X2 need to be supplied)
As an essential for new employees within their 6 or 12 month probation period.
It is a misconception that you can dismiss employees in the probation period without giving reason and be free of Fairwork scrutiny. It is also less than fair for staff members to lose their position without the chance to know why or fix the issues.
To gain a better workplace and avoid performance management situations.
Often employers leave issues ‘fester’ or deal with them in the heat of the moment leaving themselves exposed to complaints of poor handling or at worse bullying or harassment.
The problems with workplace performance reviews include:
These are not commonly done in dental practice. For dentists it is unlikely that they ever experienced a workplace review themselves and would never have been training in undertaking this exercise.
Complaints by experienced firms that doing reviews is pointless and no-one likes doing this – not managers or staff. Limited or no positive outcome is reported.
Lack of structure and goals makes the process more stressful.
With these factors in mind SmartDentist has upgraded its workplace performance review process to make it easy and simple to follow with defined goals and outcomes.
Workplace performance reviews consist of:
A very simple 2 question self-reflection for employees,
The ability and help to define specific goals for improvement via competence assessments.
A training plan with defined courses for staff to work through with others or by themselves.
To help remind the employers when and what needs to change Smartdentist has a secure form to record under performance by specific staff members and the ability to recall these per staff member at a later date. This helps because sometimes it is the little things that are repeated and annoying that could change with some discussion and allowing the staff member to work out how to do things better.
Often in dental practice we are too busy at the time to address issues and at the end of the day we are all very tired and it is not a great time to approach an employee with a performance “suggestion”.
“Sorry officer, I didn’t know!” Our short NSW holiday over the Christmas break was soured by a U turn at a set of traffic lights (fine $263). Yes, it is legal in Victoria but we now know it is not legal in NSW! We should have read the rules BEFORE we drove into NSW.
We don’t want to employ staff who say the same thing about our policies and procedures. While “I forgot” is annoying, having a staff member say “I didn’t know” is becoming a greater risk to business. Because our policies and procedures are increasing in number and importance we need a simple way to make sure our staff have access to and know about our policies and procedures. The Dental Board of Australia (AHPRA), Fairwork Australia, and Work safe seem to have a similar outlook to that NSW traffic cop and there is little tolerance of ignorance.
Helping the small business comply with the ever-increasing demands is best done by SmartDentist!
Our clever content management system allows employees immediate access to every new policy and Smartdentist has communication systems to allow you to easily communicate policies to employees.
“Smart” employers can keep track of staff signoff and be comforted knowing that staff have access to policies 24/7. What better way to have a feedback loop online so changes can be made ASAP.
Employer guide to:
Getting back on track with policy management
Go to All Policies and select the Executive report on Polices and Procedures
Check if policies need to be reviewed and update (use bulk update or update individual policies).
Check any additional template policies available in our Policy library. Have you considered the new policies for your Human Resources Manual? There are over 60 policies for you to consider from our template library.
You don’t need to let future policy additions stop you from gaining employee signoff and acknowledgement right now.
Be relaxed in knowing that at any time in the future you can email a new policy directly to every employee and then checkout signoff for that individual policy. You can also checkout when your staff have logged into SmartDentist.
Employee acknowledgement / staff signoff
The best time to get employee’s to signoff, that they have read and understood policies, is when they are first employed.
A. New staff members
Use the New Staff Induction Checklist (HR > New Staff Induction) and you will find a link to PRINT all policies. You could print to paper or print to pdf and email all policies or a selection of policies (e.g. infection control manual or human resources manual), to the new staff member.
We also recommend you print off the “Manage Policy Signoff Requests” page for an individual and use it as a hard copy to save in a staff member’s employment file.
B. Existing staff members
Start the new year with the following process.
Send all staff members an email saying that you will be doing an update on all policies and procedures to make sure that:
a. we are all working together the one way for efficiency and time-saving,
b. standards of accreditation and compliance mean there is a greater need for staff to help make sure our policies and procedures are correct and correctly followed.
Let staff members know that further details will follow and they will be asked to signoff to say they have read and understood each policy.
Ask staff members to make sure they can login to SmartDentist.
Suggest that they save their password in their mobile phone under NOTES in the practices Contact details. One of the biggest time waster and sources of frustration is a staff member who can not login. Make sure staff members know they are not to login under someone else’s login and that you can not log on if someone else is already logged on in the one browser on your computer.
Get ready to help staff with your request for signoff.
a. Print off the individual “Manage Policy Signoff” for each individual staff member (Policies > Signoff)
b. Print off one copy of all your policies
c. Place these in a folder somewhere that staff can access them.
Send another email asking staff to signoff on every policy explaining the location of the printed signoff and policy and procedure manual at work (so they can read and signoff without a computer being free) and that they need to have both Smartdentist and their personal signoff sheet completed. e.g. they need to get familiar with login to Smartdentist to access policies and procedures.
The “All Staff Signoff page” gives a quick overview so you can see how everyone is progressing.
As the administrator of Smartdentist you can also see when a staff member logged into Smartdentist and how frequently (HR> Staff profile). If they logged in and logged out you can also see the time they spent.
Make sure you follow-up each individual.
What if a staff member refuses to signoff on policies
If a staff member refuses to signoff on a policy then it is important to have a calm and rational discussion about why they wont signoff. It is best to ask for this in writing BEFORE you address their concerns as it will allow you time to consider their viewpoint.
Sometimes there is a mistaken belief by staff members that if they don’t signoff then they don’t need to do what the policy says. This is incorrect.
You can not force a staff member to signoff a policy. You can performance manage a staff member who refuses to do what your policy requires.
