Episode 613: Saving Time Hack

notes time management Dec 08, 2022

No-BS Brit joins Kiera for this episode to talk about a way to gain more freedom of time in your practice: with note templates! Believe it or not, establishing a solid note template protocol will save time on the clinical side. Kiera and Brit touch on …

  • How to update note templates

  • Why assessing templates is helpful

  • How to attach notes to procedure codes

  • The importance of locking them out

  • And more!

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0:00:05.9 Kiera Dent: Hey everyone. Welcome to the Dental A Team podcast. I'm your host Kiera Dent, and I have this crazy idea that maybe I could combine a doctor and a team member's perspective. Because let's face it, dentistry can be a challenging profession with those two perspectives. I've been a dental assistant, treatment coordinator, scheduler, biller, office manager, regional manager, practice owner, and I have a team of traveling consultants where we have traveled over 165 different offices coaching teams. Yep, we don't just understand you, we are you. Our mission is to positively impact the world of dental, and I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress, and create A teams. Welcome to the Dental A Team podcast.

0:00:51.5 KD: Hello Dental A Team listeners, this is Kiera. And you guys! I have the one and only famous no BS Britt today joining me. Britt, how are you today?


0:01:01.9 Brittany Stone: I'm good, I'm good. I like that that nickname is sticking, I'll take it.

0:01:06.0 KD: I think it's a really good one guys. Because Dental A Team, I think has wit to it, because the A team is pretty cool, and then if you tag dental in front of it, it goes to DAT, which DAT is the Dental Aptitude Test for people to get into dental school, so there's multiple layers of wit to our name. And Britt, if you guys don't know, Britt's a traveling consultant, her last name's Stone, so her initials are BS. And also Britt does no BS either. [laughter] I just, I think I appreciate levels of wit.

0:01:35.7 BS: Fitting in many ways.

0:01:38.8 KD: But today Britt was kind and decided to pop on the podcast, because guys, we wanted to give you a tip today as you guys are rocking and rolling, wrapping up your year of something that is truly going to give you guys a lot of freedom in your practice. Now, when you hear the topic, you might be like, "Oh my gosh, cool, guys, real sexy topic today," which it's true, but we're going to give you some spice. Britt's a hygienist as well, if you didn't know that. I come from dental assisting and front office, Britt has front office as well. So we're going to kind of dive into a piece of a practice that can really give you guys a lot of freedom if you do it really well, and that is diving into note templates and how to save a lot of time on the clinical side. I think oftentimes on the podcast we work so much on front office, always diving into tips for the front office or for doctors. And today we're going to hit up our clinical side. So Britt, as a hygienist, how obnoxious are notes for you?

0:02:28.0 BS: How much do I love writing notes? No, I don't love them. So anything I can do to make it easier I'm here for, and templates are a huge way to make sure, one, like it makes my life easier so I don't have to type so much. Two, it makes sure I don't miss things when I'm kind of rushing through getting my notes done and I get all the details in there. So definitely super helpful.

0:02:52.9 KD: Yeah. And I also think like, if notes are taking your team a long time, let's assess them. Because some of those note templates, like, I remember being in an office and there was a hygienist, no joke, she had to click through probably a hundred things per template of options and pieces. And so they were trying to make it efficient, but they actually made it very inefficient too. So with those note templates, I tell every office my standard and my goal personally, and what I like offices to strive for is that your notes are completed before that patient leaves the operatory. Now Britt, as a hygienist, how often was that for you?


0:03:33.5 BS: I mean, that's always my goal, and a fun tip for people, if you can even get that note template started usually at the beginning of the appointment, like I had a much better chance of getting it done by the time that patient left. If I started getting all their medical history, kind of started entering what I could from the get go when I sat that patient down, and then it wasn't as much for me to complete at the very end before I walked that patient out. Does that always happen? Not always, but my chances are surely much higher when I've got the template in there and when I started sooner rather than later.

