I’ve spent my career preparing practices to become inspection ready through the Agilio consultancy services and the problems I routinely encounter are almost always easier to avoid in the first place than to fix after you have lost control. Let me provide you with some insight on the top 5 blunders I routinely notice in practices and how you can avoid them:
Inaccurate logs / Lack of management checks
About 50% of practices I inspect have out-of-date drugs in their emergency drugs kit despite the logs having been ticked. Even more have out-of-date or open instrument sterilization pouches. However, the real issue here is managers delegating without ever checking. You shouldn’t blindly trust your team members to keep logs up to date. Check and double-check. It could be the fine line between a good and bad inspection. It may feel like you are micromanaging, but management double-checks are essential to ensure the practice runs safely and can also aid in identifying the training needs of your team.
In iComply we have responded to this by adding management double-checks to our logs. These help practice managers stay on top and not get caught out by the CQC/HIW and other regulators. We are also developing digital logs that will prompt you to carry out a check or alert you when something is wrong.
Immunity
Time and time again, practices are certain they have proof of Hepatitis B immunity, when what they have doesn’t meet the requirements. Let me run you through some examples:
- Proof of immunity that is not clear to all. I have come across proof in Greek, Italian, Spanish and Romanian, etc. While you may be fluent in that language, the inspector may not be
- A proof of injection is not proof of immunity. Having the evidence of their vaccinations is brilliant, but it does not prove they are immune. They could be non-responders who would need an additional risk assessment in place
- You have proof of immunity on file, but with recommendations that have not been followed through. I come across this in nearly half of the delivered consultancies
While this is not an exhaustive list of all scenarios, nearly all can be resolved with a referral to occupational health. Occupational Health will be able to give you indications of what actions are needed to clear that team member. Another helpful tip if you are ever stuck for information is iComply’s guidance documents on immunisations, reminders in the calendar to review and not to mention the detailed risk assessment template that can be used for Hep B Non-Responders.
Practice meetings
Although dentistry is nearly back to normal post-pandemic, more than half of the practices I’ve inspected have not been able to catch up on practice meetings. With the ever-changing guidelines and regulations, forgoing these meetings may seem like the easy option, but almost certainly would have a negative impact on your team. Practice meetings are not only a great way to pass along information, but they also help to build inter-team relationships.
I know what you are thinking: “Well, we have practice meetings, so we are absolutely fine” or “Even though it’s not written in meeting minutes, we definitely had a chat about this”. What some practices may not realize, is that their meeting minutes are not detailed enough or omit key elements that an inspector looks for when assessing if your practice is not well-led.
A proverb that I like to use is, “The faintest ink is more powerful than the strongest memory”, meaning that if there is no written evidence, it’s basically as if it did not happen. To keep on top of your practice meetings, I suggest incorporating the following:
- Actions arising from any:
- Safety alerts
- Surveys
- Audits
- Risk Assessments
- Incidents/Accidents
- Patient comments or complaints
- Training and updating the team on practice policies
- Changes in team responsibilities
- Sharing of clinical skills and experience
- Any health and safety issues
- Any other business
When I worked as a practice manager, what I enjoyed most about using iComply was that it had pre-populated agendas for every month that were aligned with my compliance tasks. It kept my team and me up-to-date and reminded me of key areas to review.
Lack of training for key roles / essential tasks
Almost every practice I visit has issues with at least one risk assessment or audit. The problem is generally that these tasks are performed by team members who have been given responsibility for an area, audit or both, e.g. The infection control lead doing the 6 monthly infection control audit or the Health and Safety ‘Manager’ doing the annual risk assessment review, and they are not competent due to lack of training. It’s key to remember that if you are asking a team member to perform a new role then the business is responsible for training them to be competent.
Ask yourself this; can the person doing the audit give a lecture on the topic, to your team, without referring to a manual? If your infection control lead doesn’t know what the right/wrong answers to the audit then they shouldn’t be doing it and, like we saw in a practice last year, you may end up with brand new nailbrushes by all your sinks!
At Agilio we’re using our combined 60 years of experience in supporting the profession to build ‘intelligent tools’ into iComply that know the right or wrong answers to audits and tell you actions to take. You still need to have trained and competent leads, but this will help them out if they’re having a bad day!
Unaware of the content of your policies
When visiting practices and requesting information on the content of certain policies, I am sometimes met with a vacant gaze. This is because even though policies are adopted from templates, they are not carefully read and therefore do not reflect the day-to-day running of the practice. When policy templates are edited, but not read and understood, it can cause confusion amongst your team, frustration for your patients and accidental omission of important compliance tasks.
Nearly all practices I have inspected have a policy in place for how to handle their safety alerts, but only half of them were aware of the contents of the document and were following it.
The alerts are received and filed, forever to be forgotten, while the team are none the wiser. This is due to the information not being passed on even though the policy clearly states that it will be distributed to all relevant team members. Another example I have seen more than once is practices having a policy on Sepsis, but when asking team members what symptoms they should watch out for, they weren’t aware of the contents of the policy.
The solution to this problem is to make the time to focus on your policies. Your policies and procedures are the lifeblood of your practice and not just templates to be edited and put on a shelf ready for inspection. When adopting a template you are making it a part of your business operations so it’s critical that you read the suggested procedure and adapt either the template to your practice or your practice to the template.
Here at Agilio, we have a knowledgeable team to help should any questions arise on how to adapt policies to your practice or if you prefer to leave it in the hands of a professional, our iManage service can do it for you, all while training your team on your bespoke policies and procedures.
Conclusion
A day in the life of a practice manager can be hectic with a never-ending stack of work, making you wish that you could split yourself in two. To help keep your head above water, it’s important to keep yourself organised and informed while effectively communicating, training and delegating responsibilities to your team. Using Agilio’s iComply alleviates the daunting task of compliance by auto-populating your calendar and giving you monthly ‘bite-size’ portions of compliance while allowing you to assign tasks. You can even take it one step further with our remote compliance management service, iManage, to alleviate the pressure and free up your time.
Bio
Fran Sorodoc is Agilio’s Professional Services Manager. She oversees the consultancies and professional services, including the beloved new iManage service. She is an experienced practice and compliance manager and has gained a wealth of knowledge from her various healthcare backgrounds. Fran believes that with the right guidance, any practice manager can be a dental compliance expert.
To find out how iComply can support your practice, click here