Fair Work says best practice for performance management is to have a Performance Management Policy. In SmartDentist subscribers will find a completed policy on Performance Management that they can use for their practice.
This policy was developed using Fair Work Ombudsman Best Practice Guide: Managing Underperformance.
Performance Management Flow Chart
Each year Fair Work deals with 1000’s of claims for unfair dismissal. In addition I have found Employers are cautious of bullying allegations as both Fair Work and Worksafe have processes for employees to complain about bullying.
With the very wise statement “Criticise in private, praise in public” I know people are wary that when they do performance management in private there are no witnesses to contradict a bullying claim. Don’t fret. Have good documentation. You are far more likely to be seen as a bully if you criticise someone in public. Humiliating someone is never the way to improve their performance.
Good performance management means good documentation. To assist you SmartDentist now has an Employee Reporting Area, that is not seen by staff, allowing you to quickly record:
Conversations with staff
Meetings with staff
The last thing an employer needs is to be challenged by Fair Work for documentation of incidents or examples of employee interactions.
A new dental staff member excitedly turns up on their first day. What sort of induction do you offer? Are you stressed or flustered trying to find forms you haven’t seen for some time? – Employee detail forms; tax declaration form; confidentiality form; Super choices form. Is it possible for New staff induction to be made easy?
Where did we find those forms last time we employed someone?
What are our legal obligations now?
We don’t employ new staff very often so it is fantastic to know that SmartDentist has just re-vamped the New Staff Induction page so it works both as a checklist and to link us to all the documents we want!
SmartDentist.com.au New staff induction page. This is customisable or you can use it as you find it. Add your own new employee forms or check off items and use the links to print off all the documentation you could want…or send the staff member to the page and they can resource everything online.
Print the page from SmartDentist and this is how it looks. What a fantastic checklist – with a space for sign off and dates.
I am so excited!
This feature wasn’t designed with you in mind! It was designed with me in mind.
We have a maternity leave replacement and we are employing a new trainee. With the SmartDentist induction page we have link to printable resources:
ATO and Super forms (compulsory)
New Employee details form
Immunisation forms for staff to take to their GP to fill in
Fairwork letter of engagement template
Fairwork Information statement (compulsory)
Job description for a role e.g. DA
Links to any compulsory policies e.g. Code of conduct; Uniform and Dress; Social Media and Mobile phone use etc (all available as templates for you to use)
Did you know that you only have about one week to be a major influence in a new employee’s life! That means you start straight away with the things that are incredibly hard to “train-out” of a person. Don’t rush with the hand hygiene policy etc. You will teach that as it is new. You will find the necessary forms from Simply Dental Chatswood and all the other fun paper work they will have to fill out and deliver them with ease, insuring the best first impression for your organization. But the mobile phone and uniform and social media are already part of this persons DNA so you need to concentrate on them first.
I am sure SmartDentist subscribers will feel the same as me – confident in appearing as professional employers on the new employee’s first day. If you need more information check out Alaska Dental Associates.
Anyone who has spoken to me about Dental Practice Accreditation will know what I think. Accreditation is a great idea in theory but in practice it loses out.
Unfortunately it is easy to pass accreditation without actually committing to the systematic focus (or any change whatsoever). How easy is it for “accreditation” to just becomes a lovely poster on the wall and a stress in 2-4 years about “having to start all over again”.
Latest news about Changing Accreditation
The latest news in the accreditation world is that the ACSQHC (the organisation which sets all the rules for accreditation) has totally re-written the healthcare accreditation standards. All healthcare organisations* who were using the present standards will switch to the newer, clearer standards from Jan 2019. * Except for dental practices who are advised not to consider the new standards because the ACSQHC is developing a new set of standards for primary care. Reading the discussion paper October 2017 Patient safety and quality improvement in primary care Consultation paper.
The consultation paper from ACSQHC includes a number of interesting propositions:
Just because we don’t have quantitative records documenting lack of safety or quality, does not mean that there are not issues. e.g ACSQHC thinks there are problems but they just not sure what they are!
“A systems focus, which involves making changes at an organisational level within services and reorganising care delivery systems, will help support improvements in the quality of primary care and ensure it is sustainable, efficient and effective.” According to the ACSQHC.
“Private Health Insurance funds are one of the drivers for improved safety and quality and are driven by the need to ensure care provided represents value for money, and that care is clinically appropriate and in line with best practice.” – or so reports the ACSQHC!
The ADA has made a submission toward this Primary Health Care paper. The ADA will be a party to the development of Primary Health Care standards. As the PHI is now recognised in this paper as a primary stakeholder towards safety and quality by the ACSQHC it will be interesting to see how involved they become in dictating the new standards.
The Best of Accreditation ideals
Following are my recommendations for practices wishing to explore the ideals of accreditation.(With or without paying QIP for the accreditation certificate):
Start using an incident reporting system so you can actually track incidents or near misses. Yes that would include stuff ups at the front desk; appointment mix ups; broken files; fillings failing too early; staff running over their feet with their chairs etc and it would also include compliments from patients – use them in marketing yourself.
When you have any incident, then objectively review it from a systematic perspective. Can we devised a system, at work, that would make this incident less likely or impossible. Don’t expect staff to be hero’s in the smooth running of the practice. Risk Management is the name of this analysis. If you decide to do nothing – document it.
Have policies (yes generic feel good policies) but also look at practical procedures. Video what happens with your iphone if quicker (put it on a private youtube acount – no cost). This is an excellent training resource or new staff induction resource.
SmartDentist supports an easy way to support practices with these processes.
Easy systems = Good systems = Practical systems.