0:04:07.1 KD: Amen. And some offices will complain and say, "But I have to click through all the things. So if I want to start a note, I can't get that way through." And I tell those offices, you can actually break these note templates into the SOAP. So if you want to, you could have each section. So their medical history section, the perio, and all of their oral assessment broken into another one, another template. So you don't have to click through the entire template, because I do agree that is kind of obnoxious. So if that helps you guys don't hesitate to make maybe one, two or three different note templates, or if you know what they're going to be, you can pre-fill those. And if something changes, you can always go back. And I would say that for the dental assistant side, dental assistants are so awesome. And they tell me, "Kiera, there's no way I can start the note template. I don't know what my doctor is going to do." And I say, "You clearly have not been in dentistry that long." Dentists don't go away from what they do. They are pretty status quo.

0:05:01.6 KD: They like their B1, B2, their A2, whatever their composite is. Look at that patient. You as assistants usually would pick out the composite that you think they're going to use. You know the steps of that filling procedure. You know what they're most likely going to do for a crown. And yes, the shades could vary for sure. But odds are, like, I knew my doctor was always two lidos, one septo. I mean, there would come maybe one or two times that he would do two septos rather than one septo, but it was pretty common that I could get through my entire note template and then just go back and verify my anesthetic count, verify my shade count rather than waiting until the end of the appointment. So agreed with Britt, my model as an assistant was, pop that blood pressure cuff on. Even if your practice doesn't do it, this buys you about 30 seconds to start that note template, get it in there while the patient is actively doing something, getting that blood pressure. So one, you should be doing that in a practice. And two, it was a great spot for me to start notes as a clinician, to be able to get those notes completed before the end.

0:06:02.5 KD: I always loved my notes to basically be done before my doctor even came into numb. Of course, you've got to make sure you double check it, but that was my tip as an assistant just to get those notes done because you really can start them sooner than later.

0:06:15.3 BS: Agreed. And then it's an easy final check and your brain can kind of remember a little bit more to be like, all right, let me go through and verify things and then just update as needed instead of like trying to remember everything at the very end.

0:06:28.1 KD: For sure. And also for hygiene on exams, I know when my doctors would come to exams and I'd swap you hygienist, who those exams can get long, but if everything's already done up to that point, I always had a little sticky pad next to me. I'd be typing my notes. And don't worry guys, I'm a real fast typist and I truly think it's because I wanted to have my notes done in the operatory before my patient left. And then I'd be charting as well. So I understand that that does take some multitasking. And I would say guys, if it's not convenient for your team members to write notes while doctors are doing the exam, swap up your operatories, even if you need to get a separate monitor or you need to get another computer, some way... And doctors, shout out to you guys, if you can scooch out of our way, it helps your team members to be able to write notes and we can flip flop back and forth between x-rays to notes to x-rays to notes for you. But if you'll move out of the way so we can shimmy in there and get our notes typed up for you, that can also help to just really make it fast and easy for your team.

0:07:29.1 KD: And truthfully, you don't forget as many things if you can get those notes written before the patient leaves. I hated end of day 10 charts and I'm like, "I don't even remember what shade we did." [chuckle] It's so hard to remember it. So that was at least tips for us. And use those quick fill ones. Every software has it to where you can just select the teeth numbers and it'll auto populate for you. It has anesthetic so you don't have to write it. You can choose the carp numbers. So really I think that that's just a fast, easy way. And again, assess those templates. Doctors, I love you guys. You sometimes make those templates psychotically long. So assess those templates and make sure what's in there truly is necessary. I'm never going to tell you to not put enough information in to protect you and to protect your license and the patient. But really, assess are all these things needed? Are there ways that we could make this faster for them? So charting can be more efficient as well. Britt, any thoughts on your side on that?

0:08:19.1 BS: And there's also something to be said on like, how detailed your auto population things are because you want each note to also be unique, right? So we can't have every single note for every single patient coming up exactly the same. So sometimes when we add so much detail in there that's exactly the same and we don't really change things or leave a spot where I need to add something specific, they can come out very uniform and that's not necessarily ideal either when it comes to using templates, because we want to make sure it isn't a digital report for each patient. So agreed on, yes, add enough in there that's fillable to make your life easy. And don't forget you still need to add unique things specific to that patient, so that it's not too uniform.

