The Aberdare Dentist Scenario

The Aberdare Dentist Scenario

2013-14

(Please note the year version before proceeding)

The Aberdare Dentist

Mr.Jones has an established Dental practice with about 25,000 patients, in a small town in South Wales. On an average day the practice sees 75 to 80 patients. The practice has 3 Dentists, including Mr.Jones, and healso employs an office manager, receptionist and four nurses. He is about to take a new Dentist into the practice, and needs to set the business matters of the practice into good order to enable it to cope with the expected increase in patient numbers resulting from the new arrival. He has expressed concern aboutAppointment Administrationin the practice.

The following information has been obtained about the system.

Patient registration.

A new patient provides basic registration information which is used to create their P3 Patient folder. The patient number is taken from the patient number book; the patient family name and first name are entered into the book. If any data items are missing the patients details are placed in a tray to wait further processing, the patient is contacted by phone for normal missing data items. If the NHS number is missing the FPC arecontacted by letter.An appointment cannot be made until the patient is registered, a patient can be registered without the NHS number.

The P3 Patient Folders are held alphabetically in the main filling cabinets. The registered patient details are used to make the first appointment

In the computerized appointment schedule. The appointment is recorded on their P3 card. The patient is sent an appointment letter and the patient is expected to attend in the future.

New Patient Appointment

After a full registration a new appointment is made. A new appointment requires two 10 minutes slots to allow for the recording of current teeth condition.

Appointment Re-arrangement

Patients can contact the clinic by phone and re-arrange for a different appointment times if required. The Patient may require a new appointment after a DNA (did not attend at the appointed time) has occurred.

The receptionist must look up the patient’s appointment, check that there was an appointment, and generate from the appointment system possible available dates. The old appointment is cancelled and a new one created. The patient’s P3 card is amended to reflect the changes. DNA appointments are in the past, while cancelled appointments are in the future.

Patient DNA

When a patient arrives for an appointment, the patient appointment schedule system is used to indicate that the appointment was kept. At the end of the day DNA letters are sent to all patients who did not attend on time. The letters DNA are entered onto the P3 card alongside the patient’s appointment. New appointments are made for the patients in the future and posted to them

Clinic Preparation

The day before a clinic, an alphabetic clinic list and a time order list areproduced automatically by the patient appointment schedule system. The alphabetic list is used to pick the patient P3 folders required for the clinic, which are stacked ready for the next day sorted in clinic time order, and place in the clinic tray.

As the record picker selects the P3 folders from the filling cabinets based upon the picking list, they tick alongside the name on the picking list to indicate the file has been found or indicate a lost record or where it made be found. When all the P3 folders have be located the stack of picked folders are sorted into clinic time order, using the time order list. The picked P3 folders are placed in the dentist’s clinic room, in their clinic tray.

POST Visit

After each patient visit, the dentistenterson the patient folder (P3) what treatment was performedalongside the appointment date. The dentist will indicate future treatment and appointment required on the P3 folder. The Patient takes the folder to the receptionist, who books further appointments as required, searching the appointment system and selecting a date and time for the patient. This follow up appointment date and time is entered onto the P3 file.

Dentimed request for payments.

If the patient is a Dentimed patient the DM83 form must be completed at the time of the treatment by the dentist. The yellow copy is separated and is given to the patient. The white and pink copies are placed in the P3 folder and returned to the receptionist for later processing. Later the receptionist or administrator completes the DM83 form with the pricing of the treatments posting the Pink copy to Dentimed leaving the white copy in the patients P3 folder. The price of the treatmentis found in the Dentimed treatment price codebook. When the payment is made by Dentimed it is recorded on the debit side of the patient’s ledger card

Follow up Patient Appointment

Follow up appointments are made after the treatment on the day and the number of time slots required for a follow up may vary.

Re-scheduling of appointments by the clinic.

Whenever Mr Jones is called away, due to a medical emergency or holiday, the receptionist must re-schedule appointments for several patients. To complete the task, the person must obtain the list of patients attending for each cancelled clinic list.

Before the patients can be contacted, their phone numbers and P3 folders must be located by searching the records, which is a laborious task. The receptionist must look at the appointment schedule to find alternate date and times and offer these to the patient. If rescheduling is taking place on the same (Emergency rescheduling) the receptionist waits for the patient to arrive. If the cancelled list is in the next 3 days the receptionist will phone the patients and reschedule the appointment. If the appointment to be rescheduled is more than three days away a letter will be sent.

The receptionist must find the earliest date available after the cancelled clinic. It is possible for the patients contacted by phone, that each appointment is then negotiated andrescheduled, the old appointment is cancelled in the schedule and on the p3 folder, the new appointment is allocated to the patient and the date and time is entered on the patient’s p3 folder. Attempts to contact the patient by phone are made until the day of the rescheduled appointed (3 days, see paragraph before).

Obtaining the NHS number

All patients have a National Health Service (NHS) number and this is obtained by sending a letter to the local Family practitioners committee(FPC) who has access to the NHS No index on the dentist’s behalf. The letter to the FPC contains the patient’s name, date of birth (DOB), and current home address. The FPCcontacts the practice by phone and provides the Patient’s NHS number.

Incomplete Data Flow Table.

Data Flow / Source / Recipient
Arrival Details / Patient / Clinic
Missing Data request / Clinic / Patient
Appointment Letter / Clinic / Patient
Re-schedule Appointment details / Clinic
Patient / Patient
Clinic
NHS Number request / Clinic
Family practitioners committee / Family practitioners committee
Clinic
Patient NHS Number / Family practitioners committee / Clinic
Reschedule Appointment Letter / Clinic / Patient
Appointment re-arrangement details / Patient
Clinic / Clinic
Patient
Registration Details / Patient / Clinic
Re-arranged Appointment Letter / Clinic / Patient
DNA Letter / Clinic / Patient
Reschedule appointment contact / Clinic
Patient / Patient
Clinic
DNA appointment request / Patient / Clinic

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Solution for Aberdare Dentist Data Flow Diagram – Incomplete Context Level

1-12 See Assumption notes

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Solution for Aberdare Dentist Data Flow - Assumptions

1. A Patient refers them self to the clinic providing the registration details.

1. On arrival the patient provides their name and time of appointment.

1. Patients are sent a “Did Not Attend” (DNA) letter if they do not attend. It is the Patients responsibility to re-book appointments.

1. Appointment detail contains the detail for one appointment. This could be the first or follow up.

1. A Re-schedule Appointment Letter contains the detail for the new and old appointments.

1. Missed or cancelled appointments are not charged for.

1. Appointment re-arrangement and re-schedule appointment arrangements are made by phone and are a two way conversation.

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