Creating the Perfect Hand-off; Making or Breaking Treatment Acceptance;Ronald F. Arndt, DDS, MBA, MAGD, MCC Mary Beth Bajornas, VA, CMT

What is the hand-off protocol in your office? Typically in many dental offices the clinical team member walks the patient to the front desk with the patient’s chart under their arm. When they reach the desk they “plop” the chart down, tells the Appointment Coordinator that the patient is done, looks at the patient and says, “Thanks Nancy, have a great day, Mary Beth will take care of you”,and then runs off to break down the room to get ready for the next patient. In the mean time, Mary Beth sits at the front desk wondering what was done, what needs to be done next, and what can I now do to not look stupid here!

In your office, is the exchange of power haphazard, fumbling, with the patient left standing at an empty front desk not knowing what to do next? Or is it seamless, smooth, leaving the patient completely educated and ready for their next appointment? Do you realize that having a well executed hand-off can actually help improve the scheduling rate of patients? This is one area where if your office chooses to shine exceptionally you will be branding yourself as exceptional and very people oriented!

The hand-off is what happens when a patient is excused from a treatment or hygiene room to the front desk. All employees need to be “in” on the hand-off. The hand-off is initiated by the assistant (from treatment side) or the hygienist and completed by the front office personnel. We have actually seen some offices hand-off’s consist of the back office employee handing a routing slip to the front office and walking away. Incredible yet true!

There are 6 main components that a successful hand-off must have:

1) Assistant/Hygienist must thank the patient by name, compliment on a job well done: “It was so nice seeing you today Mr. Smith. I’m pleased to see that you have done a wonderful job on flossing since the last time I saw you and your hygiene has been fabulous! Keep up the great work!”

2) Assistant/Hygienist must reinforce what Dr’s recommendation’s are for the patients next treatment visit (if any): “Mr. Smith, as you know Dr. Arndt has recommended a crown on tooth #4, that’s the tooth on the upper right just behind your eye tooth. Mary Beth, our talented Appointment Coordinator, will be glad to get you scheduled soon before that tooth becomes a problem.” Reiteration also needs to be given to the front desk in front of patient “Mary Beth, Dr. Arndt has recommended a crown for tooth #4 for Mr. Smith. Dr. Arndt requests a reservation of 90 minutes for him to get started, preferably within the next few weeks”.

3) Assistants/Hygienists need to verify that patient understands recommended treatment and ask if any clarification needs to be made: “Mrs. Smith, what is your understanding of what Dr. Arndt has just recommended to you?” Another way to ask the same question: “What questions, if any, do you have for me in regards to scheduling your next appointment?” If the patient has any questions in regards to treatment, these must be acknowledged immediately before handing off to front desk. Remember, objections are buying signals and indicate the patient is interested. Patients who don’t understand treatment are less likely to schedule; and one additional important thought, the Financial/Appointment Coordinator should never go over finances with a patient who doesn’t completely understand their recommended treatment as you will be setting yourself up for failure.

4) Hygienists must reiterate the need for the future hygiene appointment and what it will consist of “Mr. Smith, I am going to schedule you again in 6 months for your next dental recare visit with me. You will be due for x-rays at that time and we will want to pay close attention to those two areas of irritation that we addressed today as we don’t want them to become a problem in the future”.

5) Patients need to be thanked again and dismissed. “Thanks so much again Mr. Smith for choosing us as your dental home! We look forward to seeing you at your next appointment! Mary Beth, our amazing Appointment Coordinator, will take care of you from here! Mary Beth, Mr. Smith had a cleaning, oral exam and cancer exam today. In addition to needing a hygiene appointment scheduled with me in 6 months Dr. Arndt wants him scheduled to do a crown preparation on tooth #4 within the next two weeks”.

6) The front desk person should always ask in some fashion “Mr. Smith, how did things go with Nancy and you today?” This is a crucial question and can create a massive opportunity to address any immediate issues or scheduling concerns.

By having a hand-off protocol in place it leaves little room for misunderstandings. We have witnessed patients who have been left at the front desk waiting for someone to acknowledge them. We have also witnessed instances when the Appointment Coordinator tries to schedule for that crown and in an almost shocked voice, the patient says “Crown?!! What crown? I’m not certain what you are talking about”. Come on tell me that you haven’t witnessed such things! There should be synchronization between the administrative and clinical team. When actually applied, these systems will demonstrate unity, teamwork, and a dedication to the patient’s education and understanding. The patient must be well educated in advance and ready to schedule upon arrival at the front desk. This system reinforces the doctor’s recommendations, reinforces the patients understanding and education of treatment recommendation and creates the sense of urgency needed to complete scheduling. It will also result in happier patients and higher levels of practice income for all team members. Implementing such an easy system and being consistent can increase your treatment case acceptance and scheduling.

Take time at your next team meeting an honestly ask these questions:

* On a scale of 1 to 10 with 10 being fantastic, how would you and your team rate your patient handoffs?

* What specific steps can you implement immediately for proven results?

* When will you schedule a staff meeting today to practice creating the perfect hand-off?

Why not be proactive and add income to your bottom line? Take the initiative today! It’s all within your control.


Here’s to the perfect hand-off in your practice! You’ll notice rapid results upon implementation!


Dr. Ron Arndt, The Dental Coach   www.DrArndt.com

Mary Beth Bajornas,  Dental Support Specialties   www.DentalSupportSpecialties.com

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