0:09:04.8 KD: Hello, Dental A Team listeners. This is Kiera, and you guys, how was your 2022? I want you to look back and tell me, was it the year of years? Or was it a really hard year? Did you crush it or did it crush you? This is the time guys for end of year Dental A Team platinum is welcoming you, where we will physically fly to your practice. We will come and we will elevate your dreams and make them into a reality. And guys, space is limited and prices are going up. This is not a sales pitch. This is not something where I'm trying to scare you into it. I'm just facing the reality of inflation is here, flights are expensive and I want to see as many people as we possibly can and serve as many as we can. So if you want to be part of our elite group of people, there are limited spaces because our consultants can only see as many. We are taking on 10 new platinum offices by the end of the year and that's it. That's all we have space for.

0:10:02.9 KD: So if you want to be one of the Elite 10, come join us. Be a part of our top notch elite doctor community. Be a part of our office manager and hygiene and front office communities. Get your operations manual done and live the life that you've only been dreaming of today. Email me [email protected] and make 2023 truly a year that's unforgettable. We are a complete tax write off. And like I said, we are only taking 10 offices. So don't get left behind, be one of those 10, and I cannot wait to give you the biggest warmest welcome to completely and utterly changing your life for good. Welcome to The Dental A Team. I can't wait for you to join us. [email protected]. Cheers to 2023 and making you your best self yet.

0:10:52.7 KD: For sure. And I really do think, assess how many click through things you've got. Like I said, you can split it up and within one note, you could have three different templates. So hygienist, you can have your beginning, you can have your perio and then you can have your exam. Three different templates so you're not waiting for the exam to be able to finish your note but can really move through that. Also make enough templates but not over too many.

0:11:17.5 KD: But if you have one that's like a replacement crown instead of just having a full blown crown prep, because a replacement crown there's information we need on that that wouldn't be there if it was a first time placement. So sometimes even just having those differentiators can make notes go faster rather than asking through the template. Is this a replacement crown? Is this a first time crown? Like sometimes those questions while they seem easy to just have one crown template, it actually can make it more cumbersome than just having a replacement crown and a first time crown. So just think about those things. I also love pop ups to pop up and make sure like, when I'm doing that note template another huge pro to do the template before we start is it says, do we have a PA of this tooth? Guys as an assistant I 100% miss those PA's. Like I did it I was that person. I know I did it. And so just reminding your team on those pop ups I think can be helpful. So for me to Britt's point I liked it to be between 60 and 70% pre fillable.

0:12:16.8 KD: The remaining 30% were things that you would actually manually type in. So shades, the exam portion for hygiene, especially, and for new patients, that's obviously got to be fillable. Next visits are always there so we know what it is. Lab information, you can preselect labs. So really look at your notes and see are we about 60 to 70% just auto populate and we fill in the rest? Are we more like the 90% auto fill? When I've seen offices with that 90% auto fill it seems faster but it usually takes people longer because there's so many clicks that they have to get through to get to the end of their note that they don't want to start them early. Do you agree on that Britt? Do you think that's the right amount of time?

0:12:56.2 BS: Agreed, agreed and we get kind of numb with all those pop ups too when you can kind of get to go in like too fast through them. So 100% I like that rule. And then as I say, often like in dentistry, seconds matter. So these notes can be done like in those little pockets of time where you're chatting with a patient, doctor's out of the room for a minute, hygienist when you're waiting for exams like pop in there start getting those notes done. You can talk to the patient while you're also kind of working on your notes or if they're watching TV or watching something educational you can kind of work on those notes. So look for those little pockets of time and using the templates it really doesn't take that long to get your notes done.

0:13:35.5 KD: Yeah. And I love that you say seconds matter because I think people feel that they have to have that one to five minutes to get their notes done. I know so many hygienists tell me, "Kiera I can't get to lunch because I'm doing all of my notes," and honestly I'm not a hygienist which is why I'm glad Britt's here. Like you can get it done and look for those little pockets of time. There is another tip that I wanted to bring up. Some softwares do this and some offices like it, some don't like it. So just know, check your software it is available. I know Tiff, Spiffy Tiffy she did this in her practice and she loved it, because she got sick of notes being missed. I know in Open Dental you can run a report to actually see the notes, the clinical notes that have not been signed or completed. So there is a report. The other softwares I have yet to see that report come through. It could be there if any of you are using other softwares and it's in there please email us [email protected]. Educate us guys we try to bring the best of the best and the way we become that way is through you guys as listeners sharing and helping out.

