Go Team! Utilizing a Team Approach for Patient Safety

By Linda Harvey, RDH, MS

Just as it takes a team to win a football game, it takes a concerted approach to provide consistent quality care in the dental office.

Risk management and patient safety can be thought of as a football team: every team consists of offensive and defensive players; each player possessing a unique set of skills practiced and honed throughout the season. A recent seminar attendee described his office manager as his team’s quarterback, “Nothing happens around here without her—she keeps the schedules, calls the plays, and helps us have a winning day.”

Here are five strategies you can use to improve your quality and safety initiatives (and score big points with your patients):

Recruit the Right Players

Hire Smart. Anyone can look good on paper or on a resume, but this is not necessarily indicative of their skills or ability to work well with others. Besides validating references, take it a step further by verifying licensure credentials by checking with the state licensing board. There have been documented cases of identity theft involving imposters who posed as dental professionals.

Conditioning/Learning from Others

Once you have the right players in place, continue to learn new plays and strategies. Take into account patient safety and risk management expertise outside the field of dentistry. This body of knowledge can help you condition your team and identify areas for improvement. For example, results of a study conducted in 2000 by the American Academy of Family Practitioners showed 44% of errors in physician offices were attributed to communication and discontinuity of care. These types of errors can easily occur in a dental office. Why not consider implementing a blame-free environment that encourages staff to report errors and near misses.


Train your team well. Training shortcuts will quickly become evident once your team shows up on the field. Often training is done in a ‘trial by fire’ method—new staff members are shown the ropes while seeing patients. Of course, the new staff member can’t absorb everything thoroughly much less understand the mission, vision and philosophy of the practice through this haphazard method.

Hygienists, assistants and business staff make up more than 3⁄4 of the dental industry, and these staff members are doing most of the interacting with patients. With a thorough training and orientation program your staff will become good spokespeople on your behalf, ready to provide quality care in a safe manner once the game begins.

Game On!

The excitement is in the air! Our game is on when the patient is sitting in the chair. Just like a football team, we have an offense and a defense; however we have to play both roles (no wonder our feet hurt so much!). While patient safety and risk management are on the same team; patient safety can be likened to an offensive strategy, whereas risk management is more defensive in nature. Here is a brief snapshot of how the roles play out:

Offense (Patient Safety): The foundation of all dental care is patient safety, so naturally this is your offense. While dental procedures don’t typically involve life and death surgery, we are performing procedures and/or administering medications that affect a patient’s total body health and safety. As compared to risk management, the dental patient safety movement is still in its infancy. Currently, most patient safety information is from the hospital environment, although the body of knowledge about patient safety in other settings like dental offices is growing steadily.

Defense (Risk Management): Risk management has always been a concern for dental practices and with our litigious society the hazards increase every year. Even if a practitioner is never involved in a lawsuit, the number of complaints filed with the dental boards is on the rise. An investigation by the dental board that results in probable cause and subsequent sanctions can easily cost $10,000 or more. Tangible losses include lost production and legal expenses as well as fines and penalties paid to the board. On-going, up-to-date risk prevention practices are the best approach.


While most of us don’t have a JumbotronTM in the office to track every play, we can set benchmarks for recordkeeping success. Remember, the quality of your work is judged by your written word (patient chart), which is all dental boards have to rely on in disciplinary cases. Here are three quick tips to make sure your stats are reliable:

  • Stay alert to recordkeeping techniques whether electronic or paper. Remember if you are frequently making corrections, it may be a sign that you aren’t mentally engaged with the process at hand. Follow a logical sequence (e.g. SOAP) when documenting to keep you mentally on task and minimize opportunities for forgetting key information.
  • Focus on your choice of words and intent before putting it to paper or computer. Poorly phrased entries will be interpreted quite differently by an attorney or peer review panel.
    Read and re-read what you wrote. This doesn’t sound like a short-cut but it saves time from making corrections and finding problematic errors down the road that could make you appear negligent.

    Don’t wait to document. Do it during or at the end of each patient appointment as needed. In disciplinary cases dentists are commonly charged with simple documentation errors, such as failing to document an adequate medical history. Contemporaneous documentation ensures that critical patient care information is not omitted.

Follow these tips to ensure your team always has a winning season.