Improving productivity in the dental practice: a starting point.

Materials, patients, and information flow through the business, but all must pass through the dentist's hands. Thus they are the constraint within the dental practice. Dentists therefore must pay close attention to streamlining and simplifying clinical processes, delegating administration wherever possible, and outsourcing technical services. It is recommended that techniques such as four-handed dentistry, tray-batching of instruments, computerisation of records, and efficient scheduling of appointments, be adopted to improve through-put. Measures used to assess decision-making and performance-evaluation include the use of a computerised cashbook, appointment-book analysis, comparison of actual versus budgeted income and expenditure, net profit, and return on investment. These measurements are, however, an adjunct to intuition and experience. There must be an awareness that, if patient perceptions fall short of their expectations because of the improvement in clinical efficiencies, such optimisation would be to the detriment of the practice. To achieve on-going improvement, the dentist must create a learning environment where motivated team members are willing to engage in systematic problem solving, experimentation, and the learning and transfer of knowledge.