0:14:33.6 KD: So if you have found a way let us know. But the other tip to kind of make it a little easier if this is a benefit to your practice is, you can go into the procedure code and you can actually attach a note. So when that procedure code gets set complete a note will auto populate. So it's really cool. Some people absolutely love it. Some people absolutely hate it. What most offices do if they have it they will set complete the procedures. The notes will auto come in and then they'll just go back and look to see what they need to change and edit. So they'll almost close the appointment, reopen the appointment and go look for it. I know that sounds clunky but if you're an office that misses notes, you guys don't have notes going for insurance, your team is always forgetting to get those notes done. I think this can be a game changer. Britt what are your thoughts on that? I have like mixed feelings on it but I know for some offices this is a total game changer that really can help them.

0:15:25.1 BS: I think when your clinical team is helping you by completing procedures, which is my preferred way to do it. They're sitting in the room to know everything that was done. I think that's super helpful because they can go in right there's multiple ways to set things complete. Go in and just even complete the procedures and not complete the whole appointment depending on your software and how that works. But you go in and complete those procedures and then clinical team you can start on those notes that automatically populate when you post those procedures. So I think when clinical team is posting in the back, it's a real nice smooth way to make sure that those notes are getting done and make their lives a little easier. It's just making sure you're posting those procedures.

0:16:06.3 BS: Another tip when it comes to notes is, I was just thinking about this because I was in office and had caught this. Make sure that your notes are getting locked out. So whether it's you close out the end of the month and it locks out all your notes for the previous month or some systems you can set it up after a certain number of days, where it goes through and it locks everything. But make sure that is happening so we can't forever go back and edit notes from months or years before.

0:16:33.4 KD: Amen to that. That is a good way to protect yourself, your patients, your practice and it also forces your team to ensure that they've got those notes done. So just an spot audit. If you don't have a software that can run a report to let you know what procedures have been missed or what appointments have been missed with notes, go through and spot audit those charts. Office managers, I think that's a really good task you can take on. And every week I would go through and I would just randomly pull charts and do audits. You can have your team members on their end of day checklist confirm that they've gone through all the appointments. You can print out a schedule and have them check it off that they've double checked that those notes were completed before they leave for the day. But notes are super important. They protect us. They protect our patients. And it really is the diary log of everything going on with that patient. So when they come back, we don't forget what's going on.

0:17:21.4 KD: So I think we gave you guys a lot of solid tangibles of how to update those note templates, how to get those notes done, how to make them easier for you guys, how to attach them to procedure codes if that benefits you guys. And then also like Britt was saying, to lock them out. So really trying to dive into that clinical team, giving you guys some ways to refresh and before end of year, since this is when this will be releasing for you guys, I always love to run that report, especially in open dental or other ones, but run that report back to the beginning of the year. I know this year is about to close out. So let's find any missed notes for this year so we can have a clean year with all notes completed before we move into the next year. So those are kind of my last thoughts, Britt. Anything you want to add on note templates?

0:18:03.0 BS: No, I think those are good ones. I think just make it what's going to work for you. That's going to be easiest and all owned on this one. Sometimes hygienists and doctors, we like a little too much detail. So make sure your assistants review it, make sure it's something that's going to be easy and have everything you know that we need.

0:18:18.7 KD: Amen. That's why I love Britt. We're two different sides of the coin guys. Britt's the detail. I'm the efficient and we need both. So make sure it works on both sides. Both are great perspectives. But truly guys, try that out. If we can ever help you note templates, I'm sure definitely the reason you would call us. But guys, we do more than just note templates. So if we can help you in your practice in person or virtually, this the season. We only have so much space for traveling offices. We don't have an unlimited number of consultants. So if you wanted us to come out to your practice, be sure to email us. Hello at thedentalateam.com. And as always guys, thanks for listening and we'll catch you next time on the Dental A Team podcast.

0:19:01.5 KD: And that wraps it up for another episode of the Dental A Team podcast. Thank you so much for listening and we'll talk to you next time.



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